Mehmet Gürer - Academia.edu (original) (raw)
Papers by Mehmet Gürer
Journal of The European Academy of Dermatology and Venereology, 2001
Behçet's disease (BD) is a chronic, inflammatory multisystemic condition of unknown aetio... more Behçet's disease (BD) is a chronic, inflammatory multisystemic condition of unknown aetiology. It is clinically characterized by recurrent orogenital ulcerations and skin eruptions; ocular manifestations; arthritis; vasculitis and in some cases neurological and large vessel involvement. Aetiology has not been defined, but genetic, environmental, viral, bacterial and immunological factors have been proposed as causative agents. Treatment includes colchicine, thalidomide, steroids and immunosuppressive agents and it is based on the severity of systemic manifestations, such as central nervous system involvement, arterial aneurysms and thrombosis of the major veins. Mortality is related to major system involvement. In this article the different clinical features, the multiple faces of BD and a list of currently suspected aetiological factors of the disease are discussed, and treatment modalities summarized.
ORL, 2007
This study aimed to assess cochlear functions in Behçet&a... more This study aimed to assess cochlear functions in Behçet's disease and rheumatoid arthritis (RA) using otoacoustic emission testing (OAE), which objectively assesses outer hair cells in the cochlea. Patients with Behçet's disease (n = 16) and RA (n = 11) as well as 20 controls were tested using pure tone audiometry and transiently evoked (TEOAEs) and distortion product OAEs (DPOAEs). Pure tone results in the Behçet's group were not significantly different from controls (p > 0.05). Pure tone results in the RA group were significantly different than in controls at 250, 500 and 6,000 Hz (p < 0.05). TEOAEs could be obtained in all participants. DPOAE amplitudes in the RA group and controls were similar (p > 0.05). DPOAE amplitudes were significantly higher in the Behçet's group than in controls at 1 and 2 kHz (p < 0.05). A subtle deterioration in hearing can be seen at low and high frequencies in RA, which is not related to outer hair cell dysfunction as detected by DPOAE testing. In the patients with Behçet's disease who have hearing thresholds within the normal limits, outer hair cell functions seem spared with an increased activity in the apical regions of the cochlea.
Advances in Experimental Medicine and Biology, 2004
International Journal of Dermatology, 2000
A 54-year-old female patient with edema and erythema on both eyelids, hands, and neck was admitte... more A 54-year-old female patient with edema and erythema on both eyelids, hands, and neck was admitted to our clinic in December 1997. The lesions on the eyelids and neck appeared in September 1996, while the lesions on the hands appeared about 1 year later. The patient was using ...
International Journal of Dermatology, 1994
A 38-year-old man had lesions on the trunk and arms and numerous pruritic lesions on the lower ex... more A 38-year-old man had lesions on the trunk and arms and numerous pruritic lesions on the lower extremities, particularly on the anterior sides of the lower legs (Figs. 1 and 2), which consisted of follicular and extrafollicular papules and hyperkeratotic nodules 3 to 5 mm in diameter.
International Journal of Dermatology, 2005
International Journal of Dermatology, 1993
Background. Reticulate acropigmentation of Kitamura (RAK) is an autosomal dominantly inherited de... more Background. Reticulate acropigmentation of Kitamura (RAK) is an autosomal dominantly inherited dermatosis.
Adışen E, İlter N, Erdem Ö, Gürer MA. Early onset linear focal elastosis in a Turkish boy. Turk J... more Adışen E, İlter N, Erdem Ö, Gürer MA. Early onset linear focal elastosis in a Turkish boy. Turk J Pediatr 2007; 49: 441-443. A 14-year-old boy applied to our outpatient clinic with a three-month history of lesions on the back. The physical examination revealed linear, yellow, stria-like palpable bands surrounded by a slight erythema extending horizontally across the back. Histopathological examination of the lesional skin demonstrated coarseness in collagen bundles and homogenization and decrement in elastic fibers with van Gieson stain. These features were consistent with linear focal elastosis. In the literature, linear focal elastosis is mainly reported in the elderly. We describe here a case of early linear focal elastosis arising in a 14-year-old Turkish boy.
