Person: SEÇKİN GENÇOSMANOĞLU, DİLEK
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SEÇKİN GENÇOSMANOĞLU
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DİLEK
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Publication Metadata only Psoriasis and the liver: problems, causes and course(WILEY, 2017) SEÇKİN GENÇOSMANOĞLU, DİLEK; Tula, Elona; Ergun, Tulin; Seckin, Dilek; Ozgen, Zuleyha; Avsar, ErolBackground/ObjectivesPsoriasis patients have a higher risk of liver abnormalities such as non-alcoholic fatty liver disease (NAFLD), drug-induced hepatitis, alcoholic hepatitis and neutrophilic cholangitis, than the general population. Associated liver disease limits therapeutic options and necessitates careful monitoring. The aim of the study was to identify liver problems in psoriasis patients and to investigate the underlying causes as well as their course. MethodsThe files of 518 psoriasis patients were retrospectively reviewed. Among these, 393 patients with relevant laboratory data were analysed for liver enzymes and their relation to the known risk factors for liver disease (obesity, diabetes mellitus, alcohol consumption, hepatotoxic medications, dyslipidemia, psoriatic arthritis and infectious hepatitis). ResultsAmong 393 patients, 24% and 0.8% developed liver enzyme abnormalities and cirrhosis, respectively. The most common factors associated with pathological liver enzymes were drugs (57%) and NAFLD (22%). Other rare causes were alcoholic hepatitis, viral hepatitis, neutrophilic cholangitis, autoimmune hepatitis and toxic hepatitis due to herbal therapy. Drug-induced liver enzyme abnormalities were reversible whereas in patients with NAFLD transaminases tended to fluctuate. One patient with herbal medicine-related cirrhosis died of sepsis. ConclusionLiver enzyme abnormalities are common in psoriasis patients and are mostly associated with drugs and NAFLD. Although most cases can be managed by avoiding hepatotoxic medications and close follow up, severe consequences like cirrhosis may develop.Publication Metadata only Topical 8-methoxypsoralen increases the efficacy of narrowband ultraviolet B in psoriasis(WILEY-BLACKWELL PUBLISHING, INC, 2009) SEÇKİN GENÇOSMANOĞLU, DİLEK; Seckin, Dilek; Usta, Inan; Yazici, Zuleyha; Senol, AsliBackground: A combination of oral psoralen with narrowband ultraviolet B (UVB), defined as 'psoralen-narrowband UVB', was shown to have a superior efficacy than UVB alone and even a comparable efficacy to psoralen and ultraviolet A in psoriasis. Objective: To find out whether topical psoralen-narrowband UVB provides any additional benefit to narrowband UVB alone in psoriasis. Methods: Nineteen patients with plaque psoriasis were included. Phototherapy was given three times per week. Two symmetrical lesions were selected as target lesions. in the first 12 sessions of phototherapy, the target lesion on one side was treated with 1% 8-methoxypsoralen (MOP) gel 30 min before UVB radiation whereas the target lesion on the other side served as a control. Target lesion scores were assessed at baseline, third, sixth, ninth and 12th sessions. Side effects were recorded. Results: Sixteen patients completed the Study. Target lesion scores decreased significantly on both sides (P < 0.0001). The mean percentage of decreases was greater on the 8-MOP-applied sides compared with the control sides for all assessments, but the difference was statistically significant only at the ninth session (37.7%, vs. 58.6%, P = 0.043). Pigmentation was frequently seen in 8-MOP gel-applied lesions. Conclusion: Topical 8-MOP gel plus narrowband UVB has greater efficacy than narrowband UVB alone in psoriasis.Publication Open Access Tumor necrosis factor-alpha inhibitors for the treatment of psoriasis patients with liver cirrhosis: A report of four cases with a literature review(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2017) SALMAN, ANDAÇ; Ergun, Tulin; Seckin-Gencosmanoglu, Dilek; Salman, Andac; Qzgen, Zuleyha; Ocak, Esra Sarac; Avsar, Erol; Imeryuz, NesePatients with psoriasis are at an increased risk of developing liver disease due to various factors. The existing data regarding the treatment of psoriasis patients with associated liver cirrhosis is limited. We report four patients of psoriasis with liver cirrhosis who were treated with TNF-alpha inhibitors for a mean duration of 35.4 months. Two patients were treated with etanercept, one with adalimumab and one was treated with both infliximab and etanercept. Three patients tolerated the treatment well without any deterioration of liver disease whereas one died of progressive liver disease. Although large-scale, controlled studies are needed, this case series provides insights regarding the long-term safety of TNF-alpha inhibitors in patients with psoriasis and liver cirrhosis.Publication Metadata only The impact of antipsoriatic treatment on serum pro-BDNF, BDNF levels, depression, anxiety scores, and quality of life(WILEY, 2021) SEÇKİN GENÇOSMANOĞLU, DİLEK; Aksoy, Hasan; Ergun, Tulin; Akkiprik, Mustafa; Eyuboglu, Irem Peker; Gencosmanoglu, Dilek Seckin; Unalan, Gulru Pemra Cobek; Yoney, HakanDepression is a comorbidity of psoriasis. Suppression of neurotrophins has been proposed to cause depression. Peripheral brain-derived neurotrophic factor (BDNF) and its precursor, pro-BDNF have been shown to be altered in depression. To compare serum pro-BDNF and BDNF levels, depression, anxiety, and quality of life (QoL) in psoriasis patients, diseased, and healthy controls, to assess impact of 12-week antipsoriatic