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Öğe Basal cell carcinoma presenting as an excoriated cicatricial plaque: A case report(Elsevıer Taıwan, 2018) Acar, Emine Müge; Kilitci, Asuman; Kaya, Zeliha; Abbas, Ozan Luay; Kemeriz, FundaBasal cell carcinoma (BCC) is the most common skin cancer with several clinical and histopathological subtypes. Trauma and scar tissue have been implicated as possible etiological causes of BCC. Here, we report a case of a 37-year-old man with BCC arising on a longstanding cicatricial plaque with nearly 30 years' duration. Intractable pruritus, which had started two months ago and gradually intensified, was the patient's main complaint upon admission. The lesion presented as a linear, erythematous, excoriated cicatricial plaque in the left supraclavicular region. Pearly borders and the mildly atrophic center of the plaque, that were recognized upon close examination, were notable features and may indicate BCC. We believe that a detailed patient history and meticulous clinical examination are essential for diagnosing BCC arising in longstanding scars. Copyright (C) 2018, Taiwanese Dermatological Association. Published by Elsevier Taiwan LLC.Öğe C-reactive protein to albumin ratio: Is a new parameter for the disease severity in patients with psoriasis vulgaris?(Wolters Kluwer Medknow Publications, 2020) Kemeriz, Funda; Tu?rul, Burcu; Tuncer, Sibel ÇiğdemBackground: C-reactive protein to albumin ratio (CAR) is an inflammatory marker that is considered to have prognostic value in many inflammatory diseases. Objectives: In this study, we aimed to investigate whether there is a correlation between CAR value and disease severity in patients with psoriasis. Methods: The study included 70 plaque-type psoriasis patients and 67 healthy controls. CAR value was calculated after C-reactive protein (CRP) and albumin analysis was performed, Psoriasis Area and Severity Index (PASI) scores were documented. CAR value was compared with PASI scores in patient group. White blood cell count, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, erythrocyte sedimentation rate (ESR), and mean platelet volume and CAR values were compared among these groups. We investigated the most significant parameter for disease severity. In addition, to detect relationship between CAR, disease duration and patients' age and healthy controls, correlation analysis was performed. Results: The median CAR value was found statistically significant higher in the patient group than in the control group (P < 0.001). A significant difference of median CRP, albumin, CAR (all P values are <0.001) and ESR (P = 0.024) were found among the three groups which were arranged according to the severity of the disease. Among these parameters, CAR was found as the most associated parameter with the severity of psoriasis using receiving operator characteristic analysis. Conclusion: CAR value could be a useful parameter for evaluating disease severity, management of disease activity, and follow-up strategies.Öğe Circumscribed juvenile pityriasis rubra pilaris (Type 4) koebnerising after a hot water burn: Mild disease with maximum koebner response(Croatian Dermatovenerological Society, 2019) Acar, Emine Müge; Has, Sümeyra; Kilitci, Asuman; Kemeriz, Funda[No abstract available]Öğe Effect of isotretinoin on myopia and axial length: a pilot study(Taylor and Francis Ltd., 2020) Yaşar, Erdoğan; Gürlevik, Uğur; Kemeriz, Funda; Atalay, ErayPurpose: To investigate the effect of oral isotretinoin use on refractive error, axial length, and anteroposterior segment parameters. Materials and methods: In this prospective study, 50 eyes of 50 patients using isotretinoin with a diagnosis of acne vulgaris and 50 eyes of 50 healthy control subjects were included. After detailed biomicroscopy, measurements were taken of axial length, lens thickness, central corneal thickness, anterior chamber depth, central retinal thickness, and subfoveal choroidal thickness. The pupils of both eyes were dilated with one drop of cycloplegic drops after refraction measurement. Visual acuity examination was performed with a Snellen chart the next day. The same procedure