International Journal of Dermatology, 2009
American Journal of Clinical Dermatology, 2008
A 50-year-old woman who presented with intermittent symmetric edema and wrinkling of the palms af... more A 50-year-old woman who presented with intermittent symmetric edema and wrinkling of the palms after soaking in water was found to have transient reactive papulotranslucent acrokeratoderma (TRPA). This is the oldest patient ever reported to have this condition. The patient was advised to avoid water exposure as much as possible and to wear gloves. Topical treatment with 5% salicylic acid in Vaseline also provided some relief. TRPA presents with translucent, white, confluent papules that become evident on the palms after 3-5 minutes' exposure to water (the so-called 'hand-in-the-bucket' sign) and resolve within a short time after drying. It is a rare disorder with fewer than 40 cases having been reported in the world literature. The disease is seen mostly in female patients, with ages ranging from 6 to 44 years prior to our case in a 50-year-old woman. The most common histologic findings are hyperkeratosis and dilated eccrine ostia. The etiopathogenesis of the disease remains unknown but a transitory structural or functional alteration of components of the stratum corneum or aberration of the sweat duct have been considered. TRPA has been reported in patients with cystic fibrosis and more recently, in patients taking selective cyclo-oxygenase-2 inhibitors. Therefore, the pathogenesis of the condition appears to be related to increased water absorption as a result of an increased epidermal sodium level. Treatment with barrier creams such as hydrophilic petrolatum, glycerin emollients, 5-20% salicylic acid in Vaseline, 10% urea cream, and 12% ammonium lactate cream have been reported. Cases with associated hyperhidrosis respond well to aluminum chloride-containing products.
International Journal of Dermatology, 2008
Bone, 2015
The degradation of the main fibrillar collagens, collagens I and II, is a crucial process for ske... more The degradation of the main fibrillar collagens, collagens I and II, is a crucial process for skeletal development. The most abundant dipeptides generated from the catabolism of collagens contain proline and hydroxyproline. In humans, prolidase is the only enzyme able to hydrolyze dipeptides containing these amino acids at their C-terminal end, thus being a key player in collagen synthesis and turnover. Mutations in the prolidase gene cause prolidase deficiency (PD), a rare recessive disorder. Here we describe 12 PD patients, 9 of whom were molecularly characterized in this study. Following a retrospective analysis of all of them a skeletal phenotype associated with short stature, hypertelorism, nose abnormalities, microcephaly, osteopenia and genu valgum, independent of both the type of mutation and the presence of the mutant protein was identified. In order to understand the molecular basis of the bone phenotype associated with PD, we analyzed a recently identified mouse model for the disease, the dark-like (dal) mutant. The dal/dal mice showed a short snout, they were smaller than controls, their femurs were significantly shorter and pQCT and μCT analyses of long bones revealed compromised bone properties at the cortical and at the trabecular level in both male and female animals. The differences were more pronounce at 1 month being the most parameters normalized by 2 months of age. A delay in the formation of the second ossification center was evident at postnatal day 10. Our work reveals that reduced bone growth was due to impaired chondrocyte proliferation and increased apoptosis rate in the proliferative zone associated with reduced hyperthrophic zone height. These data suggest that lack of prolidase, a cytosolic enzyme involved in the final stage of protein catabolism, is required for normal skeletogenesis especially at early age when the requirement for collagen synthesis and degradation is the highest.
Photodermatology Photoimmunology & Photomedicine, 2002
Background/Purpose: Free oxygen radicals are involved in inflammatory skin reactions induced by u... more Background/Purpose: Free oxygen radicals are involved in inflammatory skin reactions induced by ultraviolet B (UVB). In this study, the effect of a herbal antioxidant Ginkgo biloba extract (EGb 761) was investigated in UVB irradiated mice skin.Methods: The study was carried out on four groups of mice (n = 6 in each group). The first group was a control group (G1). The second group (G2) was only exposed to acute UVB irradiation. The third group (G3) received 100 mg/kg/day of EGb 761 orally for 5 days before UVB irradiation and the fourth group (G4) was given only a single dose of EGb 761 immediately after UVB irradiation. Eighteen hours after exposing to UVB, lipid peroxide levels, and superoxide dismutase (SOD) activities were studied and UVB damage was evaluated histopathologically according to ‘sun-burn cell count’.Results: The SOD activities and Malondialdehyde (MDA) levels in G2, G3 and G4 were found to be decreased significantly when compared with G1 (P < 0.05). The SOD activities of G3 and G4 were higher when compared with G2 (P < 0.05). The number of sunburn cells (SBCs) was the highest in G2.Conclusions: Our results suggest that EGb 761 may have an important effect, both as a protective and therapeutic agent, in sunburn after UVB irradiation.