treatment on abovementioned markers. At baseline, all groups completed Beck Depression Inventory (BDI), Spielberger State-Trait Anxiety Inventory-II (STAI-II) and DLQI; serum BDNF, proBDNF levels were measured. These were repeated after 3-months of treatment in psoriasis patients. Depression and anxiety were significantly higher, QoL was poorer in psoriasis. ProBDNF and proBDNF/BDNF ratios were not different among groups at baseline but significantly decreased after treatment in psoriasis. Depression and QoL improved significantly, BDNF and anxiety scores did not change. Altered pro-BDNF and proBDNF/BDNF ratios may have a role in depression pathogenesis in psoriasis. Antipsoriatic treatment causes improvement in depression, QoL, and reduction of proBDNF and proBDNF/BDNF ratios. Effective disease control may reverse dysregulated neurotrophin pathways and its consequences like depression.Publication Open Access Current Approach to Phototherapy Applications in Dermatology Practice: Part 2. Phototherapy in Vitiligo, Mycosis Fungoides, Atopic Dermatitis, Sclerosing Diseases and Psoriasis(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2017-06-15) SEÇKİN GENÇOSMANOĞLU, DİLEK; Gencosmanoglu, Dilek SeckinMany skin diseases can be treated with phototherapy, however, the method choice depends on the disease's characteristics. First-line phototherapy for generalized plaque psoriasis is narrowband ultraviolet B whereas it is psoralen and ultraviolet A for plaque stage mycosis fungoides and ultraviolet A1 for severe localized scleroderma. In this review, efficacy of different phototherapy methods in the most common diseases treated with phototherapy such as vitiligo, mycosis fungoides, atopic dermatitis, sclerosing diseases and psoriasis will be discussed in light of current guidelines.Publication Open Access Psychiatric Disorders, Family Functions, and Parent Psychiatric Symptoms in Children and Adolescents with Chronic Dermatological Diseases Treated with Phototherapy(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2021) SEÇKİN GENÇOSMANOĞLU, DİLEK; Ayyildiz, Didem; Fis, Nese Perdahli; Gumustas, Funda; Seckin, DilekObjective: The aim of this study was to examine comorbid psychiatric disorders, family functioning, and parental psychiatric symptoms in children and adolescents with chronic dermatological diseases and compare them with those of healthy controls. Materials and Methods: The research sample consisted of patients between the age of 9 and 18 years (n = 45) with alopecia areata, vitiligo, or psoriasis and a control group (CG) of healthy children and adolescents of the same age (n = 42). The psychiatric diagnoses of cases were established using Schedule for Affective Disorders and Schizophrenia for School Aged Children Present-Lifetime Version. Family assessment device (FAD) was used to evaluate family functioning levels. Parental psychiatric symptom levels were obtained by the Symptom Checklist-90-R. Results: Children and adolescents with chronic dermatological diseases had significantly higher rates of any anxiety disorders and any axis I comorbid psychiatric disorders than healthy controls after adjusting for socioeconomic status (P < 0.05). There were no significant differences in parental psychiatric symptom levels and family functioning levels between two groups; however, families of patients with comorbid psychiatric disorders had significantly higher scores in problem-solving and communication subscales of the FAD when compared to those of patients without psychiatric disorders and CG. Conclusions: Our findings suggest that children and adolescents with chronic dermatological diseases have higher risk for anxiety disorders. When psychiatric disorders co-occur with the dermatological disease in children and adolescents, they may adversely affect the family functioning, in the domains of problem-solving and communication skills.Publication Metadata only Efficacy, safety and drug survival of conventional agents in pediatric psoriasis: A multicenter, cohort study(WILEY, 2017) SALMAN, ANDAÇ; Ergun, Tulin; Seckin Gencosmanoglu, Dilek; Alpsoy, Erkan; Bulbul-Baskan, Emel; Saricam, Merve Hatun; Salman, Andac; Onsun, Nahide; Sarioz, AbdullahThe data on long-term efficacy, safety and drug survival rates of conventional systemic therapeutics in pediatric psoriasis is lacking. The primary aim of this study is to investigate acitretin, methotrexate, cyclosporin efficacy, safety and drug survival rates in pediatric patients as well as predictors of drug survival. This is a multicenter study including 289 pediatric cases being treated with acitretin, methotrexate and cyclosporin in four academic referral centers. Efficacy, adverse events, reasons for discontinuation, 1, 2- and 3-year drug survival rates, and determinants of drug survival were analyzed. A 75% reduction of Psoriasis Area and Severity Index score or better response rate was obtained in 47.5%, 34.1% and 40% of the patients who were treated with acitretin, methotrexate and cyclosporin, respectively. One-year drug survival rates for acitretin, methotrexate and cyclosporin were 36.3%, 21.1% and 15.1%, respectively. The most significant determinant of drug survival, which diminished over time, was treatment response whereas arthritis, body mass index and sex had no influence. Although all three medications are effective and relatively safe in children, drug survival rates are low due to safety concerns at this age group. Effective disease control through their rational use can be expected to improve survival rates.