was repeated at the end of the third and sixth month of drug treatment. Results: Forty-seven patients with acne vulgaris and 45 healthy controls met the inclusion criteria and were included in the analysis. The mean ages of the patients and the controls were 21.7 ± 2.5 years (range, 18–28 years) and 22.6 ± 2.7 years (range, 19–27 years), respectively. No significant changes were observed in any parameters in the third and sixth month in the control group (p > 0.05). The most important result was significant increases in myopia and axial length in the sixth month of isotretinoin use (p = 0.01, p = 0.04, respectively). There were no significant relationships between increases in myopia and axial length and patients’ age, sex, drug dose, and initial refraction (p > 0.05). The changes in spherical equivalent and axial length differed significantly between the drug group and the control group (p = 0.001, p = 0.001, respectively). Conclusions: Isotretinoin is one of the important molecules in the aetiology of myopia. Oral isotretinoin treatment may increase myopia and axial length, although not to a clinically significant degree. However, as this was a pilot study, there is a need for further studies with more patients and longer follow-up periods.Öğe Evaluation of 25-hydroxy vitamin D levels and disease severity in patients with acne vulgaris(Blackwell Publishing Inc., 2020) Kemeriz, Funda; Tuncer, Sibel Çiğdem; Acar, Emine Müge; Tu?rul, BurcuAcne vulgaris is a multifactorial skin disorder. Many etiological factors are speculated to contribute to the pathogenesis of acne, one of these is vitamin D deficiency. Previous studies reported contradictory results about serum 25 hydroxy vitamin D (25-OH vitamin D) levels, its association with acne, some claimed that acne lesion might improve with vitamin D supplementation. We aimed to assess serum 25-OH vitamin D levels in acne patients, identify their relation with disease severity in a larger study group. The study included 134 acne patients, 129 controls. Acne disease severity was identified with Global Acne Grading Scale (GAGS) scores. Serum 25-OH vitamin D levels were measured in all groups. Serum 25-OH vitamin D levels were significantly lower in acne patients than in controls (P <.001). The prevalence of vitamin D deficiency was significantly higher in acne group than in control group (77.6% vs 63.9%; P =.041). There was a negative-strong statistically significant correlation detected between serum 25-OH vitamin D levels and GAGS scores in patient group (P <.001; r = ?.910). According to these results, we claim that evaluating serum 25-OH vitamin D levels in acne patients, vitamin D supplementation as a treatment option may be a consideration for further studies.Öğe Evaluation of neopterin level and disease severity in patients with psoriasis vulgaris treated with narrowband UVB(Wolters Kluwer Medknow Publications, 2019) Kemeriz, Funda; Gönül, Müzeyyen; Cengiz, Fatma Pelin; Emiro?lu, Nazan; Cemil, Bengü ÇevirgenBackground: Neopterin is a biochemical marker of cellular immunity. It has been reported that serum and urine neopterin levels increase in psoriasis and decrease with treatment. Nevertheless, assessment of a direct link between narrowband ultraviolet B (UVB) therapy and neopterin level in association with Psoriasis Area and Severity Index (PASI) scores has not been performed yet. We aimed to evaluate the serum neopterin level in patients with psoriasis treated with narrowband UVB therapy in association with disease severity. Materials and Methods: The study included 35 patients with chronic plaque-type psoriasis who had PASI scores of >10 or below 10 but resistant to topical therapies and 30 healthy individuals. The narrowband UVB therapy was administered to the patient group (n = 35). Serum neopterin analysis was performed with an enzyme-linked immunosorbent assay method before and after treatment. Results: There was statistically significant correlation between neopterin level and PASI score in the patient group (P = 0.011). The serum neopterin level was significantly increased in patients with higher PASI score. Moreover, the serum neopterin level was