International Journal of Dermatology, 1999
Objective We investigated the skin problems of high level musicians in a professional orchestra. ... more Objective We investigated the skin problems of high level musicians in a professional orchestra. This study was prompted by our observation of violinists with skin changes.Methods Ninety-seven musicians were evaluated. Twelve reporting dermatitis associated with the playing of their instruments were patch tested. We also examined 20 singers (nonplayers).Results Positive patch test reactions to nickel and colophony were found in only three patients. Musicians were subject to a variety of skin problems from playing their instruments, however, such as hyperhidrosis, cheilitis, and calluses of the fingertips. Singers had skin problems including lichen planus, psoriasis, seborrheic dermatitis, and urticaria. It was thought that emotional factors exacerbate their problems.Conclusions The results of this survey suggest a significant incidence of occupational- and stress-related skin problems in musicians.
Clinical and Experimental Dermatology, 2005
Inflammation in Behcet's disease is thought to be mediated by cytokines derived from T-helper typ... more Inflammation in Behcet's disease is thought to be mediated by cytokines derived from T-helper type 1 (Th1) lymphocytes. In this study, we tried to determine serum interleukin (IL)-18 and tumour necrosis factor (TNF)-α levels of patients with Behcet's disease. Twenty-seven patients with active Behcet's disease, and 20 healthy control subjects were included in this study. Differences between mean serum IL-18 and TNF-α level of patients with Behcet's disease were significantly increased when compared with the control group. A significant correlation was found between serum IL-18 and TNF-α levels of Behcet patients (rs = 0.627, P < 0.0001). IL-18 and TNF-α levels may be related to disease pathogenesis. Increased levels of IL-18 also support Th1 predominance in Behcet's disease.
International Journal of Dermatology, 2007
... How to Cite. Adişen, E., Öztaş, M. and Gürer, MA (2007), Lack of efficacy of etanercept in ac... more ... How to Cite. Adişen, E., Öztaş, M. and Gürer, MA (2007), Lack of efficacy of etanercept in acrodermatitis continua of Hallopeau. ... Our result shows that, under certain circumstances, dermatologic diseases can be very resistant and can cause impairment of a patient's quality of ...
International Journal of Dermatology, 2007
A 40-year-old man was referred to our department in January 2000 with persistent, scaly, pustular... more A 40-year-old man was referred to our department in January 2000 with persistent, scaly, pustular and tender plaques on the distal portion of the digits. He first noted pustulation around the nail, which was followed by scaling and crust formation, and subsequently led to nail dystrophy. Earlier treatment had included topical antibiotics, antimycotics, and corticosteroids, as well as systemic antibiotics, without any success. His past medical history was otherwise unremarkable. Post-traumatic fingertip amputation of the third finger of the right hand was repaired with a full-thickness skin graft. On dermatologic examination, there was a severe erythematosquamous, psoriasiform, pustular eruption surrounded by a hyperemic area affecting the terminal phalanges of nine of the 10 digits. The skin of the graft was intact. Examination of the digits revealed anonychia of six of the 10 fingernails (Fig. 1) The rest of the physical examination was normal. Clinical and histologic findings led to the diagnosis of acrodermatitis continua of Hallopeau (ACH). X-Rays of both hands showed osteolysis of two of the 10 terminal phalanges.Figure 1. Before therapy: acrodermatitis continua of Hallopeau demonstrating acral pustule formationDownload figure to PowerPointFigure 1. Before therapy: acrodermatitis continua of Hallopeau demonstrating acral pustule formationDownload figure to PowerPointInitial therapy was with acitretin (up to 1 mg/kg). This treatment produced moderate clinical improvement, but was discontinued after 4 months because of a sudden increase in serum lipids. Treatment with topical corticosteroids under occlusion, combined with psoralen plus ultraviolet A (PUVA) twice