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 Secukinumab and infectious adverse effects: A real-life experience of 63 psoriasis patients(2021) SEÇKİN GENÇOSMANOĞLU, DİLEK; Ergun, Tulin; Seckin, Dilek; Demir, Gizem; Direskeneli, HanerPublication Open Access Erlotinib induced ectropion following papulopustular rash(SPECJALISCI DERMATOLODZY, 2015-06-30) SALMAN, ANDAÇ; Salman, Andac; Cerman, Eren; Seckin, Dilek; Kanitez, MetinBackground: Erlotinib is a targeted anti-cancer drug which acts through the inhibition of epidermal growth factor receptor (EGFR). Main observations: A 79-year-old developed bilateral ectropion after he received erlotinib treatment for lung adenocarcinoma. The ectropion completely resolved with symptomatic treatment without any modification in erlotinib therapy. Conclusions: EGFR inhibitors are frequently associated with a variety of mucocutaneous adverse events. Ocular toxicity associated with these agents has been reported rarely. We present this case to underline the importance of recognition of newly reported cutaneous and ocular adverse events of targeted therapies.Publication Open Access Drug eruption: A mimicker of Coronavirus disease-2019 rash(2022-01-01) ERGUN, SAFİYE ATLAS TÜLİN; SEVEN, SEDA; SEÇKİN GENÇOSMANOĞLU, DİLEK; TİGEN, ELİF; AKTAŞ, MERYEM; ERGUN S. A. T., Ergenc I., SEVEN S., SEÇKİN GENÇOSMANOĞLU D., CÖMERT ÖZER E., AKTAŞ M., TİGEN E.Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infections can be associated with several cutaneous lesions, among which maculopapular rash is the most common. A maculopapular rash can also be induced by medications used for Coronavirus disease-2019 (COVID-19) treatment. The distinction between viral rash and drug eruption may be difficult especially in case of several medication use for COVID-19. Thus, this study aimed to describe cutaneous manifestations in six patients with COVID-19 and highlight dues for distinguishing SARS-CoV-2-related rash and drug eruption. Between March and June 2020, 1,492 patients were hospitalized for COVID-19 and treated with hydroxychloroquine in Marmara University Hospital. Among them, six cases were consulted for possible COVID-19-related rash or drug reaction. Hydroxychloroquine was given as monotherapy in one patient. All six patients developed an erythematous, symmetrical, and maculopapular eruption that mainly affected the trunk, axilla, and genitocrural region, 5-21 days after the onset of COVID-19 symptoms. Five patients developed rash in 4-11 days after treatment completion. Pruritus was severe. All were treated with topical corticosteroids and oral antihistamines, which provided partial relief. The resolution of the eruption was typically slow, which took a few weeks. A long period between the COVID-19 symptoms and the eruption, as well as slow recovery, is in favor of drug eruption. The effects of co-existent viral infection, a well-known promoting drug eruption factor, in facilitating adverse drug reaction in patients with COVID-19 needs further observations and research.Publication Open Access Growth Arrest-Specific 6 and Cardiometabolic Risk Factors in Patients with Psoriasis(WILEY, 2015-04) SEÇKİN GENÇOSMANOĞLU, DİLEK; Sunbul, Murat; Cagman, Zeynep; Gerin, Fethullah; Ozgen, Zuleyha; Durmus, Erdal; Seckin, Dilek; Ahmad, Sarfraz; Uras, Fikriye; Agirbasli, MehmetObjectivesAn increased risk for cardiovascular disease with psoriasis has been reported. Growth Arrest-Specific 6 (GAS6) amplifies pro-inflammatory endothelial cell activation via TAM receptors. However, it also inhibits inflammation by multiple mechanisms including phagocytosis. The objective of this study was to investigate whether plasma GAS6 levels are associated with conventional cardiometabolic (CM) risk factors in patients with psoriasis. MethodsForty patients diagnosed with psoriasis (22 male, mean age: 43.313.8years) and 40 age-/sex-matched healthy controls (22 male, mean age: 39.38.9years) were included in the study. CM risk factors (hypertension, hyperlipidemia, diabetes mellitus, and cigarette smoking) were identified. GAS6 levels were measured by ELISA. ResultsThere were no significant differences between the plasma GAS6 levels of patients with psoriasis compared to the control group (6.6 +/- 2.0ng/mL, 7.6 +/- 2.8ng/mL, respectively, P>0.05). However, GAS6 levels of patients with psoriasis having a smoking history (n=11) were significantly lower than both patients with psoriasis who had no smoking history (n=29) and controls (5.5 +/- 1.7ng/mL, 6.9 +/- 1.9ng/mL, 7.6 +/- 2.8ng/mL, respectively, P<0.05). Similarly, psoriasis patients with at least one CM risk factor showed lower GAS6 levels compared to subjects without any CM risk factor (5.7 +/- 1.7ng/mL, 7.3 +/- 2.0ng/mL, P<0.01). There was no correlation between the GAS6 level, disease duration or PASI score (r=0.150, -0.150, and P=0.310, 0.398, respectively). ConclusionsThis pilot study provides the first evidence in humans for an association between low plasma GAS6 levels and conventional risk factors in psoriasis. Further large scale, prospective studies are needed to confirm these results.Publication Metadata only Assessment of left atrial volume and function in patients with psoriasis by using real time three-dimensional echocardiography(SPRINGER WIEN, 2015) ÇİNÇİN, AHMET ALTUĞ; Atas, Halil; Kepez, Alper; Bozbay, Mehmet; Gencosmanoglu, Dilek Seckin; Cincin, Altug; Sunbul, Murat; Bozbay, Ayfer Yildiz; Darvishova, Ramila; Ergun, TulinBackground Left atrial (LA) volume has been identified as a predictor of adverse cardiovascular outcomes, both in the general population and in selected clinical conditions. The aim of this study was to evaluate the effect of psoriasis on LA volume and mechanical function. Methods A total of 40 consecutive normotensive psoriasis patients free of any cardiovascular disease and 39 healthy volunteers were