found to be statistically higher in severe psoriasis group (PASI score ?10, n = 14) than the mild-moderate group (PASI score <10, n = 21) (P = 0.001). Furthermore, a significant decrease was observed according to serum neopterin level after the narrowband UVB therapy in the remaining 20 patients who were able to comply with the scheduled therapy and follow-up procedure (P = 0.026). Conclusion: Serum neopterin levels were found to be an useful marker for evaluating disease severity and efficacy of narrowband UVB treatment. Thus, our findings may provide a new approach with the management of disease and follow-up strategies in patients with psoriasis.Öğe Evaluation of ocular psoriasis with meibography(Elsevier, 2022) Kemeriz, Funda; Tuğrul, Burcu; Yaşar, ErdoğanBackground Previous studies has shown that dry eye test abnormalities, meibomian gland dysfunction (MGD), may occur in psoriasis. Objectives The authors aimed to evaluate the dry eye disease (DED), MGD, in psoriasis patients with meibography which is a current, objective, noninvasive method for patients with meibomian gland diseases, to investigate the relationship between disease severity and ocular involvement. Methods This study included 50 participants with psoriasis and 50 healthy individuals. All subjects were examined by the same dermatologist and referred for ophthalmological examination including meibomian gland obstruction, lid margin alterations assessment, ocular surface disease index assessment, tear film break-up time test, Schirmer test, corneal conjunctival fluorescein staining assessment. Additionally, upper and lower lids were evaluated for meibomian gland loss with meibography.Öğe Evaluation of oral isotretinoin effects on hearing system in patients with acne vulgaris: Reversible or not?(Wiley, 2021) Kemeriz, Funda; Kayabaşı, Serkan; Çevirgen Cemil, Bengü; Hızlı, ÖmerSystemic isotretinoin is commonly used for severe acne treatment. It has many side effects, one of these is about hearing system, which has rarely been reported, also previous studies reported contradictory results about systemic isotretinoin and its association with hearing system. In this study, we aimed to investigate whether systemic isotretinoin affected on the hearing system or not. The study included 32 acne vulgaris patients (64 ears) who treated with oral isotretinoin 0.5 mg/kg body weight for at least 4 months and audiometric tests including pure-tone, speech, bilateral acoustic reflexes, and tympanometric measurements were performed at baseline, in the first week, in the first month, and third month of treatment, and sixth month after treatment. Audiometric tests were performed for right and left ears separately. A significant difference was found in the pure-tone thresholds (before treatment, first week, first month, third month of treatment, and sixth month after treatment) for the both ears at 8000 Hz (P < .001) and a significant decrease in the sixth month post-treatment pure-tone thresholds compared to pre-treatment thresholds at 8000 Hz. Additionally, a statistically significant increase was observed in serum LDL and triglyceride levels in the third month of treatment and a significant decrease at the sixth month after treatment (P < .001). Systemic isotretinoin caused bilateral hearing threshold changes in acne patients during the therapy but the changes improved after discontinuation. Therefore, our findings may provide safety using for dermatologists about hearing effects of isotretinoin, which is quite effective on severe acne.Öğe Evaluation of the relationship between rosacea cutaneous subtype and meibography findings(Kare Yayıncılık, Ali Cangül, 2022) Kemeriz, Funda; Erdal Çalıkoğlu, Emel; Yaşar, Erdoğan; Gürlevik, Uğur; Aksoy Saraç, GülhanAcne rosacea (AR) is a chronic inflammatory skin disease that can cause serious ocular complications. This study was designed to evaluate dry eye disease (DED) and meibomian gland dysfunction (MGD) in AR patients and to investigate the relationship between the cutaneous subtype of AR and ocular involvement. Materials and Methods: This study included 67 participants with AR and 50 healthy individuals. Patients