weekly, was started, but this gave only a slight improvement. Over the following 5 months, the patient developed generalized pustular psoriasis. Treatment was therefore started with methotrexate (intravenously, 25 mg weekly) in combination with fluocortolone (0.5 mg/kg body weight/day). Methotrexate was stopped after 6 weeks because of a sudden increase in liver transaminases and a lack of efficacy. The patient was subsequently lost to follow-up for more than 6 months. Until the time of presentation to our outpatient clinic, he had continued topical corticosteroids. He was admitted to our department and therapy with cyclosporine (5 mg/kg/day) was started. After 4 weeks the condition still remained active and the patient refused further doses of the drug. We therefore started topical therapy with tacrolimus 0.1% ointment (Protopic) twice daily under occlusion. This therapy gave only a slight improvement and was later replaced by mycophenolate mofetil (up to 3 g/day) because of failure to improve the patient's symptoms. Response to this treatment was rather limited, even after the addition of cyclosporine. Because of the initial success with acitretin, therapy with acitretin 35 mg daily was started again. Despite using a lipid-lowering agent, serum lipids again increased rapidly. Further systemic therapies were tried. These included dapsone (200 mg/day), cyclosporine (200 mg/day) in combination with acitretin (35 mg/day), and acitretin in combination with PUVA twice weekly for 9 weeks. All were unsuccessful. Because of recent publications reporting success in the treatment of ACH with anti-tumor necrosis factor-α agents, therapy with etanercept (Enbrel®, Wyeth) was considered. Purified protein derivative of tuberculin test was performed and found to be negative. Chest X-ray was also normal. Etanercept was initiated at a dose of 25 mg subcutaneously twice weekly in combination with topical corticosteroids. The response to etanercept therapy has been reported to be dose dependent, and therefore the dose was increased to 50 mg twice weekly after the second injection. The patient tolerated the therapy without any reactions or adverse effects; his blood count, liver enzyme levels, and renal function remained normal throughout treatment. The patient is now on the 12th week of therapy, but his condition still remains active and has spread proximally (Fig. 2).Figure 2. After 12 weeks of etanercept monotherapyDownload figure to PowerPointFigure 2. After 12 weeks of etanercept monotherapyDownload figure to PowerPoint
International Journal of Dermatology, 2009
International Journal of Dermatology, 2007
CASE 1: A 27-year-old woman presented with a 6 x 6 mm, soft, pink-brown papule located on the rig... more CASE 1: A 27-year-old woman presented with a 6 x 6 mm, soft, pink-brown papule located on the right axilla (Fig. 1). Dermoscopic examination showed a central scar-like white-colored area, a cleft-like appearance in the central area, and a fine pigment network in the periphery of the lesion (Fig. 2). CASE 2: A 5-year-old girl presented with a 4 x 4 mm pink nodule on her left abdominal region. Dermoscopic examination showed a central scar-like white-colored area, and a fine pigment network in the periphery of the lesion. CASE 3: An 18-year-old man presented to our outpatient clinic suffering from a firm, tender, painful, 7 x 7 mm brownish pink nodule located on his left hypochondrium. Upon dermoscopic examination, a central white scar-like area was detected. A cleft-like appearance was also detected in the central region. In the periphery of the lesion, there was a fine pigment network. CASE 4: An 8-year-old girl reported to our outpatient clinic with a congenital 5 x 5 mm brownish papule on her right inguinal region. Dermoscopic examination showed a central white scar-like area, a cleft-like appearance in the central region, and a fine pigment network in the periphery of the lesion (Fig. 3). CASE 5: A 2-month-old girl was referred to our pigmented lesions clinic with a 3 x 3 mm brownish pink papule located on the right subcostal region lesion that had been noted by a pediatrician. Dermoscopic examination showed a central white area, central streak, and a very faint pigmented network at the periphery.
