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Öğe Aleksitimi, Ruminasyon ve Stresle Başa Çıkmanın Psöriyazis ile İlişkisi ve Psöriyazis Kliniğine Etkisi(2020) Baysak, Sevim; Kılıç, Fatma Arzu; Karagün, Ebru; Baysak, ErkanAmaç: Psöriyazis hastalığında, psöriyatik plaklarda artış ile stres arasındailişki olduğu gösterilmiştir. Psöriyazis, ayrıca yüksek aleksitimi düzeylerive stres ile de ilişkilidir. Depresyon ve çeşitli psikiyatrik hastalıklarda,ruminasyon ile hem hastalığın başlaması hem de süreğenleşmesiarasında ilişki olduğu bildirilmiştir. Bu çalışmada stresle ilişkili diğer birfaktör olan ruminasyon incelenmiştir.Yöntem: 96 psöriyazis hastası ve 93 sağlıklı kontrol çalışmaya alınmıştır.Katılımcıların tamamına Sosyodemografik Veri Formu, TorontoAleksitimi Ölçeği, Stresle Başa Çıkma Tarzları Ölçeği, RuminatifDüşünme Biçimi Ölçeği ve Hastane Anksiyete Depresyon Ölçeğiuygulanmıştır. Hasta grubunda, psöriyatik plaklarda son 1 ayda artışolup olmadığı klinisyen tarafından kayıt altına alınmıştır.Bulgular: Hem hasta hem de kontrol grubunda ruminasyon puanlarıile aleksitimi puanları (hasta grubu, r=0,47; p<0,01; kontrol grubu,r=0,38; p<0,01) ve çaresiz stresle başa çıkma tarzı puanları (hasta grubu,r=0,56; p<0,01; kontrol grubu, r=0,57; p<0,01) arasında anlamlı ilişkisaptanmıştır. Depresyon ve anksiyete puanları kontrol edildiğinde hastagrubunda, ruminasyon puanları ile duyguları tanıma güçlüğü puanları(r=0,42; p<0,01), duyguları ifade güçlüğü puanları (r=0,25; p<0,05) veçaresiz stresle başa çıkma becerileri puanları (r=0,41; p<0,01) arasındapozitif yönde anlamlı ilişki olduğu görülmüştür. Depresyon ve anksiyetepuanları kontrol edildiğinde kontrol grubunda ise ruminasyon düzeyiile duyguları tanıma güçlüğü puanları (r=0,27; p<0,05) ve çaresiz streslebaşa çıkma becerileri puanları (r=0,42; p<0,01) arasında pozitif yöndeanlamlı ilişki olduğu görülmüştür. Psöriyatik plaklarda son 1 ayda artışolan ve olmayan hastalar karşılaştırıldığında, ruminasyon puanları(p<0,01), duyguları ifade etmede güçlük puanları (p<0,05) ve toplamaleksitimi puanları (p<0,05) arasında anlamlı fark olduğu saptanmıştır.Sonuç: Psöriyaziste aleksitimi ve pasif stresle başa çıkma tarzlarınınruminasyon ile ilişkisi hastalık seyrini etkiliyor olabilir.Öğe Assesment of acne vulgaris patients’ attention tests during the isotretinoin treatment(2020) Karagün, EbruBackground and Design: This study aimed to investigate any relationship between an emerging attention deficit in patients with acne vulgarisand have reached cumulative doses under isotretinoin treatment.Materials and Methods: A total of 100 patients (aged 16-40 years) with acne vulgaris who have reached cumulative doses under isotretinoinmedication for over a period of 6 months were included in the study. Using the Stroop Color and Word Test (SCWT), attention was assessedin the patients at the beginning and 3rd and 6th month of the treatment.Results: A repeated measures ANOVA analysis was performed to determine whether there was any change in the SCWT results over timeafter the first dose and 3rd and 6th month of the treatment. The changes in all SCWT results were statistically significant with respect to time.The time required for each task assessed by means of the SCWT was found to be significantly reduced over time.Conclusion: After evaluating the results of the SCWT performed at the beginning and 3rd and 6th month of the treatment, it was concludedthat the treatment with the cumulative doses of isotretinoin was not significantly associated with any emerging attention deficit symptoms orsigns in patients with acne vulgaris. It is possible that the patients were trained during the SCWT with the repeated performances in the study,which may have resulted a significant decrease in the test duration. This prospective study suggests that there is no casual relationship betweenthe use of isotretinoin and attention deficit in patients with acne vulgaris.