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Öğe Artificial nail modelling systems in healthcare workers: An emerging risk of contact sensitization to a well-known occupational allergen in an alternative way(Wiley, 2024) Keskinkaya, Zeynep; Mermutlu, Selda Isik; Kaya, Ozge; Cakir, HaileBackground: Artificial nail modelling systems (ANMS) pose a significant risk for nail stylists and their clients regarding acrylate sensitization, which might jeopardize the use of acrylate-containing medical devices. Objectives: To evaluate the frequency of artificial nail practices among female healthcare workers (HCWs) compared with controls and assess ANMS-related side effects. Methods: In this comparative, cross-sectional, single-centre study, a face-to-face interview with 200 female HCWs and 200 age-matched female dermatology patients (controls) was conducted regarding the use of ANMS between March and November 2023. Results: Among 400 participants (median age: 25), 85 (21.3%) have applied ANMS at least once. The prevalence of ANMS application was significantly higher in HCWs (n = 54/200, 27%) compared with controls (n = 31/200, 15.5%) (p < 0.05). Long-lasting nail polish was the most commonly preferred technique (n = 82/85, 96.5%). ANMS were mainly performed in nail studios by nail stylists (n = 79/85, 92.9%), while three participants were using home kits. Nail brittleness was the most frequently reported side effect (n = 19/85, 22.4%). No case of allergic contact dermatitis (ACD) was detected. Conclusions: The popularity of ANMS among young female HCWs is growing. This striking trend might further put these individuals not only at risk of medical device-related adverse events but also occupational ACD.Öğe 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, HaileObjective: 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.Öğe EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS OF HIDRADENITIS SUPPURATIVA PATIENTS: 10-YEAR EXPERIENCE FROM A SINGLE TERTIARY CENTER(Istanbul Univ, Fac Medicine, Publ Off, 2023) Mermutlu, Selda Isik; Keskinkaya, ZeynepObjective: To investigate the clinico-epidemiological profile of hidradenitis suppurativa (HS) patients.Material and Method: In this retrospective cross-sectional single tertiary center study, the HS patients diagnosed and/or followed up between 2012-2022 were evaluated regarding demographic features, clinical findings, associated comorbidities, therapies initiated for HS and their outcomes.Results: Of 101 HS patients (male:female ratio=1.7:1), 23.3% (n=20) had a history of early-onset disease (<18 years). The majority had no family history of HS (82.7%, n=62). The patients were classified according to disease severity as Hurley I (33.7%, n=34), Hurley II (46.5%, n=47) and Hurley III (19.8%, n=20). Patients with early-onset disease and Hurley III HS had a significantly higher number of affected anatomical sites (p<0.05). The axillary region was the most commonly involved anatomical site (n=78), followed by the inguinal (n=57) and gluteal regions (n=23). Sixty-four patients (74.4%) were overweight/obese, and 84.5% (n=71) were current or ex-smokers. Acne vulgaris was the main dermatological comorbidity associated with HS (n=23). Pilonidal sinus disease was present in 25.5% (n=25). Patients with Hurley III HS presented with significantly higher rates of pilonidal sinus disease and involvement of the gluteal and perianal regions (p<0.05). Nineteen patients were diagnosed with metabolic syndrome. Systemic antibiotics were the most frequently prescribed first-line agents. Hidradenitis Suppurativa Clinical Response (HiSCR) achievement was observed most frequently with biologics, particularly adalimumab.Conclusion: In line with the current literature, HS poses an increased disease burden with its associated comorbidities. The predominance of the male sex and the anatomical involvement patterns seen in our HS patients are compatible with previously reported Turkish series. Pilonidal sinus disease and involvement of the gluteal and perianal regions in HS patients are important signs of severe disease, also highlighted in recent studies. The biologic agents seem to be the best therapeutic option for achieving HiSCR, especially in severe HS forms.Öğe 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 OguzIntroduction: 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.