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    Association between stasis dermatitis and length of stay in heart failure hospitalizations
    (Wolters Kluwer Medknow Publications, 2020) Kaya, Ozge; Sahin, Anil; Kaya, Hakki
    Background: Stasis dermatitis (SD) is caused by venous hypertension that can be associated with peripheral congestion due to heart failure (HF). Length of stay (LOS) is the primary driver of HF hospitalization costs. Therefore, it is important to determine those patients who will have longer LOS. We aimed to investigate the relationship between the SD and LOS in HF patients. Methods: A total of 308 patients, who were hospitalized between January 2012 and January 2014 due to acute decompensated HF (ADHF) in our center, were evaluated in this retrospective observational cohort study. Patients' baseline clinical characteristics and presence of SD diagnosis within the past 3 months prior the HF hospitalization were assessed by a review of cardiology and dermatology clinics medical records. Results: A total of 237, acutely decompensated, HF patients were enrolled in the study. The median LOS was 5 days, and the mean LOS was 5.4 ± 2 days. Prolonged LOS was defined as LOS >5 days, and the patients were classified into two groups: Those with LOS ?5 days (Group I) and those with LOS >5 days (Group II, longer LOS). The presence of SD diagnosis was higher in Group II compared to patients in Group I (22% vs. 46%, P < 0.001). In the multivariate logistic regression model, presence of SD diagnosis, presence of moderate-to-severe tricuspid regurgitation, presence of atrial fibrillation, left atrial diameter, creatinine level, sodium level remained associated with longer LOS after adjustment for age, gender and for the variables found to be statistically significant in univariate analysis and correlated with LOS. Conclusions: This was the first time in the literature that a study demonstrated that the presence of SD was associated with an increased the risk of prolonged hospitalization independent of other factors in patients with reduced ejection fraction heart failure admitted for ADHF. © 2020 Society of Cardiovascular Academy. All rights reserved.
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    COVID-19 Among Patients with Psoriasis: A Single-Center Retrospective Cross-Sectional Study
    (Doc Design Informatics Co Ltd, 2023) Kaya, Ozge; Keskinkaya, Zeynep; Mermutlu, Selda Isik; Kilic, Sevilay Oguz; Cakir, Haile
    Objective: Psoriasis patients may have been affected by COVID-19 differently than the nor-mal population due to using different types of treatments, including immunosuppressive agents and biological therapies, the probability of lower effectiveness, and different side effects of the vaccines. This study aimed to evaluate the epidemiologic and clinical features of COVID-19 and the effect of the psoriasis treatment on it. Materials and Methods: Psoriasis patients followed up in our clinic between March 2020 and July 2022 were evaluated in terms of clinicodemographic characteristics, treatment methods, and COVID-19 vaccination status and compared regarding COVID-19 history. Results: A total of 110 patients (female:male ratio=1:1.2) with a mean age of 45.6 +/- 14.3 years were evaluated. Thirty patients (27.2%) developed COVID-19 during psoriasis treatment. Unvaccinated patients had COVID-19 (6/11, 55%) more frequently than vaccinated ones (24/99, 24%), but it was not statistically significant (p=0.067). Although patients who re-ceived biological therapy were also more frequently infected with SARS-CoV-2 than pa-tients who received other types of therapies (18/53 [34%] versus 12/57 [21%], respectively), the difference was again not statistically significant. A patient with hypertension using acitretin was hospitalized for pulmonary involvement because of COVID-19. No exacerba-tion of psoriasis was observed in patients who developed COVID-19, while psoriasis flares occurred following COVID-19 mRNA vaccination in two patients. Conclusion: Patients with psoriasis should get vaccinated against COVID-19, as vaccination prevents the disease and does not result in serious side effects. Although using biological agents for the treatment of psoriasis could be related to a higher risk of getting COVID-19, these agents do not increase the risk of severe COVID-19. Therefore, they may be beneficial in reducing the risk of both psoriasis exacerbations and severe COVID-19 due to the cy-tokine storm among patients using biological for psoriasis. However, large-scale and con-trolled studies are needed to support our conclusions.
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    EPICARDIAL FAT THICKNESS INCREASE IN PATIENTS WITH SEBORRHEIC DERMATITIS AS A CLINICAL BIOMARKER OF CARDIO-METABOLIC RISK
    (Termedia Publishing House Ltd, 2023) Kaya, Ozge; Kaya, Hakki
    Background. Seborrheic dermatitis (SD) can be associated with cardiometabolic conditions. This study aimed to evaluate epicardial fat thickness (EFT), a marker of cardiometabolic disease, in SD patients.Material and methods. In this cross-sectional and observational study, 90 patients with SD and 50 age-and sex-matched control subjects were evaluated for echocardiographic EFT and metabolic profile data.Results. Systolic blood pressure, heart rate, high sensitive C-reactive protein, monocyte count and EFT were found to be significantly higher in the SD group (53 female; mean age, 39.3 +/- 13.3 years) compared to the control group (34 female; mean age, 39.9 +/- 13.4 years). In the multivariate logistic regression analysis, the EFT and heart rate were found to be independently associated with SD. Additionally, in the multivariate linear regression analysis including the parameters correlated with EFT and the parameters associated with EFT at the p<0.001 level in univariate analysis; BMI (beta: 0.341, p<0.001) and SD disease duration (beta: 0.435, p<0.001), as well as seborrheic dermatitis area and severity index (beta: 0.177, p=0.037) were found to be independently associated with EFT.Conclusions. EFT is increased in patients with SD and was also found to be independently associated with SD. Prolonged and severe SD may be a dermatological sign regarding cardiometabolic disease.