Öğe Atypically Located Basal Cell Carcinoma: Three Case Reports(2020) Karagün, Ebru; Gamsızkan, Mehmet; Eyup, Yavuz; Bahcivan, Atike; Özcan, Yunus; Buyucek, SeymaBasal cell carcinoma (BCC) is the most common malignant tumor in humans. It can be seen anywhere in the skin,although more than 80% occurs in areas exposed to the sun, such as the head and neck. Chronic exposure to sunlight is thought to bethe main etiological factor. Although the risk of metastasis in BCC is very low, the tumor may be locally aggressive and cause tissuedestruction. We present three cases of BCC in atypical locations, the waist region, the lateral femoral region, and the perinealregion. No predisposing factor in terms of etiology of BCC was encountered in these patients’ histories. We are presenting ourcases, together with a discussion of the current literature, to emphasize that BCC should be considered even in atypically locatedlesions.Öğe CD123 immunoexpression in cutaneous lupus erythematosus, polymorphous light eruption, pityriasis rosea, and mycosis fungoides(Termedia Publishing House Ltd, 2021) Karagün, Ebru; Gamsızkan, Mehmet; Büyücek, Şeyma; Coşkun, SinemIntroduction: CD123-positive plasmacytoid dendrocytes are prominent in the infiltrate of cutaneous lupus erythematous. Aim: To determine the significance of the CD123 immunostain, which labels plasmacytoid dendritic cells (PDC), in cutaneous lupus erythematous (CLE), polymorphous light eruption (PLE), pityriasis rosea (PR) and mycosis fungoides Material and methods: A total of 76 cases, including MF (n = 27), CLE (n = 19), PR (n = 19), and PLE (n = 11), were included in the study after reviewing their diagnostic clinical features and pathologic findings. The primary antibody against CD123 was performed in all cases. Results: CD123+ immunostaining in PDCs was positive in all cases. The highest mean percentage was noted in CLE (15.2%), followed by PLE (15%), PR (8.8%), and MF (2%). Besides, the clustering of CD123-positive cells was significant in CLE and PLE compared to MF and PR. Conclusions: PDC may have an important role in the aetiology of PLE and CLE cases. CD123 is a useful marker for differentiating CLE and PLE from MF and PR.Öğe Çocukluk Çağı Herpes Zoster Enfeksiyonu: Retrospektif Çalışma(2019) Karagün, EbruAmaç: Varisella zoster virüsünün neden olduğu herpes zoster (HZ), çocukluk çağında nadirdir. Bu çalışmada dermatoloji polikliniğine başvuran ve HZ tanısı alan 0-12 yaş arasındaki çocukların demografik özellikleri, klinik bulguları ve komplikasyonlarının incelenmesi amaçlanmıştır.Yöntemler: Mart 2014-Kasım 2015 tarihleri arasında dermatoloji polikliniğine başvuran ve HZ tanısı konulan 12 yaşından küçük hastaların verileri retrospektif olarak incelendi. Hastalar yaş, cinsiyet, geçirilmiş varisella öyküsü, varisella aşısı, klinik bulgular, eşlik eden hastalık, komplikasyon gelişimi ve tedavi açısından değerlendirildi.Bulgular: Kırk sekiz hastanın 22’sini kız, 26’sını erkek hastalar oluşturmaktaydı. Ortalama yaş 5,9’du. Hastalardan 5’i 0-1 yaş aralığındaydı. Tutulum dağılımında kraniyal: 4 hasta, servikal: 9 hasta, torakal: 14 hasta, lumbosakral: 17 hasta, femoral: 4 hasta mevcuttu. En belirgin şikayet yanma-batma-kaşıntı hissiydi. İki hastada gelişen Ramsay-Hunt sendromu dışında komplikasyon gelişen hasta yoktu, hiçbir hastada postherpetik nevralji gelişmedi.Sonuç: HZ her yaşta görülebilen fakat çocukluk çağında nadir görülen bir hastalıktır. İmmünosüpresyon önemli predispozan faktör iken sağlıklı çocuklarda da görülebildiği, klinik özelliklerinden sakral ve servikal tutulumun çocukluk çağında daha sık olabildiği ve postherpetik nevralji riskinin çok nadir olduğu tespit edilmiştir.