included. All participants underwent comprehensive transthoracic echocardiographic examination. LA volume and mechanical function were evaluated using real-time three-dimensional echocardiography (RT3DE). Results There were no significant differences between psoriasis and control groups with regard to conventional echocardiographic parameters. Individuals with psoriasis had a higher incidence of left ventricular diastolic dysfunction (LVDD) than the controls; nine people with psoriasis (23 %) and three control individuals (8 %) had LVDD (p = 0.06). With regard to the parameters obtained from RT3DE, LA maximum, LA minimum, passive stroke volume, and passive emptying fraction were significantly higher; whereas LA active emptying fraction, LA total emptying fraction, LA expansion index, and active stroke volume values were significantly lower in individuals with psoriasis compared with controls. Disease duration and Psoriasis Area of Severity Index (PASI) score correlated with the majority of volume parameters. Conclusion Individuals with psoriasis had higher LA phasic volumes and impaired LA mechanical function compared with healthy controls. LA volume and functional analysis with RT3DE may facilitate recognition of subtle LA dysfunction in patients with psoriasis.Publication Open Access Current Approach to Phototherapy Applications in Dermatology Practice: Part 1. History, Lamps, Ultraviolet Radiation Levels Measurement and Phototherapy Modalities(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2017-03-15) SEÇKİN GENÇOSMANOĞLU, DİLEK; Gencosmanoglu, Dilek SeckinLately, important advances take place in dermatological treatment. Phototherapy, as one of the oldest treatment modalities in the history of dermatology, does not fall behind these advances; on the contrary, it is still used widely in the treatment of many skin diseases with the advantages of being effective and safe. This article aims to give practical and basic information about artificial ultraviolet sources, dosimetry and calibration standards of these sources and ultraviolet treatment protocols, starting with the history of current phototherapy modalities.Publication Open Access Atypical presentations of eosinophilic fasciitis(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2016) SALMAN, ANDAÇ; Ergun, Tulin; Seckin, Dilek; Salman, Andac; Ocak, Esra Sarac; Yucelten, Ayse Deniz; Direskeneli, Haner; Demirkesen, Cuyan; Ekinci, Gazanfer; Bayik, MahmutEosinophilic fasciitis is an uncommon connective tissue disease that may mimic and overlap with other sclerosing disorders such as morphea and lichen sclerosus. Herein, we report four patients (two men and two women, aged 16-64 yeas) with eosinophilic fasciitis. There was overlap with both morphea and lichen sclerosus in 2 patients and with morphoea alone in 1 patient. Magnetic resonance imaging (MRI) was used for diagnosis in three patients and for assessing treatment response in one patient. Eosinophilic fasciitis may co-exist with morhoea and lichen sclerosus. In view of the overlapping clinical and histopathological features of these disorders, MRI may be helful in delineating the conditions by detecting involvement of fascia.Publication Open Access Cutaneous leishmaniasis mimicking verrucous carcinoma: A case with an unusual clinical course(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2015) SALMAN, ANDAÇ; Salman, Andac; Yucelten, Ayse Deniz; Seckin, Dilek; Ergun, Tulin; Demircay, ZeynepPublication Metadata only Enhanced functional stability of plasminogen activator inhibitor-1 in patients with livedoid vasculopathy(SPRINGER, 2011) SEÇKİN GENÇOSMANOĞLU, DİLEK; Agirbasli, Mehmet; Eren, Mesut; Eren, Fatih; Murphy, Sheila B.; Serdar, Zehra A.; Seckin, Dilek; Zara, Tuba; Mat, M. Cem; Demirkesen, Cuyan; Vaughan, Douglas E.Livedoid vasculopathy (LV) is a chronic, recurrent, painful cutaneous disease with distinctive clinical features and an uncertain etiology. The skin lesions are recognizable by focal purpura, depigmentation and shallow ulcers. Thrombophilic conditions occur frequently in patients with LV. While no definitive treatment exists for LV, smoking cessation, antiplatelet therapy, immunosuppressive treatment, and anabolic steroids are often included in the therapeutic ladder. Recently, a possible link between LV and impaired fibrinolysis was established as cutaneous LV lesions responded to tissue plasminogen activator (t-PA) infusion suggesting that inhibition of the fibrinolysis through plasminogen activator inhibitor-1 (PAI-1) activity may determine the disease course in patients with LV. In this study, we investigated PAI-1 antigen (Ag) and activity levels in 20 patients with biopsy proven LV (mean age 26 +/- 11, M/F = 7/13, median disease duration 3.5 years). All patients received antiplatelet treatment with aspirin and/or dipyrimadole and 14 patients received anabolic steroids or immunosuppressive treatment. Fasting PAI-1 Ag and activity levels were measured at 9 AM in all patients. Both Ag (34 (26) ng/ml) (median (interquartile range)) and specific activity (17 (23) IU/fmole) levels of PAI-1 were moderately elevated in LV patients compared to the controls, however, PAI-1 kinetic studies demonstrated markedly enhanced stability of PAI-1 activity in plasma from patients with LV. Specific activity at 16 h was significantly higher than expected specific activity levels (7 (11) vs. 0.07 (0.09) IU/fmole, P < 0.01). While the exact mechanism of increased stability of PAI-1 activity is not known, it may be due to post-translational modifications or increased binding affinity for a stabilizing cofactor. In conclusion, enhanced stability of PAI-1 may contribute to the pathophysiology of LV, and systemic or local treatment with PAI-1 inhibitors may offer a potential treatment alternative in patients with LV.
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