Person: ONSUN, NAHIDE
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Publication Open Access The relationship between pruritus and clinical variables in patients with psoriasis(2017-07-01) Su, Ozlem; Bahali, ANIL GÜLSEL; Onsun, NAHİDE; OZKAYA, Dilek Biyik; Dizman, DİDEM; TOPUKCU, Bugce; Uysal, Omer; BAHALI, ANIL GÜLSEL; ONSUN, NAHIDE; SU KÜÇÜK, ÖZLEM; DİZMAN, DİDEM; UYSAL, ÖMERPruritus is the most commonly occurring subjective symptom of dermatological disease. Published data on both prevalence and intensity of pruritus in psoriasis is limited. Objective: In this study we aimed to investigate the prevalence of pruritus and its relation with psoriasis area severity index, body mass index and presence of systemic disease in patients with psoriasis. Methods: We analyzed data of psoriatic patients diagnosed in our psoriasis outpatient clinic between March 2013 and June 2014 collected retrospectively from PSR-TR registration system. Results: In total, 880 patients were analyzed. Pruritus was more prominent in female patients. This difference was statistically significant. No significant associations were found between age of patients, clinical type of disease and pruritus. The itching was more common in patients with higher body mass index. Presence of pruritus was correlated significantly with severity of psoriasis. Five hundred and sixty of 880 patients had no systemic disease. The presence of pruritus was not related with presence of systemic disease. Existence of systemic disease with psoriasis has minimal effect on pruritus. Study Limitations: We did not evaluate intensity of pruritus. Conclusions: Pruritus is not mentioned within the classical symptoms of psoriasis. Pruritus in psoriasis is a very unpleasant symptom with great potential to impair patient’s quality of life and may exacerbate psoriasis as a Koebner phenomenon. Keywords: Patients; Psoriasis; PruritusPublication Open Access Dermoscopic Features of Small, Medium, and Large-Sized Congenital Melanocytic Nevi(2017-02-01) Cengiz, FATMA PELİN; Emiroglu, NAZAN; OZKAYA, Dilek Biyik; Onsun, NAHİDE; CENGİZ, FATMA PELIN; EMİROĞLU, NAZAN; SU KÜÇÜK, ÖZLEM; ONSUN, NAHIDEBackground: Congenital melanocytic nevi (CMN) are present at birth. It is well known that the presence of large-sized congenital nevus in early life could predict a major risk of developing melanoma. Objective: To investigate the clinical and dermoscopic features of the CMN, to search for and highlight any differences between small-sized, medium-sized, large-sized CMN. Methods: A nonrandomized observational study was performed. A total of 108 melanocytic nevi were analysed by clinical and dermoscopic examination. Results: Of the subjects, 57.4% were aged less than 16 years, 42.6% were aged 16 and more. Of the nevi, 26 had reticular pattern (24.1%), 35 had globular pattern (32.4%), 13 had reticular-globular pattern (12.0%), 16 had homogeneous pattern (14.8%), 6 had reticular-homogeneous pattern (5.6%), 2 had globular-homogeneous pattern (1.9%), 7 had cobblestone pattern (6.5%), 3 had reticular patchy pattern (2.8%). Atypical dots and globules, focal hypopigmentation and perifollicular hypopigmentation are the most common dermoscopic features of CMN. The rarest dermoscopic feature is the blue-whitish veil. Conclusion: Most of the dermoscopic features related with dysplastic nevi up to the present, such as atypical dots and globules, focal hypopigmentation, perifollicular hypopigmentation were observed in CMN, in our study. Congenital nevus and dysplastic nevi may share the same dermoscopic features, therefore it is important to know it is found at birth or not.Publication Open Access The allergens causing contact sensitization in textile industry workers(2014-09-01) Su, Ozlem; OZKAYA, Dilek Biyik; PIRMIT, Serpil; ULUSAL, Hande Arda; Onsun, NAHİDE; SU KÜÇÜK, ÖZLEM; ONSUN, NAHIDEBackground and Design: Our aim was to determine the frequency of contact sensitization to textile materials and the most common textile allergens in patients who work in the textile industry and have