Öğe Demographic findings of patients diagnosed with pernio and comparison of their vitamin B12, folate and ferritin levels with a control group(2019) Karagün, Ebru; Baysak, SevimBackground and Design: Pernio is an inflammatory disease that occurs in the acral regions of the body after exposure to cold. The studyaimed to investigate the demographic findings of patients diagnosed with pernio and to determine the role of vitamin B12, folate and ferritinvalues in the pathogenesis of pernio.Materials and Methods: This study was conducted in pernio patients diagnosed at the Ağrı State Hospital, Dermatology Outpatient Clinic(Ağrı, Turkey) between September 2015 and April 2016. The healthy control group participants were of similar age and gender. Vitamin B12,folate and ferritin levels were compared between the groups.Results: The patient and control groups were similar in age and gender. Vitamin B12 and ferritin levels were significantly lower in the patientgroup (p<0.05). Folate levels did not differ significantly between the groups (p>0.05).Conclusion: According to the data obtained from our study, when the demographic findings of the pernio patients were compared with thosein the literature, the results were found to be similar. In the patients with pernio, it is likely that low Vitamin B12 was involved in the pernioetiology via the mechanism of vasoconstriction/vasodilatationÖğe Dermatological Side-Effects Developing in Patients Using Targeted Chemotherapy Drugs: A Review of the Literature(2020) Karagün, Ebru; Eşbah, OnurObjectives: Numerous dermatological side-effects are reported with the use of targeted therapies. These adverseevents derive from common signaling pathways implicated in malignant behavior and normal homeostatic activity ofboth the epidermis and dermis.Methods: Patients under follow-up at the Oncology Clinic 12 using bevacizumab, five cetuximab, four sunitinib, foursorafenib, three panitumumab, one pazopanib, one trastuzumab, and one using vemurafenib, were included in thestudy. Patients’ cutaneous drug side-effects were assessed at dermatological examinations before starting treatmentand at months 1, 3, and 6 during treatment.Results: The most common finding was xerosis, seen in 54% (17/31) of our patients receiving targeted treatment.Papulopustular eruption was observed in 63% (12/19) of patients using epidermal growth factor receptor inhibitors.The most common finding in the nails was brittleness-tenderness. Dry mouth was prominent among the mucositisfindings. The four patients with nosebleeds were using antiangiogenesis agents. Papulopustular eruptions emergedin the first month, xerosis in the second and third, dry mouth in the third, and pyogenic granuloma, nail findings, andnosebleeds in the fourth to sixth months.Conclusion: Dermatological side-effects can impact on the patient’s quality of life and cause significant morbidity.Dermatologists and oncologists should therefore collaborate closely to manage these side-effects.Öğe Dermatopathological Correlation of Clinically Challenging Cutaneous Lesions: a Single Center Experience of 2184 Cases(Mattioli 1885, 2022) Özcan, Yunus; Özlü, Emin; Karagün, Ebru; Uyar, Belkız; Gamsızkan, MehmetIntroduction: Although a trained eye can easily identify typical skin lesions, histopathological exam-ABSTRACT ination and clinicopathological correlation are critical in challenging cases. Objectives: The primary objective is to organize the final diagnoses reached following clinicopathological consensus in clinically challenging cutaneous lesions, identifying the most common diagnostic scenarios encountered by dermatopathologists and discussing their diverse differentials submitted by clinicians. The secondary objective is to investigate how the case profile and clinician decision-making processes evolved during the COVID-19 pandemic. Methods: Skin and mucosa samples collected by the dermatology department between 2016 and 2020 were classified based on pathology reports. For frequent diagnoses, preliminary diagnoses stated by clinicians on pathology requisition forms were reviewed. The years preceding and following