Ayşe Esra Koku Aksu’s research while affiliated with Istanbul Training and Research Hospital and other places

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Publications (81)


Dermatofibroma: análise clinicopatológica de 239 casos
  • Article

January 2025

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10 Reads

Anais Brasileiros de Dermatologia (Versão em Português)

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Ayşe Esra Koku Aksu

Effects of Botulinum Toxin Type A Treatment on Clinical and Biophysical Parameters in Patients With Erythematotelangiectatic Rosacea: A Prospective, Randomized, Controlled, Double-Blind Study

December 2024

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12 Reads

Dermatologic Surgery

BACKGROUND Erythematotelangiectatic rosacea (ETR) lacks a gold-standard treatment. Recent studies show that intradermal Botulinum Toxin-A (BoNT-A) is effective for erythema, though objective data are limited. OBJECTIVE This study aims to evaluate the efficacy and tolerability of intradermal BoNT-A in patients with ETR. METHODS In this randomized, double-blind, split-face study, 30 patients were enrolled. One side of the face received 15 units of BoNT-A, reconstituted in 10 mL of saline, while the control side received saline injections. Assessments were made at baseline and 1-month posttreatment. Clinician's Erythema Assessment (CEA) scale and Patient Self-Assessment (PSA) scores were recorded. Erythema and Melanin Index measurements using a Mexameter. Background erythema was assessed through dermatoscopy, while vascular structure and density were evaluated using Investigative Global Assessment (IGA) scores through videocapillaroscopy. RESULTS The BoNT-A-treated side demonstrated significant reductions in CEA scores, Erythema Index, and dermatoscopic background erythema, while no significant changes were observed on the saline control side. IGA scores indicated a significant response to treatment on the BoNT-A side. Patient Self-Assessment scores improved on both sides. No serious adverse events requiring hospitalization were reported. CONCLUSION Intradermal BoNT-A effectively reduces erythema and vascular density in patients with ETR and is well-tolerated.


Olgu Sunumu: Werner Sendromu

December 2024

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13 Reads

STED / Sürekli Tıp Eğitimi Dergisi

Werner sendromu (WS), hızlandırılmış yaşlanmayı düşündüren klinik özellikler sergileyen nadir bir genetik hastalıktır. İlk olarak 1904'te Alman tıp öğrencisi Otto Werner tarafından tanımlanmıştır. Nadir ve otozomal resesif bir erken yaşlanma bozukluğu olan WS, boy kısalması, alopesi, iki taraflı katarakt, cilt ülserleri, diyabet, osteoporoz, arterioskleroz ve kromozomal instabilite gibi yaşlanmayla ilişkili hastalıkların erken başlangıcıyla karakterizedir. Bu makalede, erken yaşlanma, büyüme gelişme geriliği belirtileri taşıyan ve Werner Sendromu tanısı konulan 45 yaşındaki kadın olgu ele alınmıştır.






Clinical Characteristics of Local Recurrent Basal Cell Carcinoma After Surgical Excision: A Retrospective Study of the Patients From a Tertiary Clinical Center
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  • Full-text available

August 2024

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17 Reads

Cureus

Background: Basal cell carcinoma (BCC) is the most frequent form of skin cancer. The etiology of recurrent BCC is multifactorial, and the recurrence rate is variable. Objective: The aim of the study was to identify the risk factors of local recurrence after surgical excision in primary BCC. Materials and methods: In our study, 934 patients histopathological diagnosed with BCCs between January 2017 and June 2022 were evaluated retrospectively. Among these, patients who were regularly followed up for at least three years were included in the study. Patients who underwent non-excision treatment were excluded. All the patients who had pathologically confirmed, surgically excised BCCs with safety margins and those with a clinicopathological diagnosis of recurrent BCCs. Demographic and clinical features of 78 patients with non-recurrent primary BCC and 55 patients with local recurrent BCC were compared. Results: The mean age was 69.7±11.7 years. The gender distribution was M/F:1.3. The time from diagnosis to total surgical excision was 2.3±1.4 months, and the time of recurrence was 27.5±23.3 months. The age of the patients, the time from diagnosis to total excision, the lesion size > 2 cm, and the presence of risk factors (such as radiotherapy, malignancy, and immunosuppression) were higher in the recurrent group than in the non-recurrent group (p < 0.05). Location (high/medium/low-risk area) and the presence of multiple lesions did not differ significantly between the recurrent and non-recurrent groups. Conclusion: In patients with BCC, recurrence is often detected in the first three years after diagnosis. Our study determined age, lesion size, accompanying risk factors, and the length of time until total excision as risk factors for recurrence in BCC patients. The histological subtype and lesion localization did not differ between the group with and without recurrence.