been diagnosed with allergic contact dermatitis (ACD). Materials and Methods: Fifty textile industry workers, who attended our outpatient clinic with the diagnosis of ACD, between October 2005-December 2009, were enrolled in this study. While 50 patients were tested with the Thin layer-Rapid-Use-Epicutaneous (TRUE) test, 36 patients were tested with the TRUE test and textile series allergen. The results were analyzed as percentage and statistically. Results: Of the 50 patients, 34 (68%) were men, 16 (32%) were women. The mean of the subjects was 37.4 years. In 38.8 of the patients in whom TRUE test and textile series allergens applied together, at least one allergic reaction was seen. Of the 36 patients applied textile series in addition to the TRUE test, 33.3% of patients had positive reaction to only textile allergens, 2.7% to only standard series allergens, and 2.7% of subjects had positive reaction to both textile series and standard series allergens. 76.9% of these reactions were to dyes, 15.3% to resins and 7.6% of them were to both of them. Disperse blue 106(8.3%), acid red 359 (8.3%) and disperse red 17(5.5%) were the most positive reaction seen dyes. 18% of 50 patients tested with TRUE test alone showed at least one positive reaction. The most common standard series allergens were nickel sulphate (6%) and ethylenediamine dihydrocloride (6%). Both the relationship between atopy and contact sensitization and also the relationship with hand localization and contact sensitization to textile allergens were not statistically significant. Conclusion: In occupational textile dermatitis, contact sensitization is common and especially seen to disperse dyes. For the contact sensitization to textile materials, standard series allergens cannot be adequate in finding causative agent.Publication Open Access Dermatoscopic findings of pigmented purpuric dermatosis(2016-09-01) Su, Ozlem; OZKAYA, Dilek Biyik; Emiroglu, NAZAN; Cengiz, FATMA PELİN; Bahali, ANIL GÜLSEL; Yildiz, PELİN; DEMIRKESEN, Cuyan; Onsun, NAHİDE; EMİROĞLU, NAZAN; SU KÜÇÜK, ÖZLEM; CENGİZ, FATMA PELIN; BAHALI, ANIL GÜLSEL; YILDIZ, PELİN; ONSUN, NAHIDEackground:: Pigmented purpuric dermatosis is a chronic skin disorder of unknown aetiology characterised by symmetrical petechial and pigmented macules, often confined to the lower limbs. The aetiology of pigmented purpuric dermatosis is unknown. Dermatoscopy is a non-invasive diagnostic technique that allows the visualisation of morphological features invisible to the naked eye; it combines a method that renders the corneal layer of the skin translucent with an optical system that magnifies the image projected onto the retina. Objectives:: The aim of this study is to investigate the dermatoscopic findings of pigmented purpuric dermatosis. Methods:: This study enrolled patients diagnosed histopathologically with pigmented purpuric dermatosis who had dermatoscopic records. We reviewed the dermatoscopic images of PPD patients who attended the outpatient clinic in the Istanbul Dermatovenereology Department at the Bezmialem Vakıf University Medical Faculty. Results:: Dermatoscopy showed: coppery-red pigmentation (97%, n = 31) in the background, a brown network (34%, n = 11), linear vessels (22%, n = 7), round to oval red dots, globules, and patches (69%, n = 22; 75%, n = 24; 34%, n = 11; respectively), brown globules (26%, n = 8) and dots (53%, n = 17), linear brown lines (22%, n = 7), and follicular openings (13%, n = 4). Conclusion:: To our knowledge, this is the first study to report the dermatoscopy of pigmented purpuric dermatosis. In our opinion, dermatoscopy can be useful in the diagnosis of pigmented purpuric dermatosis.Publication Metadata only Impact of Helicobacter pylori infection on severity of psoriasis and response to treatment(2012-01-01) Onsun, NAHİDE; Su, Ozlem; BEYCAN, Ismet; OZKAYA, Dilek Biyik; Senocak, Mustafa; ONSUN, NAHIDE; SU KÜÇÜK, ÖZLEMThe aims of this study were to determine the prevalence of H. pylori seropositivity in patients with psoriasis, to evaluate the