Journal of The European Academy of Dermatology and Venereology, 2001
Behçet's disease (BD) is a chronic, inflammatory multisystemic condition of unknown aetio... more Behçet's disease (BD) is a chronic, inflammatory multisystemic condition of unknown aetiology. It is clinically characterized by recurrent orogenital ulcerations and skin eruptions; ocular manifestations; arthritis; vasculitis and in some cases neurological and large vessel involvement. Aetiology has not been defined, but genetic, environmental, viral, bacterial and immunological factors have been proposed as causative agents. Treatment includes colchicine, thalidomide, steroids and immunosuppressive agents and it is based on the severity of systemic manifestations, such as central nervous system involvement, arterial aneurysms and thrombosis of the major veins. Mortality is related to major system involvement. In this article the different clinical features, the multiple faces of BD and a list of currently suspected aetiological factors of the disease are discussed, and treatment modalities summarized.
ORL, 2007
This study aimed to assess cochlear functions in Behçet&amp;amp;amp;amp;amp;amp;amp;amp;a... more This study aimed to assess cochlear functions in Behçet&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease and rheumatoid arthritis (RA) using otoacoustic emission testing (OAE), which objectively assesses outer hair cells in the cochlea. Patients with Behçet&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease (n = 16) and RA (n = 11) as well as 20 controls were tested using pure tone audiometry and transiently evoked (TEOAEs) and distortion product OAEs (DPOAEs). Pure tone results in the Behçet&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s group were not significantly different from controls (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). Pure tone results in the RA group were significantly different than in controls at 250, 500 and 6,000 Hz (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). TEOAEs could be obtained in all participants. DPOAE amplitudes in the RA group and controls were similar (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). DPOAE amplitudes were significantly higher in the Behçet&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s group than in controls at 1 and 2 kHz (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). A subtle deterioration in hearing can be seen at low and high frequencies in RA, which is not related to outer hair cell dysfunction as detected by DPOAE testing. In the patients with Behçet&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease who have hearing thresholds within the normal limits, outer hair cell functions seem spared with an increased activity in the apical regions of the cochlea.
Advances in Experimental Medicine and Biology, 2004
International Journal of Dermatology, 2000
A 54-year-old female patient with edema and erythema on both eyelids, hands, and neck was admitte... more A 54-year-old female patient with edema and erythema on both eyelids, hands, and neck was admitted to our clinic in December 1997. The lesions on the eyelids and neck appeared in September 1996, while the lesions on the hands appeared about 1 year later. The patient was using ...
International Journal of Dermatology, 1994
A 38-year-old man had lesions on the trunk and arms and numerous pruritic lesions on the lower ex... more A 38-year-old man had lesions on the trunk and arms and numerous pruritic lesions on the lower extremities, particularly on the anterior sides of the lower legs (Figs. 1 and 2), which consisted of follicular and extrafollicular papules and hyperkeratotic nodules 3 to 5 mm in diameter.
International Journal of Dermatology, 2005
International Journal of Dermatology, 1993
Background. Reticulate acropigmentation of Kitamura (RAK) is an autosomal dominantly inherited de... more Background. Reticulate acropigmentation of Kitamura (RAK) is an autosomal dominantly inherited dermatosis.
Adışen E, İlter N, Erdem Ö, Gürer MA. Early onset linear focal elastosis in a Turkish boy. Turk J... more Adışen E, İlter N, Erdem Ö, Gürer MA. Early onset linear focal elastosis in a Turkish boy. Turk J Pediatr 2007; 49: 441-443. A 14-year-old boy applied to our outpatient clinic with a three-month history of lesions on the back. The physical examination revealed linear, yellow, stria-like palpable bands surrounded by a slight erythema extending horizontally across the back. Histopathological examination of the lesional skin demonstrated coarseness in collagen bundles and homogenization and decrement in elastic fibers with van Gieson stain. These features were consistent with linear focal elastosis. In the literature, linear focal elastosis is mainly reported in the elderly. We describe here a case of early linear focal elastosis arising in a 14-year-old Turkish boy.