the first nationally reported COVID-19 case were compared to investigate the pandemic’s impact on the distribution of dermatology and dermatopathology cases. Results: One thousand nine hundred and eighty-nine reports were classified into 4 major categories: inflammatory (49.8%), neoplastic (30.1%), other diseases (7.1%), and non-diagnostic (12.8%). We further classified inflammatory diseases based on major tissue reaction patterns and neoplasms based on cell origin. We analyzed the leading diagnoses in each category, discussed their differential diagnoses, and provided clinicians with clues to reduce errors in practice. Following the pandemic, the overall number of pathology reports and patient admissions dropped dramatically, with significant changes in case profiles. Conclusions: We presented and discussed the frequently encountered confounding cases to sketch the diagnostic landscape. In the authors’ experience, clinicopathological correlation can increase the rate of reaching the diagnosis by up to 75.3%. © 2022 Ozcan et al.Öğe The Effect of Isotretinoin-Induced Myalgia on Daily Quality of Life and Evaluation of Serum Creatine Phosphokinase Levels(2019) Karagün, EbruObjective: The aim of this study was to evaluate the effect of themyalgia observed as a side effect of isotretinoin used for severeand treatment-resistant moderate acne on patient quality of lifeand to investigate the relationship between serum creatinephosphokinase (CPK) levels and myalgia in these patients.Materials and Methods: Two hundred and sixteen patients whoare between the ages of 15 and 40 presenting to the outpatientclinic were included in the study. During isotretinoin treatment,the effect of muscle pain on the daily quality of life of patientswith myalgia was evaluated according to the myalgia severity level(0:N/A; 1:Significant in the morning but not preventing normalactivity during the day; 2:Affecting normal activity during the day;3:Preventing normal daily activities). CPK levels of patients werescreened retrospectively from their files.Results: Of the 216 patients included in the study, 124 werefemale, 92 were male and the mean age was 24±5.3. Myalgia wasdetected in 48% of the patients (n: 104). Of the patientsdiagnosed with myalgia, 61.5% (n: 64) were classified as 1, 32.6%(n: 34) as 2 and 5.7% as 3. Serum CPK levels were elevated in30.7% (n: 32) of the 104 myalgia patients.Conclusion: Myalgia is a common side effect that can be seen innearly half of patients during isotretinoin use. It was determinedthat the myalgia observed during isotretinoin use was at atolerable level and had no significant effect on the daily quality oflife. No correlation was found between myalgia and serum CPKlevels.Öğe Erken Evre Lyme Hastalığı Tanısı Konulan İki Olgu Sunumu(2019) Karagün, Ebru; Özcan, YunusLyme hastalığı, ixodes türü keneler tarafından taşınan bir spiroket olan Borrelia burgdorferi’ninneden olduğu multisistemik enfeksiyöz bir hastalıktır. Yaz aylarında sık görülmektedir. Kırsalve ormanlık alanlarda yaşayanlarda risk daha fazladır. Klinik bulgular enfeksiyonun seyriboyunca evrelere göre değişmektedir. Lyme hastalığının erken tanısı deri bulgularının tanınmasınabağlıdır ki tüm hastaların yaklaşık %60-80’i deri bulguları göstermektedir. Başlıca kutanöz işaretide eritema migranstır. Serolojik testler klinik tanının desteklenmesi için kullanılabilmektedir.Erken dönemde teşhis edilebilirse tamamıyla tedavi edilebilen bir hastalıktır, tedavi edilmemiş hastalardakronik artrit ve ciddi nörolojik bulgular ortaya çıkabilmektedir. Tedavide ilk seçenek, doksisiklinve amoksisilindir. Bu çalışmada, eritema migrans tanısı konularak serolojik olarakdoğrulanmış iki erken lokalize Lyme olgumuz, Batı Karadeniz Bölgesi’nin endemik olduğunu belirtmekve sık görülmeyen hastalığı tekrar hatırlatmak amacıyla sunulmuştur.