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Figure 1 (A) Pediatric melanocytic nevus with a diameter of 3.5 mm homogenous-globular pattern in the center and peripheral globules arranged regularly in a single row. (B) There is an increase in nevus diameter to 4.3 mm in 12 months with similar number of peripheral globules. (C) Increase in nevus diameter continues, with a decrease in peripheral globules. (D) Noticeable enhancement in the central homogenous structure and a significant decrease in peripheral globules, nevus starts to stabilize with a diameter of 4.6 mm at 36 th months.
Figure 2 (A) Pediatric nevus with a diameter of 2.3 mm with darker globular-homogenous pattern and the globules are prominent at the periphery. (B) In the follow up of the same nevus, diameter increases to 3.5 mm in 12 months, homogenization in the central region and a lightening of color to light brown are observed. (C) In a different nevus, a globular structure is vaguely discernible around and the nevus has taken an almost homogenous structure with stabilization. (D) Nevus with a raised dermal component in the center and a continuation of the globular structure at the periphery.
Nevi size according to presence of peripheral globules.
Dermoscopic monitoring of pediatric melanocytic nevi regarding pattern and diameter changes

July 2024

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29 Reads

Anais Brasileiros de Dermatologia

Background Childhood and adolescence are dynamic period in terms of nevogenesis, and the development and growth of new melanocytic nevus are frequently observed. In this study, the aim was to examine the pattern and diameter changes seen in the follow-up of pediatric melanocytic nevus. Objectives To describe the pattern and diameter changes seen in the follow-up of pediatric melanocytic. Methods Our study involved the assessment of 301 pediatric melanocytic nevi in 50 patients attended at the Dermatology Clinic of Istanbul Training and Research Hospital between January 2008 and 2022. The pediatric melanocytic nevi were diagnosed clinically and dermoscopically. Subsequently, we conducted video-dermoscopic monitoring of these nevi over a span of 3 months to 3 years. Results 46% of our patients were female (n = 23), with a mean age of 11.5 years. While the pattern of nevi was globular in 40% patients, the rate of globular pattern decreased to 30% in the follow-up. The basal homogeneous nevus pattern was seen in 10% patients, but was detected in 13.9% in the follow-up. Peripheral globules were observed in 19.3% of the cases, but in the follow-up, 61.1% of the globules regressed completely. Nevus excision was indicated in only 11 of 301 nevi. Study limitations Single-center study and a small of studies available on this subject. Conclusions Pediatric melanocytic nevi can show dynamic changes compared to nevi in adults. In this study, growth rates, dermoscopic features, and pattern changes seen in the follow-up of melanocytic nevi were evaluated. The globular pattern was observed most frequently. The presence of peripheral globules is frequently observed in pediatric melanocytic nevi with regression during the follow-up period.


Comparison of quality of life scale score levels according to clinical type.
Comparison of quality of life scale score levels according to oral mucosa.
Evaluation of the Quality of Life and the Demographic and Clinical Characteristics of Patients With Pemphigus With Oral Mucosal İnvolvement: A Multicenter Observational Study

April 2024

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69 Reads

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1 Citation

Dermatology Practical & Conceptual

Introduction: Pemphigus vulgaris (PV) is an autoimmune disease primarily affecting the oral mucosa. Objectives: This study aimed to determine the demographic, clinical and treatment characteristics of PV patients with oral mucosal involvement and to assess the impact on their quality of life. Methods: We conducted a prospective observational study among 106 patients diagnosed with PV and presenting oral mucosal involvement. Demographic data, clinical and treatment characteristics, and quality of life questionnaires were recorded. Results: The study included 106 patients, 55 (51.89%) were male and there was a predominance of the mucocutaneous subtype in 83 individuals (78.38%). Oral mucosa was the initial site of manifestation in 44 patients (41.51%). Bilateral buccal mucosa was the most frequently affected site. The predominant symptom reported was a burning sensation, noted in 91 patients (85.85%). Oral mucosal examination revealed erosions in 85.85% of the patients. Systemic steroids were the most commonly administered treatment, and rituximab was used in 18 patients (16.98%). A positive and significant correlation was found between pemphigus severity and Oral Health Impact Profile-14, Dermatology Life Quality Index and Dermatological Quality of Life Scale scores (P < 0.05). The presence of superficial ulcers, flaccid bullae, lesion diameter ≥1 cm, and >10 lesions were factors that markedly diminished quality of life. Complete response to treatment was noted in all patients administered rituximab. Conclusions: The most common area of involvement was bilateral buccal mucosa, and the severity of PV closely correlated with a decline in quality of life measures. These results highlight the need for careful clinical oversight of PV, taking into account its effects on patients quality of life.


Citations (45)


... It also possesses anti-inflammatory and immunomodulatory properties that can be used for various skin diseases, not only acne 29 . Moreover, oral isotretinoin could be an effective treatment option for reducing the size of scars and their severity and at the same time improving the elasticity of the skin 30 . Although it is highly effective, isotretinoin has some adverse effects. ...

Reference:

Acne vulgaris in adolescents – the review
The Effects of Oral Isotretinoin on Atrophic Acne Scars Measured by Shear-wave Elastography: An Observational, Single-center Study
  • Citing Article
  • September 2023

Journal of Clinical and Aesthetic Dermatology

... Overexpression of IL-31 caused severe pruritus in mice, leading to the identification of the pruritogenic function of IL-31 which eventually led to the term "pruritogenic cytokine". While role of IL-31 in pruritus is supported by several studies, including some recent ones [27][28][29][30][31], there is evidence in literature that unravels its role in several dermatologic and non-dermatologic diseases with consequences far beyond the induction of itch [2]. ...