relationship between PASI (Psoriasis Area and Severity Index) scores and H. pylori infection, and to assess the impact of H. pylori infection on the response to treatment. A total of 300 patients with psoriasis and 150 non-psoriatic healthy controls were enrolled in the study. Patient PAST scores were recorded and H. pylori stool antigen tests performed in both patients and controls. Fifty patients with H. pylori infections were randomly assigned to one of two groups, one of which received acitretin with H. pylori treatment and the other acitretin alone. Statistical analyses were performed using chi-square and logistic regression tests. PASI scores were significantly higher in patients with H. pylori infections. Treatment aimed at eradicating H. pylori infection enhanced the effectiveness of acitretin therapy and shortened response times. Our results suggest that H. pylori infection plays a role in the severity of psoriasis, and that eradicating such infections enhances the effectiveness of psoriasis treatment.Publication Metadata only The Relationship of Psoriasis and Melanocytic Nevi(2016-11-01) Su, Ozlem; Cengiz, FATMA PELİN; Emiroglu, NAZAN; Bahali, ANIL GÜLSEL; OZKAYA, Dilek Biyik; Onsun, NAHİDE; CENGİZ, FATMA PELIN; EMİROĞLU, NAZAN; BAHALI, ANIL GÜLSEL; SU KÜÇÜK, ÖZLEM; ONSUN, NAHIDEBackground: There is limited data about the relationship between psoriasis and melanocytic lesions and melanoma. Immunologic pathways which were implicated in psoriasis induce a reduction in the number of melanocytic nevi. Aims and Objectives: To investigate the number of melanocytic nevi in psoriatic patients compared with controls and its relationship with disease severity and type of treatment. Methods: We performed a prospective study in 100 psoriatic patients and 100 controls. Clinical data were recorded for all participants. Results: As compared with controls, patients had overall fewer nevi congenital nevi. Among psoriatic patients, biologic agents and disease severity did not correlate with the number of nevi. Conclusions: Psoriatic patients have fewer nevi than controls. Frequency of nevi in psoriatic patients is not related to treatment and disease severity.Publication Metadata only Evolution of Spitz Nevi(2017-07-01) Su, Ozlem; Emiroglu, NAZAN; Yildiz, PELİN; OZKAYA, Dilek Biyik; Bahali, ANIL GÜLSEL; Onsun, NAHİDE; EMİROĞLU, NAZAN; YILDIZ, PELİN; BIYIK ÖZKAYA, DİLEK; BAHALI, ANIL GÜLSEL; SU KÜÇÜK, ÖZLEM; ONSUN, NAHIDEBackground/ObjectivesSpitz nevi are melanocytic lesions with clinical, dermoscopic, and histopathologic presentations that may resemble those of melanoma. The evolution of Spitz nevi is a well-known feature. The objectives of this study were to investigate the clinical and dermoscopic features of Spitz nevi and define their evolution.Publication Open Access The relationship between severity of disease and vitamin D levels in children with atopic dermatitis(2017-01-01) Su, Ozlem; BEHALI, Anil Gulsel; DEMIR, Aysegul Dogan; OZKAYA, Dilek Biyik; Uzuner, SELÇUK; Dizman, DİDEM; Onsun, NAHİDE; SU KÜÇÜK, ÖZLEM; UZUNER, SELÇUK; DİZMAN, DİDEM; ONSUN, NAHIDEIntroduction: Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disorder. Vitamin D is a liposoluble vitamin synthesized mainly in the skin. Vitamin D has several effects on the skin. Aim: To assess the serum level of vitamin D in children with AD and determine its relation to AD severity. Material and methods: Sixty patients with AD were enrolled in the study. We evaluated disease severity using the SCORing Atopic Dermatitis (SCORAD) index. The control group consisted of 37 healthy subjects. Results: The mean serum concentration of 25(OH)D3 in patients with AD was not statistically different from control subjects (p = 0.065). The vitamin D level was significantly lower in moderate and severe AD compared with mild AD, and this difference was statistically significant (p = 0.001 and p = 0.004). Vitamin D showed a negative correlation with serum total IgE levels (p = 0.007). There was no significant correlation between total IgE levels and SCORAD