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    Evaluation of Clinical and Laboratory Findings of COVID-19 Patients with Dermatological Involvements: A Single-Center Retrospective Cross-Sectional Study
    (Bilimsel Tip Yayinevi, 2023) Kaya, Ozge; Alkan, Sevil; Keskinkaya, Zeynep; Cinpolat, Yasemin Havva; Mermutlu, Selda Isik; Kilic, Sevilay Oguz
    Introduction: Cutaneous manifestations of the coronavirus disease-2019 (COVID-19) are increasingly reported, with their incidence and pathophysiological mechanisms yet to be clarified. The aim of this study was to evaluate COVID-19 patients presenting with dermatological involvement.Materials and Methods: COVID-19 patients with dermatological involvements followed up in a single tertiary center between August 2020 and August 2021 were assessed in terms of demographic characteristics, clinical and laboratory findings, and treatment methods.Results: A total of 65 patients (female:male ratio= 0.4:1, mean age= 59.7 +/- 18.2 years) were evaluated. The dermatological involvements due to COVID-19 were maculopapular rash (n= 49, 75.4%), urticaria (n= 9, 13.8%), herpes zoster (HZ) (n= 6, 9.2%), and pernio (n= 1, 1.5%). In COVID-19 patients with dermatological involvements pulmonary involvement rate was 96.9%. The most common accompanying symptoms were anosmia (n= 47, 72.3%) and ageusia (n= 43, 66.2%), The mean time between the first COVID-19 symptom and the onset of dermatological involvement was 3.3 +/- 1.2 days, and the mean time to regression of the lesions was 3.2 +/- 1.8 days.Conclusion: Anosmia, ageusia, and pulmonary involvement were common findings especially in patients with maculopapular rash and HZ, probably due to increased inflammation and cytokine storm. The assessment of anosmia and ageusia, especially in patients presenting with maculopapular rash and HZ, may help early recognition of COVID-19 cases. In addition, it should be predicted that individuals with this combination may have a higher risk of pulmonary involvement and disease severity and necessary precautions should be taken during the early stages.
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    Evaluation of the quality, reliability, and popularity of Turkish YouTube videos on acne treatment
    (Galenos Publ House, 2022) Kaya, Ozge; Solak, Sezgi Sarikaya
    Background and Design: Social media is extremely popular for obtaining information on dermatological diseases and their treatments. The present study aimed to evaluate Turkish YouTube videos on acne treatment and compare them in terms of quality, reliability, and popularity based on the upload source.Materials and Methods: The first 120 Turkish YouTube videos on acne treatments were reviewed. The number of views, likes, dislikes, comments, video age, and video length were recorded. The quality and reliability of the videos were evaluated with the video power index (VPI). Then, the findings were compared based on the upload source.Results: A total of 104 videos uploaded by 52 physicians and 52 non-physicians (female: male ratio: 3.3:1) were assessed in this study. The DISCERN Score and Global Quality Score (GQS) were higher in the physicians' group (n=52, 50%) (p<0.001). The number of views, likes, dislikes, comments and VPI were significantly higher in the non-physicians group. The time elapsed since the upload day was longer in the videos uploaded by physicians, and the video duration was longer in the videos uploaded by non-physicians (p<0.001). The DISCERN and GQS in videos uploaded by dermatologists (n=30, 54%) were higher (p<0.001) than in those uploaded by non-dermatologists (n=22, 46%). No statistically significant difference was found in other findings.Conclusion: This study's findings confirmed that Turkish YouTube videos on acne treatment uploaded by doctors, especially dermatologists, were of higher quality and reliable, albeit with lower viewing rates and popularity.
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    Long-Term Omalizumab Therapy in Patients with Chronic Spontaneous Urticaria: Does it Increase the Risk of COVID-19?