Öğe Extended nasolabial flap for reconstruction of a complex nasal tip and columella defect in an elderly polymorbid patient(OrtadogŸu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2018) Karagün, EbruHomozygous familial hypercholesterolemia is a rare autosomal dominant disorder with a rate of 1/1.000.000. The main defect in familial hypercholesterolemia is related to the low-density lipoprotein receptor located in the short arm of chromosome 19. These defects include a reduction in the number of resultant low-density lipoprotein receptors or a total absence, or alternatively, a defective receptor construction.These defects lead to tendon and skin xanthomas, early-onset coronary artery disease and myocardial infarction-related deaths due to excessive accumulation of low-density lipoprotein cholesterol in the plasma. It s the first finding xanthomas are know. Coronary artery disease can be prevented with early diagnosis. Here we present a case of familial homozygous hypercholesterolemia diagnosed by xanthomastia at 3 years of age and the etiopathogenesis, diagnosis and treatment of the disease are reviewed in the light of the literature. Copyright © 2018 by Türkiye Klinikleri.Öğe Keratoconus Could Be Associated With Psoriasis: Novel Findings From a Comparative Study(Lippincott Williams & Wilkins, 2019) Akçam, Hanife Tuba; Karagün, Ebru; İritaş, İlter; Eyüp, YavuzPurpose: To explore the relationship between keratoconus (KC) and psoriasis. Methods: One hundred ten eyes of 55 patients with psoriasis (study group, SG) and 110 eyes of age-sex-matched 55 healthy volunteers (control group, CG) were included in the study. All cases underwent a detailed dermatological and ophthalmological examination including corneal topography. Moreover, Psoriasis Area and Severity Index (PAST) scoring of the patients was carried out in the SG. A thorough comparison of pachymetric, aberrometric, and topometric values between the groups was performed, and the results were interpreted. A chi(2) test, Mann-Whitney U test, and Pearson correlation test were used for statistical assessment. Results: Although the average Kmax (44.6 in the SG; 44.5 in the CG; P = 0.613) and Belin/Ambrnsio enhanced ectasia total deviation value (1.34 in SG; 1.20 in CG; P = 0.880) were similar between the groups, the mean index of vertical asymmetry value in the SG (0.14 mm) was significantly higher than that in the CG (0.11 mm) (P = 0.041). Moreover, 28 eyes from 16 patients with psoriasis were found to be associated with KC because 26 of those 28 eyes were KC suspects and 2 of them were definite KC. A positive correlation was found among topometric parameters, especially between duration of the disease and PASI score. A negative correlation was discovered between topometric parameters and the early beginning of psoriasis. Conclusions: Serious changes in topography maps may occur in psoriatic patients. The changes were found to be more evident in the presence of a higher PAST score and the early beginning and longer duration of the disease. The results hinted a potential relationship between psoriasis and KC.Öğe Myoclonic Astatic Resistant Epilepsy and Disproportionate Overgrowth Carrying a Duplication in 2q13 and Deletion in the 6p21.32 Chromosomal Regions(Coll Physicians & Surgeons Pakistan, 2022) Turay, Sevim; Eröz, Recep; Karagün, EbruCopy number variants have been increasing due to a rise in the availability of array comparative genomic hybridisation, which occupies an important place in diagnosis, especially in patients with epilepsy, dysmorphic findings, and intellectual disability. We detected 2q13 chromosomal duplication and 6p21.32 chromosomal deletion in a patient under follow-up due to epilepsy, developmental retardation, dysmorphic findings, and asymmetric overgrowth in our clinic since the age of six months. The parents had only 2q13 mutations. Copy number variation in 2q13 is associated with dysmorphic findings, psychiatric disorders, and developmental delays. However, the exact pathogenicity is not yet known. We think that 6p21.32 chromosomal deletion caused resistant epilepsy and lipodystrophy in this patient. We anticipate that this case will contribute to the literature by linking disorders caused by the current chromosomal abnormality to clinical findings.