scores (p = 0.089). Conclusions: This study suggests that a low serum vitamin D level is inversely associated with severity of AD in children. Vitamin D has not been included in the routine treatment of AD because of the conflicting results of various studies. Thus, there is a need for more detailed and prospective studies.Publication Metadata only Prognostic Evaluation of Neutrophil/Lymphocyte Ratio in Patients with Mycosis Fungoides(2017-01-01) Su, Ozlem; Cengiz, FATMA PELİN; Emiroglu, NAZAN; OZKAYA, Dilek Biyik; Bahali, ANIL GÜLSEL; Onsun, NAHİDE; CENGİZ, FATMA PELIN; EMİROĞLU, NAZAN; BAHALI, ANIL GÜLSEL; SU KÜÇÜK, ÖZLEM; ONSUN, NAHIDEBackground. The role of inflammation has been established in cancer biology and the neutrophil to lymphocyte ratio postulated as a marker of systemic inflammatory response. The prognostic significance of neutrophil to lymphocyte ratio has never been explored in patients with mycosis fungoides. Methods. Data from 119 mycosis fungoides (MF) patients, diagnosed between 1998 and 2015 at a single centre, were evaluated retrospectively. The prognostic influence of the neutrophil to lymphocyte ratio and other clinico-pathological factors including age, lactate dehydrogenase, stage of disease, beta-2-microglobulin levels, and total IgE levels were evaluated. Results. The mean value of absolute neutrophil count and absolute lymphocyte count (ANC/ALC) ratio was 2.07 +/- 1.17 in the patient group, whereas it was 1.76 +/- 0.53 in the control group (P<0.05). An ANC/ALC value of 2.85 corresponded to the maximum combined sensitivity and specificity on the ROC curve. ANC/ALC ratios of 2.85 or higher at diagnosis were positively correlated with elevated Beta-2-microglobulin (P=0.026), advanced disease stage, and disease progression (P=0.026, r=0.204) (P=0.006, r=0.251) (P=0.018, r=0.216). Conclusion. In the present study, we showed that a high ANC/ALC ratio at diagnosis of MF represents a simple, poor prognostic factor for identifying high-risk patients with MF.Publication Open Access The relationship between body mass index, waist circumference and psoriatic arthritis in the Turkish population(2016-01-01) OZKAYA, Dilek Biyik; Onsun, NAHİDE; Su, Ozlem; Bahali, ANIL GÜLSEL; Dizman, DİDEM; Rezvani, AYLİN; Uysal, Omer; ONSUN, NAHIDE; SU KÜÇÜK, ÖZLEM; BAHALI, ANIL GÜLSEL; DİZMAN, DİDEM; REZVANİ, AYLİN; UYSAL, ÖMERIntroduction: Psoriasis is a chronic, immune-mediated inflammatory disease predominantly affecting the skin, with a complex aetiology. Recently it has been suggested that the chronic inflammation of psoriasis may cause metabolic and vascular disorders. The relationship between obesity and psoriatic arthritis (PsA) is not clear, and there are insufficient prospective studies addressing this subject. Aim: To investigate the relationship between psoriatic arthritis, severity of psoriasis and obesity in the Turkish population. Material and methods: Patient data from psoriasis outpatient clinics from February 2007 to July 2013 were reviewed retrospectively using the Psoriasis-Turkey (PSR-TR) registration system. Patients' age, onset age, body mass index (BMI), waist circumference, psoriasis area and severity index (PASI), and arthritis information were reviewed. In the outpatient clinics, patients who had joint pain consulted rheumatology clinics. The CASPAR criteria were used for the diagnosis of arthritis. Results: A total of 443 males and 495 females enrolled in this study. The mean age of females was 43.9 years (18-93 years) and the mean age of males was 44.6 years (18-89 years). A total of 231 (25%) patients had psoriatic arthritis. Investigation of the relationship between PASI, BMI, waist circumference (WC) and arthritis revealed a statistically significant relationship between each variable. Conclusions: In this study we observed a relationship between PsA and high BMI, high WC and high PASI. Psoriatic arthritis is a chronic inflammatory disorder and a chronic inflammatory state induced by adiposity may lead to PsA.
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