International Journal of Dermatology, 2009
American Journal of Clinical Dermatology, 2008
A 50-year-old woman who presented with intermittent symmetric edema and wrinkling of the palms af... more A 50-year-old woman who presented with intermittent symmetric edema and wrinkling of the palms after soaking in water was found to have transient reactive papulotranslucent acrokeratoderma (TRPA). This is the oldest patient ever reported to have this condition. The patient was advised to avoid water exposure as much as possible and to wear gloves. Topical treatment with 5% salicylic acid in Vaseline also provided some relief. TRPA presents with translucent, white, confluent papules that become evident on the palms after 3-5 minutes&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; exposure to water (the so-called &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;hand-in-the-bucket&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; sign) and resolve within a short time after drying. It is a rare disorder with fewer than 40 cases having been reported in the world literature. The disease is seen mostly in female patients, with ages ranging from 6 to 44 years prior to our case in a 50-year-old woman. The most common histologic findings are hyperkeratosis and dilated eccrine ostia. The etiopathogenesis of the disease remains unknown but a transitory structural or functional alteration of components of the stratum corneum or aberration of the sweat duct have been considered. TRPA has been reported in patients with cystic fibrosis and more recently, in patients taking selective cyclo-oxygenase-2 inhibitors. Therefore, the pathogenesis of the condition appears to be related to increased water absorption as a result of an increased epidermal sodium level. Treatment with barrier creams such as hydrophilic petrolatum, glycerin emollients, 5-20% salicylic acid in Vaseline, 10% urea cream, and 12% ammonium lactate cream have been reported. Cases with associated hyperhidrosis respond well to aluminum chloride-containing products.
International Journal of Dermatology, 2008
Bone, 2015
The degradation of the main fibrillar collagens, collagens I and II, is a crucial process for ske... more The degradation of the main fibrillar collagens, collagens I and II, is a crucial process for skeletal development. The most abundant dipeptides generated from the catabolism of collagens contain proline and hydroxyproline. In humans, prolidase is the only enzyme able to hydrolyze dipeptides containing these amino acids at their C-terminal end, thus being a key player in collagen synthesis and turnover. Mutations in the prolidase gene cause prolidase deficiency (PD), a rare recessive disorder. Here we describe 12 PD patients, 9 of whom were molecularly characterized in this study. Following a retrospective analysis of all of them a skeletal phenotype associated with short stature, hypertelorism, nose abnormalities, microcephaly, osteopenia and genu valgum, independent of both the type of mutation and the presence of the mutant protein was identified. In order to understand the molecular basis of the bone phenotype associated with PD, we analyzed a recently identified mouse model for the disease, the dark-like (dal) mutant. The dal/dal mice showed a short snout, they were smaller than controls, their femurs were significantly shorter and pQCT and μCT analyses of long bones revealed compromised bone properties at the cortical and at the trabecular level in both male and female animals. The differences were more pronounce at 1 month being the most parameters normalized by 2 months of age. A delay in the formation of the second ossification center was evident at postnatal day 10. Our work reveals that reduced bone growth was due to impaired chondrocyte proliferation and increased apoptosis rate in the proliferative zone associated with reduced hyperthrophic zone height. These data suggest that lack of prolidase, a cytosolic enzyme involved in the final stage of protein catabolism, is required for normal skeletogenesis especially at early age when the requirement for collagen synthesis and degradation is the highest.
Photodermatology Photoimmunology & Photomedicine, 2002
Background/Purpose: Free oxygen radicals are involved in inflammatory skin reactions induced by u... more Background/Purpose: Free oxygen radicals are involved in inflammatory skin reactions induced by ultraviolet B (UVB). In this study, the effect of a herbal antioxidant Ginkgo biloba extract (EGb 761) was investigated in UVB irradiated mice skin.Methods: The study was carried out on four groups of mice (n = 6 in each group). The first group was a control group (G1). The second group (G2) was only exposed to acute UVB irradiation. The third group (G3) received 100 mg/kg/day of EGb 761 orally for 5 days before UVB irradiation and the fourth group (G4) was given only a single dose of EGb 761 immediately after UVB irradiation. Eighteen hours after exposing to UVB, lipid peroxide levels, and superoxide dismutase (SOD) activities were studied and UVB damage was evaluated histopathologically according to ‘sun-burn cell count’.Results: The SOD activities and Malondialdehyde (MDA) levels in G2, G3 and G4 were found to be decreased significantly when compared with G1 (P < 0.05). The SOD activities of G3 and G4 were higher when compared with G2 (P < 0.05). The number of sunburn cells (SBCs) was the highest in G2.Conclusions: Our results suggest that EGb 761 may have an important effect, both as a protective and therapeutic agent, in sunburn after UVB irradiation.