Öğe Platelet-rich plasma administration to the lower anterior vaginal wall to improve female sexuality satisfaction(Galenos Yayincilik, 2019) Sukgen, Gökmen; Kaya, Aşkı Ellibeş; Karagün, Ebru; Çalışkan, ErayObjective: To investigate the effect of platelet-rich plasma (PRP) injection to the lower one-third of the anterior vaginal wall on sexual function, orgasm, and genital perception in women with sexual dysfunction. Materials and Methods: Four sessions of PRP were administered to the anterior vaginal wall of 52 female patients with sexual dysfunction and orgasmic disorder [Female Sexual Function Index (FSFI) total score <= 26 orgasmic subdomain score <= 3.75]. Prior to the PRP administrations in each session, the FSFI validated in Turkish, the Female Genital Self-Image Scale (FGSIS), the Female Sexual Distress Scale-Revised (FSDS-R), and Rosenberg's Self-Esteem Scale were used and in the final follow-up, and the Patient Global Impression of Improvement (PGI-I) was performed and the results were analyzed. Results: Following the application of the PRP, the total FSFI score was observed as 27.88 +/- 4.80 and the total score was 26 and above in 50% of the patients (p<0.001). Orgasm subdomain scores were found as 2.11 +/- 1.20 before the PRP treatment and 4.48 +/- 1.14 afterwards (p<0.001). A significant change was observed in all sub-domains after PRP and it was observed that this change started after the first administration (p<0.001). A statistically significant increase was determined in FGSIS genital perception scores, which was significant between the and 2nd months (p<0.001). The FSDS-R scores showed a minimal increase in stress scores as the application number increased, but a statistically significant decrease was observed in the 4th administration (p<0.001). No statistically significant difference was found in Rosenberg Scale scores before and after treatment (p=0.389). High satisfaction was found in PGI-I scores. Conclusion: As a minimally invasive method, PRP administration to the distal anterior vaginal wall may improve female sexuality with high satisfaction.Öğe Prevalence of Obstructive Sleep Apnea Syndrome in Psoriasis Patients(2019) Karagün, Ebru; Balbay, Ege GüleçAim: Psoriasis is a frequently seen chronic systemic inflammatory disease accompanied byseveral comorbid conditions that affects 2-3% of the general population. One of thecomorbidities rarely accompanying psoriasis is obstructive sleep apnea syndrome (OSAS).OSAS is a disease characterized by recurrent complete (apnea) or partial (hypopnea) upperairway obstruction episodes and frequently by decreased blood oxygen saturation. The purposeof this study was to evaluate the risk factors for OSAS by investigating OSAS symptoms inpsoriasis patients.Material and Methods: Eighty-two patients aged over 16, diagnosed with psoriasis, and underfollow-up by the Duzce University Medical of Faculty, Dermatology and Venereal DiseasesPolyclinic, Turkey, were included in the study. Patients’ OSAS symptoms were investigated.The Epworth Sleepiness Scale was used to assess excessive daytime somnolence.Results: Of the patients 51.2% (n=42) were male and 48.8% (n=40) female. Patients’ meanage was 47.09±14.10 years. Patients’ mean time of psoriasis diagnosis was 16.97±10.55 years,and mean Psoriatic Area Severity Index (PASI) score was 11.25±6.32. Severe disease waspresent in 54.9% of patients (n=45) based on PASI classification. Prevalence of 56.1% forsnoring, 25.6% for excessive daytime sleepiness, and 15.9% for witnessed apnea weredetermined in these patients. Forty-seven (57.3%) cases had at least one major symptom. Themost common minor symptoms were inability to sleep with 25.6% (n=21) and insufficientdisrupted sleep with 22.0% (n=18).Conclusion: Prevalence of OSAS symptoms in psoriasis patients were found high. Psoriasispatients with OSAS symptoms must be referred to relevant specialists for polysomnographicevaluation.