Person: SEÇKİN GENÇOSMANOĞLU, DİLEK
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SEÇKİN GENÇOSMANOĞLU
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DİLEK
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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 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 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.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 risk of tuberculosis in patients with psoriasis treated with anti-tumor necrosis factor agents(WILEY-BLACKWELL, 2015) SEÇKİN GENÇOSMANOĞLU, DİLEK; Ergun, Tulin; Seckin, Dilek; Bulbul, Emel Baskan; Onsun, Nahide; Ozgen, Zuleyha; Unalan, Pemra; Alpsoy, Erkan; Karakurt, SaitBackgroundTumor necrosis factor-alpha (TNF-) antagonist treatment is associated with 1.6 to 27 times higher risk of tuberculosis (TB). ObjectiveTo find TB incidence of psoriasis patients treated with TNF- antagonists and define risk factors related with this condition in a country with moderately high risk of TB. MethodsThree hundred seventy psoriasis patients treated by anti-TNF agents in four referral centers were included. The data on the characteristics of the patients, TB history, tuberculosis skin test results, anti-TNF agent type and exposure time, localization of TB, and isoniazide prophylaxis state were analyzed. ResultsFour patients (1.08%) developed TB, three pulmonary and one gastrointestinal, 2-23months after initiating anti-TNF agents. Other than the patient with gastrointestinal TB, who was using methotrexate and corticosteroid concomitantly, none had contributing risk factors for TB. Two patients developed pulmonary TB in spite of chemoprophylaxis. Three patients with pulmonary TB completely recovered following antiTB treatment whereas patients with gastroinrestinal TB developed renal failure. LimitationsThe major limitation of the study is the lack of a diseased control group, which enables us to compare the risk of psoriatics with that of patients having other inflammatory diseases. ConclusionTuberculosis is a rare but a severe complication of anti-TNF treatment and may develop in spite of chemoprophylaxis. The risk of TB in psoriasis patients in the present study is comparable to literature mostly based on rheumatology patients.Publication Open Access Mesalazine-induced bullous fixed drug eruption(WILEY) SALMAN, ANDAÇ; Salman, Andac; Gencosmanoglu, Dilek Seckin; Alahdab, Yesim O.; Gimenez-Arnau, Ana M.Publication Metadata only Patient's perspective: an important issue not to be overlooked in assessing acne severity(JOHN LIBBEY EUROTEXT LTD, 2008) SEÇKİN GENÇOSMANOĞLU, DİLEK; Demircay, Zeynep; Seckin, Dilek; Senol, Asli; Demir, FigenAcne has significant negative effects on an individual's psychosocial. functions. There is not always a correlation between the severity of acne and its impact on quality of life. Our objective was to evaluate the correlation between quality of life scales and both the physician's and patient's assessments of acne severity and to find out which quality of life scale is more sensitive to changes in acne severity by using generic and acne specific scales. One hundred and twenty acne patients were enrolled. The physician's assessment of acne severity was made by means of Global Acne Grading System. Patients evaluated their acne severity on a 10-point Likert-type scale. Quality of life was measured by the Turkish version of Acne Quality of Life (AQOL) scale and Short Form-36 (SF-36). One hundred and seven patients answered the questions of the AQOL scale completely and were included in the statistical analysis. The AQOL scale did not correlate with the physician's assessment of acne severity whereas there was a correlation between patients' self assessments and AQOL scale. No correlation was found between SF-36 and either the physician's or patients' own assessments. Assessment of acne should not be limited to objective acne severity measures but also include patients' self assessments and acne specific quality of life scales. These measures, which provide a better understanding of patients' perception of severity, are important tools when taking treatment decisions.