International Journal of Dermatology, 1999
Objective We investigated the skin problems of high level musicians in a professional orchestra. ... more Objective We investigated the skin problems of high level musicians in a professional orchestra. This study was prompted by our observation of violinists with skin changes.Methods Ninety-seven musicians were evaluated. Twelve reporting dermatitis associated with the playing of their instruments were patch tested. We also examined 20 singers (nonplayers).Results Positive patch test reactions to nickel and colophony were found in only three patients. Musicians were subject to a variety of skin problems from playing their instruments, however, such as hyperhidrosis, cheilitis, and calluses of the fingertips. Singers had skin problems including lichen planus, psoriasis, seborrheic dermatitis, and urticaria. It was thought that emotional factors exacerbate their problems.Conclusions The results of this survey suggest a significant incidence of occupational- and stress-related skin problems in musicians.
Clinical and Experimental Dermatology, 2005
Inflammation in Behcet's disease is thought to be mediated by cytokines derived from T-helper typ... more Inflammation in Behcet's disease is thought to be mediated by cytokines derived from T-helper type 1 (Th1) lymphocytes. In this study, we tried to determine serum interleukin (IL)-18 and tumour necrosis factor (TNF)-α levels of patients with Behcet's disease. Twenty-seven patients with active Behcet's disease, and 20 healthy control subjects were included in this study. Differences between mean serum IL-18 and TNF-α level of patients with Behcet's disease were significantly increased when compared with the control group. A significant correlation was found between serum IL-18 and TNF-α levels of Behcet patients (rs = 0.627, P < 0.0001). IL-18 and TNF-α levels may be related to disease pathogenesis. Increased levels of IL-18 also support Th1 predominance in Behcet's disease.
International Journal of Dermatology, 2007
... How to Cite. Adişen, E., Öztaş, M. and Gürer, MA (2007), Lack of efficacy of etanercept in ac... more ... How to Cite. Adişen, E., Öztaş, M. and Gürer, MA (2007), Lack of efficacy of etanercept in acrodermatitis continua of Hallopeau. ... Our result shows that, under certain circumstances, dermatologic diseases can be very resistant and can cause impairment of a patient's quality of ...
International Journal of Dermatology, 2007
A 40-year-old man was referred to our department in January 2000 with persistent, scaly, pustular... more A 40-year-old man was referred to our department in January 2000 with persistent, scaly, pustular and tender plaques on the distal portion of the digits. He first noted pustulation around the nail, which was followed by scaling and crust formation, and subsequently led to nail dystrophy. Earlier treatment had included topical antibiotics, antimycotics, and corticosteroids, as well as systemic antibiotics, without any success. His past medical history was otherwise unremarkable. Post-traumatic fingertip amputation of the third finger of the right hand was repaired with a full-thickness skin graft. On dermatologic examination, there was a severe erythematosquamous, psoriasiform, pustular eruption surrounded by a hyperemic area affecting the terminal phalanges of nine of the 10 digits. The skin of the graft was intact. Examination of the digits revealed anonychia of six of the 10 fingernails (Fig. 1) The rest of the physical examination was normal. Clinical and histologic findings led to the diagnosis of acrodermatitis continua of Hallopeau (ACH). X-Rays of both hands showed osteolysis of two of the 10 terminal phalanges.Figure 1. Before therapy: acrodermatitis continua of Hallopeau demonstrating acral pustule formationDownload figure to PowerPointFigure 1. Before therapy: acrodermatitis continua of Hallopeau demonstrating acral pustule formationDownload figure to PowerPointInitial therapy was with acitretin (up to 1 mg/kg). This treatment produced moderate clinical improvement, but was discontinued after 4 months because of a sudden increase in serum lipids. Treatment with topical corticosteroids under occlusion, combined with psoralen plus ultraviolet A (PUVA) twice