    (Mattioli 1885, 2023) Kaya, Ozge; Keskinkaya, Zeynep; Mermutlu, Selda Isik; Kilic, Sevilay Oguz; Ozturk, Sevgi
    Introduction: Based on the existing literature, omalizumab (OMZ) is considered a safe treatment modality in chronic spontaneous urticaria (CSU) during the coronavirus disease 19 (COVID-19) era. Objectives: The aim of this study is to evaluate the effects of OMZ on CSU patients regarding COVID-19 infection. Methods: In this retrospective study, files of CSU patients using OMZ during the COVID-19 pandemic were reviewed in terms of demographic features, medical history including COVID-19 vaccination status, clinical characteristics, pretreatment laboratory parameters, duration, and dosing regimen of OMZ treatment. Patients with a history of COVID-19 infection while on OMZ therapy and patients without COVID-19 history were compared with respect to these parameters. The urticaria activations following COVID-19 infection or vaccination were also recorded. Results: Sixty-eight patients with CSU (female:male ratio = 1.8:1; mean age = 47.2 +/- 15.1 years) continued to receive OMZ treatment. The median duration of OMZ treatment was 12 months (range: 6-60). Twelve patients (17.6%) were diagnosed with COVID-19 showing no exacerbation in urticaria. The duration of OMZ treatment was significantly higher in the group with COVID-19 infection history compared to patients with no history of COVID-19 (P = 0.01). Among 51 patients (75%) vaccinated against COVID-19, urticaria activation occurred in 4 patients without any recurrence following booster vaccinations. Conclusions: Considering the likelihood of increased COVID-19 infection risk in the setting of long-term OMZ in CSU patients, the duration of OMZ therapy might be kept at a minimum, or a temporary interruption of the treatment period might be preferred, particularly in high-risk patients regarding COVID-19.
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    MONOCYTE-TO-HDL CHOLESTEROL RATIO AS A NEW PARAMETER OF SYSTEMIC INFLAMMATION AND DISEASE SEVERITY IN TREATMENT-RESISTANT CHRONIC SPONTANEOUS URTICARIA
    (Dokuz Eylul Univ Inst Health Sciences, 2023) Kaya, Ozge; Mermutlu, Selda Isik
    Purpose: Chronic spontaneous urticaria (CSU) is characterized by inflammation and increased oxidative stress in its pathogenesis. The study aims to evaluate new inflammatory markers indicating systemic inflammation in resistant CSU and to determine their relationship with disease activity. Material and Methods: The files of CSU patients and matched healthy volunteers were reviewed and compared in terms of demographics, medical history, clinical features, laboratory parameters, and new inflammatory markers [NLR:neutrophil-lymphocyte ratio, MLR: monocyte-lymphocyte ratio, MHR:monocyte-to-high-density lipoprotein cholesterol (HDL-C)]. Results: Sixty-one CSU patients and 50 healthy controls were evaluated (female: male ratio=1.9:1, mean age=43.97 +/- 14.88 years). The median erythrocyte sedimentation rate, C-reactive protein (CRP), white blood cell, monocyte count, and MHR were higher in the CSU group; in contrast, the mean HDL-C level was lower. The median NLR and MLR were also higher in the CSU group but were not statistically significant. There was a positive correlation between urticaria activity score 7 (UAS7) and MHR and a negative correlation between UAS 7 and HDL-C. MHR was positively correlated with MLR, CRP, and UAS7. Conclusion: MHR might serve as an indicator of inflammation intensity and predisposition to MS in CSU patients. It might also be used as an objective tool for evaluating disease severity and treatment response in CSU
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    The role of salusins and interleukin 12 family in the rosacea pathogenesis
    (Wolters Kluwer Medknow Publications, 2023) Demir, Nesrin; Kaya, Ozge; Keskinkaya, Zeynep; Oguz Kilic, Sevilay; Ekinci, Alper; Karadeli, Umit
    Aim: Salusins and recently discovered interleukin (IL)-12 family members (IL-35 and IL-39) have been investigated in various disorders associated with chronic inflammation. The aim of this study was to evaluate the roles of salusin-alpha (alpha), salusin-beta (beta), IL-35, and IL-39 in the pathogenesis of rosacea. Methods: This study is a single-center, prospective case-control study performed in a tertiary healthcare institution. Salusin-alpha, salusin-beta, IL-35, and IL-39 were analyzed by enzyme-linked immunosorbent assay method from venous blood of 50 rosacea patients who did not receive any treatment and 50 age-matched healthy controls, and the test results were compared between the two groups as statistically. Results: Patients in the rosacea group (female:male ratio = 1.9:1; median age: 56 years) had significantly higher mean salusin-alpha, IL-35, and IL-39 levels compared with the control group (female:male ratio = 2.1:1; median age: 41 years). There was no statistically significant difference between the two groups in terms of salusin-beta levels. Conclusion: The increased vascularity and Th1-mediated inflammation might be possible explanations for the elevated salusin-alpha and IL-39 levels in rosacea patients. On the other hand, the higher mean IL-35 level detected in the same group was an unexpected finding due to the immunosuppressive effect of the cytokine. Recently, targeted therapies have become popular in many inflammatory diseases. In this context, salusins, IL-35, and IL-39 seem to be possible molecules that could be modified for therapeutic reasons in the future in the treatment of rosacea.