Divergent in situ expression of IL-31 and IL-31RA between bullous pemphigoid and pemphigus vulgaris
  • Citing Article
  • June 2023

... The above finding underscores the pathological similarities between PASC and SLE. While the autoimmune aspects of PASC have been previously suggested (24)(25)(26), this study uniquely highlights both the similarities and differences between PASC and SLE, i.e. the presence of anti-dsDNA and anti-Sm antibodies and the coordinated upregulation of all types of IFN, respectively. ...

Antinuclear Antibody Positivity in Patients With Hair Loss After COVID-19 Infection

Dermatology Practical & Conceptual

... 16,18 Malignancy-associated and childhood GA also presented on the extremities in most patients. 18,19 In most of the studies that assessed the histopathologic findings of GA, interstitial pattern was the more common type of GA and 33%-71% of cases demonstrated this pattern. 11,16,17,19,20 However, Cheng et al. ...

Clinical and Histopathological Evaluation of Forty-one Cases of Pediatric Granuloma Annulare

Dermatology Practical & Conceptual

... A toxina botulínica tipo A é amplamente utilizada tanto em aplicações estéticas quanto terapêuticas, destacando-se como uma importante ferramenta na dermatologia moderna. Desde sua introdução no tratamento de estrabismo, seu uso foi expandido para procedimentos estéticos, como a redução de rugas faciais, e para tratamentos de condições médicas, como hiperidrose e cicatrizes hipertróficas (Erdil et al., 2022;Campanati et al., 2023). A pesquisa científica tem demonstrado que, além dos efeitos de paralisia muscular, a toxina apresenta propriedades anti-inflamatórias que podem beneficiar a saúde da pele (Vincent, 2024;Carrero et al., 2018). ...

The clinical effect of botulinum toxin on pigmentation
  • Citing Article
  • December 2022

International Journal of Dermatology

... Entomodermoscopy made the colorful visualization, imaging, and whole extraction of maggots through the depth of the stratum corneum more feasible than the traditional methods [28] . The dermoscopy is of two types: 1) polarized dermoscopy which is a handheld device that does not need direct skin contact; 2) non-polarized dermoscopy which functions by direct skin contact. ...

Evaluation of serum vascular endothelial growth factor level and findings of nailfold capillaroscopy by dermatoscope in the differential diagnosis of palmoplantar psoriasis and palmoplantar eczema
  • Citing Article
  • October 2022

Microvascular Research

... This finding reflects raised awareness among studied females, as most were highly educated. This result contradicts the findings of Manav et al. [16], as most cosmetic procedures were performed by aestheticists (13.9%) in hairdressers as well as skincare centers (5.9%)due to socioeconomic factors. Nonetheless, when complications arise, patients seek treatment from dermatologists. ...

Perceptions and knowledge toward cosmetic procedures: A cross-sectional survey

... Joint involvement in BD, resulting in recurrent migratory arthritis, synovitis, and joint degeneration, predominantly affecting the knee [41] and commonly characterized by asymmetric polyarticular arthralgias of the knees, hips, and elbows [42]. Also,an increase in neck pain complaints among BD patients was noted [43]. Yafei Cui et al. reported a case of a patient with BD whose main complaint was recurring neck pain resulting from atlanto-axial dislocation [44].In the present study, neck and knee pain were among the most reported regions of discomfort among BD patients. ...

Association between Intervertebral Disc Degeneration and Behçet's Disease

... The HADS-Anxiety scores were found to be significantly higher in patients with sensitive skin and a strong positive correlation was found between the HADS-Anxiety scores and the erythema index in these patients. 20 As for the classification of SS, the special interest group on SS of the International Forum for the Study of Itch (IFSI), referred to three types based on their physiological parameters: type I (low barrier function group), type II (inflammation group with normal barrier function and inflammatory changes) and type III (pseudo-healthy group in terms of normal barrier function and no inflammatory changes). 1 Going deeper into the diagnosis of SS, it is possible to use the reactions to TRPs agonists as an indicator of SS. ...

Association between biophysical properties and anxiety in patients with sensitive skin

... But sometimes, there is not any obvious cause at all. 1,3,[9][10][11][12][13][14][15][16][17][18][19][20][21] Because there are so many potential triggers of a flare, oncoming flares are very difficult to avoid, which is serious, because systemic inflammation is common, 1 and flares can be lifethreatening if left untreated. 5 Patients can also experience skin failure during a flare, which is a state of total dysfunction of the skin, or acute skin failure, resulting in a high risk for highoutput cardiac failure, renal failure, and sepsis. ...

Sociodemographic, Clinical, Laboratory, Treatment, and Prognostic Characteristics of 156 Generalized Pustular Psoriasis Patients in Turkey: A multicenter case series