weekly, was started, but this gave only a slight improvement. Over the following 5 months, the patient developed generalized pustular psoriasis. Treatment was therefore started with methotrexate (intravenously, 25 mg weekly) in combination with fluocortolone (0.5 mg/kg body weight/day). Methotrexate was stopped after 6 weeks because of a sudden increase in liver transaminases and a lack of efficacy. The patient was subsequently lost to follow-up for more than 6 months. Until the time of presentation to our outpatient clinic, he had continued topical corticosteroids. He was admitted to our department and therapy with cyclosporine (5 mg/kg/day) was started. After 4 weeks the condition still remained active and the patient refused further doses of the drug. We therefore started topical therapy with tacrolimus 0.1% ointment (Protopic) twice daily under occlusion. This therapy gave only a slight improvement and was later replaced by mycophenolate mofetil (up to 3 g/day) because of failure to improve the patient's symptoms. Response to this treatment was rather limited, even after the addition of cyclosporine. Because of the initial success with acitretin, therapy with acitretin 35 mg daily was started again. Despite using a lipid-lowering agent, serum lipids again increased rapidly. Further systemic therapies were tried. These included dapsone (200 mg/day), cyclosporine (200 mg/day) in combination with acitretin (35 mg/day), and acitretin in combination with PUVA twice weekly for 9 weeks. All were unsuccessful. Because of recent publications reporting success in the treatment of ACH with anti-tumor necrosis factor-α agents, therapy with etanercept (Enbrel®, Wyeth) was considered. Purified protein derivative of tuberculin test was performed and found to be negative. Chest X-ray was also normal. Etanercept was initiated at a dose of 25 mg subcutaneously twice weekly in combination with topical corticosteroids. The response to etanercept therapy has been reported to be dose dependent, and therefore the dose was increased to 50 mg twice weekly after the second injection. The patient tolerated the therapy without any reactions or adverse effects; his blood count, liver enzyme levels, and renal function remained normal throughout treatment. The patient is now on the 12th week of therapy, but his condition still remains active and has spread proximally (Fig. 2).Figure 2. After 12 weeks of etanercept monotherapyDownload figure to PowerPointFigure 2. After 12 weeks of etanercept monotherapyDownload figure to PowerPoint
International Journal of Dermatology, 2009
International Journal of Dermatology, 2007
CASE 1: A 27-year-old woman presented with a 6 x 6 mm, soft, pink-brown papule located on the rig... more CASE 1: A 27-year-old woman presented with a 6 x 6 mm, soft, pink-brown papule located on the right axilla (Fig. 1). Dermoscopic examination showed a central scar-like white-colored area, a cleft-like appearance in the central area, and a fine pigment network in the periphery of the lesion (Fig. 2). CASE 2: A 5-year-old girl presented with a 4 x 4 mm pink nodule on her left abdominal region. Dermoscopic examination showed a central scar-like white-colored area, and a fine pigment network in the periphery of the lesion. CASE 3: An 18-year-old man presented to our outpatient clinic suffering from a firm, tender, painful, 7 x 7 mm brownish pink nodule located on his left hypochondrium. Upon dermoscopic examination, a central white scar-like area was detected. A cleft-like appearance was also detected in the central region. In the periphery of the lesion, there was a fine pigment network. CASE 4: An 8-year-old girl reported to our outpatient clinic with a congenital 5 x 5 mm brownish papule on her right inguinal region. Dermoscopic examination showed a central white scar-like area, a cleft-like appearance in the central region, and a fine pigment network in the periphery of the lesion (Fig. 3). CASE 5: A 2-month-old girl was referred to our pigmented lesions clinic with a 3 x 3 mm brownish pink papule located on the right subcostal region lesion that had been noted by a pediatrician. Dermoscopic examination showed a central white area, central streak, and a very faint pigmented network at the periphery.