Öğe Psoriazis Hastalarında Sistemik Tedavinin Hematolojik Parametreler Üzerine Etkisi(2019) Karagün, EbruAmaç: Nötrofil lenfosit oranı (NLO)- Trombosit lenfosit oranı (TLO), eritrosit dağılım değişikliği (RDW) , ortalama trombosit hacmi (OTH) düzeyleri sistemik inflamasyonun bir göstergesi olabileceği ve birçok kardiyovasküler hastalık, maliniteler, romatolojik hastalıklar, enfeksiyon hastalıklarında prognoz ve mortalite ile ilişkili olabileceği son yıllarda yapılan çalışmalarda gösterilmiştir. Bu çalışmanın amacı sistemik kronik inflamatuar bir hastalık olan psoriazis hastalarının sistemik tedavi öncesi ve tedavinin 12. haftasında PAŞİ(Psoriatik Alan Şiddet İndeksi)75 değerine ulaşan hastalarda Lökosit, Nötrofil, Trombosit, NLO, TLO, OTH ve RDW düzeylerindeki değişimi incelemektir. Gereç ve Yöntem: Metotreksat(Mtx)- Siklosporin- Asitretin- dbUVB- İnfiksimab ve Adalimumab tedavisi başlanan kronik plak psoriazisli 60 hastanın hematolojik parametreleri incelenmiştir. Tedavi öncesinde ve tedavinin 12. haftasında PAŞİ75 değerine ulaşan hastaların Lökosit, Nötrofil, Trombosit, NLO, TLO, OTH ve RDW düzeyleri değerlendirilmiştir. Bulgular: Hastaların başlangıç PAŞİ değerleri 16,68±6,5 (Min:6,6,Max:29,6). Tedavi sonrası lökosit, nötrofil ve trombosit ortalamaları tedavi öncesi ortalamalara göre anlamlı derecede düşüş gösterirken (p=0,01; p<0,001; p<0,001), tedavi öncesi ve sonrası lenfosit, OTH ve RDW ortalamaları arasında istatistiksel olarak anlamlı bir farklılık gözlenmemiştir(her biri için p>0,05). Tedavi sonrası NLO ve TLO ortalamaları tedavi öncesi ortalamalara göre istatistiksel olarak düşük bulunmuştur (p=0,043; p=0,009). Tedavi seçeneklerine göre tedavi öncesi ve sonrası ortalamalar karşılaştırıldığında MTX nötrofil, trombosit ve RDW üzerine etkili olmuşken, Asitretin ve Siklosporin nötrofil ve OTH üzerine etkili olmuştur. dbUVB tedavisi verilen hastalarda tedavi öncesi ve tedavi sonrası ortalamalar arasında anlamlı farklılık gözlenmemiştir. Sonuç: NLO ve TLO düzeylerinin tedavi sonrasında anlamlı farklılık göstermesi literatürde yapılan çalışmalarla benzerlik göstermektedir. Çalışmada verilen sistemik tedavi ajanlarından kardiyovasküler risk belirteçleri olarak bilinen hematolojik parametreler üzerine en etkili ilacın Mtx olabileceği düşünülmektedir.Öğe Sjögren’s syndrome and catastrophic antiphospholipid syndrome with severe skin involvement(2020) Karagün, Ebru; Öneç, Birgül; Akbaş, Türkay; Gamsızkan, MehmetCatastrophic antiphospholipid syndrome is a rare butrapidly progressing form of antiphospholipid antibodysyndrome with high mortality. The syndrome causesmultiorgan failure associated with diffuse microthromboses. Necrotic-appearing ecchymotic lesionsemerging from the distal aspect of both lower extremitiesand progressing to the upper leg region, and to the upperextremities developed in a 58-year-old woman.Histopathological examination of the biopsy specimenrevealed intravascular microthrombi in the dermis.Laboratory findings for anti-cardiolipin antibodies IgMand lupus anticoagulant resulted positive. Lung and kidneyinvolvement was observed. The clinical course progressedvery quickly, and catastrophic antiphospholipid syndromewas diagnosed with these findings. Two-thirds ofcatastrophic antiphospholipid syndrome cases developdue to secondary causes, the most common beinginfections. Catastrophic antiphospholipid syndrome mayalso accompany autoimmune diseases, particularlysystemic lupus erythematosus. This report is presented toemphasize that Sjögren's syndrome should be consideredin the etiology of catastrophic antiphospholipid syndrome