diagnosed with 3 cutaneous subtypes were examined: erythematotelangiectatic rosacea (ETR), papulopustular rosacea (PPR), and phymatous rosacea (PR). An ophthalmatological examination was performed that included an evaluation of lid margin alterations due to meibomian gland (MG) obstruction, Ocular Surface Disease Index assessment, tear film break-up time testing, Schirmer testing, and a corneal conjunctival fluorescein staining assessment. Meibography was used to evaluate the upper and lower lids for MG loss. Results: Findings in the AR group revealed MGD in 45.5% and DED in 28.1%. The meibomian gland loss rate (MGLR) was 38.7±16.9% and the meibomian gland loss grade (MGLG) was 1.57±0.82%. The rate of MGLR and MGLG was significantly greater in the AR group than in the control group (p<0.001). PPR was seen in 59.7% of the 67 patients, ETR in 29.9%, and PR in 13.4%. A comparison of the MGD, MGLR, MGLG, and presence of DED in the 3 cutaneous subtype groups yielded statistically insignificant results. Conclusion: AR can affect MG morphology, which may result in MGD or DED. Though we did not find a significant difference in the ocular findings by subgroup, ocular involvement is a recognized risk in AR. Ophthalmologists and dermatologists should cooperate in the evaluation of AR patients. Additional studies to further examine the effects in subtype groups are recommended.Öğe Generalized neutrophilic fixed drug eruption induced by gabapentin(Turkish Society of Physical Medicine and Rehabilitation, 2021) Acar, Emine Müge; Çorum Şirin, Serpil; Kilitçi, Asuman; Elmaz, Ömer Faruk; Kemeriz, Funda; Günay, ÜmranA 65-year-old woman was referred to our clinic with multiple erythematous plaques on the trunk and arms (Figure 1). The eruption occurred three days after starting a 75 mg daily dose of gabapentin prescribed by a physical medicine and rehabilitation specialist for neuropathic pain in her arm. The skin lesions were accompanied by a fever of 38.3°C. The laboratory investigations revealed a white blood count of 18.820/mm3 and neutrophilic leukocytosis with a percentage of 89.4%. Further investigations revealed no infectious condition.Öğe Hemosiderotic dermatofibroma mimicking melanoma in a 12-year-old boy: a case report(Wiley, 2018) Acar, Emine Müge; Tad, Murat; Kilitci, Asuman; Kemeriz, Funda[Abstract Not Available]Öğe Lichen planus actinicus treated successfully with topical tacrolimus 0.1%: A report of six cases(Blackwell Publishing Inc., 2020) Kemeriz, Funda; Acar, Emine Müge; Kilitçi, AsumanLETTERLichen planus actinicus treated successfully with topicaltacrolimus 0.1%: A report of six casesDear Editor,Lichen planus actinicus (LPA) is a photodistributed variant of lichenplanus (LP) that frequently occurs individuals with dark complexionson sun-exposed areas.1,2All of the cases admitted to our clinics forasymptomatic discoloration and rash on different parts of the faces.Five of six cases were male and one of them was female. Lesions ofthree male patients were on the forehead; one of these was in torm of an annular brown-violaceous plaque and two of these were inthe form of hyperpigmented patch lesion (case-1, 3, 6). Other two ofthem had hyperpigmented patch lesions on the neck (case-2, 5).Hyperpigmented patch lesions of female patient were on perioralregion (case-4). Detailed demographic and clinical features of thecases were presented in Table 1, and clinical images of the cases wereshown in Figure 1. Histopathology results of all patients revealedÖğe Omalizumab induced lichenoid drug eruption triggered by sun exposure(Blackwell Publishing Inc., 2020) Kemeriz, Funda; Acar, Emine Müge; Ordu, MelikeDear Editor Omalizumab is a humanized monoclonal antibody against human immunoglobulin E that is mainly indicated in asthma, allergic rhinitis, chronic spontaneous urticaria and is being increasingly used for other dermatological diseases, including atopic dermatitis, mastocytosis, hyper-IgE syndrome, and bullous pemphigoid.1,2 Rare cutaneous side effects, such as itching, skin rash, urticaria, and photosensitivity, have been reported to be associated with omalizumab use.Öğe Pasini ve Pierini'nin idyopatik atrofoderması ile morfeanın birlikteliği(Dicle Üniversitesi, 2018) Kemeriz, Funda; Gönül, Müzeyyen; Gökçe, Aysun; Alper, MuratPasini ve Pierini’nin İdiyopatik Atrofoderması (PPİA) nadir görülen etyolojisi bilinmeyen bir dermal atrofi tipidir. Lezyonlar tek ya da birden fazla oval ya da yuvarlak, simetrik, deriden hafif çökük, keskin sınırlı plaklar şeklindedir. Çoğunlukla sırtta lokalize olan lezyonlar sonrasında göğüs ve abdominal bölgede de ortaya çıkabilmektedir. Lezyonların boyutu 1-20 cm arasında değişebilmektedir ve lezyonlar zaman içerisinde yavaşça genişler. Hastaların çoğu kadın olup, genelde ikinci-üçüncü dekatlarda görülmektedir. Nadiren PPİA ve morfea bir arada görülebilir. Bu makalede sırtında asemptomatik çökük kahverengi leke ile polikliniğimize başvuran, klinik ve histopatolojik bulgularla PPİA ve morfea tanısı konulan 27 yaşında bayan hasta sunulmaktadır.Öğe The effect of isotretinoin on meibomian glands in eyes: a pilot study(Springer Science and Business Media B.V., 2022) Gürlevik, Uğur; Kemeriz, Funda; Yaşar, ErdoğanThe aim of this pilot study was to quantify the meibography changes in patients administered with oral isotretinoin. Methods: This prospective pilot study included 30 eyes of 30 patients who received oral isotretinoin treatment due to acne. Each patient underwent a general ophthalmological examination. After fluorescence staining of the ocular surface, the tear film break-up time (TFBUT) test, meibography and Schirmer test were carried out and noted. All of these procedures were applied before the treatment and repeated at 1, 3, and 6 months after the treatment. Results: The percentage of upper meibomian gland (MG) loss at 3 and 6 months after the treatment was 22.2% (p = 0.001) and 23.6% (p = 0.001), respectively. The percentage of lower MG loss at 3 and 6 months after the treatment was 18.7% (p = 0.001) and 20.7% (p = 0.001), respectively. The corneal fluorescein staining score at 3 and 6 months after treatment was 0.57 (p = 0.001), and 0.47 (p = 0.012), respectively. Conclusion: These findings show that oral isotretionin treatment may affect MG morphology. The study findings also suggest that isotretinoin may cause tear film instability with Meibomian gland dysfunction and may cause evaporative type of dryness.Öğe Two years of experience related to pityriasis rosea patients from Turkey: Where to place allergy topics in the pathogenesis?(Aksaray Üniversitesi, 2024) Acar, Emine Müge; Kemeriz, Funda; Ordu, Meliked autoimmunity are suspected to play a role in the etiopathogenesis. The study was designed to evaluate the demographic and clinical characteristics and underlying etiologic factors associated with PR. It was also aimed to evaluate the relationship between PR and history of atopy and allergen exposure. Materials and Methods: Materials and Methods: The study included 170 patients diagnosed with PR between 2018 and 2020. Age and gender-matched 170 healthy participants participated in the study. Comorbidities, occupations, etiological factors, atopy history and the histopathological features of the biopsy specimens of the patients were also recorded. Results: Results: The mean age of the patients was 27.8±1.04, the mean disease duration was 29.3±5.24 days. Stress was the most common triggering factor (44.1%) followed by infections (33.5%). Twenty-six patients (15.2%) had gardening history that brought them in contact with plants. The number of cases describing stress was significantly higher than control group (p<0.001) . 28 patients (16.4%) had a history of atopy. Between the groups, atopy frequency was not statistically significantly different (p=0.765). Nonetheless, atopy frequency was significantly higher in patients who had PR recurrence than the patients without recurrence (p=0.002). Relatively higher numbers of eosinophils were seen in the histology of the patients describing a history of plant contact (p<0.001). Conclusion: Although PR was found most frequently associated with stress and upper respiratory tract infections in this study, it should be considered that allergen exposure may be a crucial triggering factor in patients with PR who have chronic progression and recurrence.