Öğe Evaluation of Serum Tumor Necrosis Factor-alpha-Induced Adipose-Associated Protein (TIARP/STEAP4) Level and Its Association with Disease Activity in Patients with Psoriasis: ASingle-Center Prospective Comparative Study(Galenos Publ House, 2024) Kaya, Ozge; Keskinkaya, Zeynep; Sehitoglu, Muserref Hilal; Mermutlu, Selda Isik; Kilic, Sevilay OguzAim: Tumor necrosis factor-alpha (TNF-alpha)-induced adipose-associated protein (TIARP/STEAP4) is a protective metalloreductase against oxidative stress that is induced by various proinflammatory cytokines, including TNF-alpha and interleukin-17. This study aimed to evaluate whether STEAP4 is elevated in patients with psoriasis and whether it is associated with disease activity. Materials and Methods: In this prospective cross-sectional single-center study, serum STEAP4 levels measured by the ELISA method in serum samples collected from psoriasis patients and healthy individuals. The association between STEAP4 levels and demographic characteristics and clinical findings in patients with psoriasis was further evaluated. Results: Forty-one psoriasis patients with a female: male ratio of 1:1 and a median age of 44 years and 40 controls were included in the study. The median STEAP4 level of the patients with psoriasis (9.25) was significantly higher than that of the control group (1.04) (P < 0.001). Although STEAP4 levels did not differ significantly in patients with psoriasis regarding sex, joint, and nail involvement, no significant correlation was found with age, age at disease onset, disease duration, and severity. Conclusion: The high levels of STEAP4 detected in patients with psoriasis might reflect its anti-inflammatory effects on Th-1 and Th-17 responses and on neutrophil and macrophage infiltration. On the other hand, a possible genetic variation or defect at the receptor level for STEAP4 in patients with psoriasis might hamper an adequate anti-inflammatory effect and lead to increased STEAP4 expression as a compensation mechanism. The present study not only indicates that STEAP4 might play a role in the pathogenesis of psoriasis but also suggests potential implications for its role in treatment and follow-up, which offers a promising direction for further investigation.Öğe 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, SevgiIntroduction: 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.Öğe Maculopapular Eruption in COVID-19 Patients: A Single-Center Comparative Study(Galenos Publ House, 2025) Kaya, Ozge; Alkan, Sevil; Mermutlu, Selda Isik; Cinpolat, Havva Yasemin; Kilic, Sevilay OguzAim: Maculopapular eruption (MPE) due to the coronavirus disease 2019 (COVID-19) is increasingly reported. This study aimed to evaluate COVID-19 patients presenting with MPE and compare them with COVID-19 patients without MPE. Materials and Methods: COVID-19 patients with and without MPE followed up in a single tertiary center between March 2020 and December 2020 were assessed and compared in terms of demographic characteristics, clinical and laboratory findings. Results: A total of 114 COVID-19 patients (female: male ratio=0.4: 1, mean age: 51.44 +/- 16.62 years) confirmed by total polymerase chain reaction testing were evaluated. Patients with MPE during COVID-19 (n=44) and patients without MPE during COVID-19 (n= 70) were divided into two groups and compared. Among clinical findings, the incidence of fever, myalgia, anosmi and ageusia, rhinorrhea, and/or nasal congestion was significantly higher in COVID-19 patients with MPE. In terms of laboratory findings, creatinine, alkaline phosphatase (ALP), gamma-glutamyl transferase, lactate dehydrogenase, vitamin D, erythrocyte sedimentation rate, procalcitonin, ferritin, fibrinogen median levels were significantly higher in COVID-19 patients with MPE. In complete blood count, median hemoglobin, red blood cell, monocyte, eosinophil, and basophil counts were also significantly higher in the MPE group. In the multivariate logistic regression model, ALP was independently associated with MPE in COVID-19 patients (odds ratio: 1.099, 95% confidence interval: 1.056-1.144, p<0.00). Conclusion: The MPE in COVID-19 patients may be indicative of increased inflammation and organ damage. Early diagnosis and isolation of these patients and close follow-up are crucial in reducing the risk of organ damage and severe disease. In addition, ALP is an important laboratory parameter related to MPE in COVID-19 patients.Öğe 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 IsikPurpose: 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 CSUÖğe Predicting the Speed of Response to Omalizumab in Chronic Spontaneous Urticaria(Karger, 2024) Keskinkaya, Zeynep; Kaya, Ozge; Mermutlu, Selda Isik; Ogretmen, ZerrinIntroduction: Two distinct chronic spontaneous urticaria (CSU) endotypes, IgE-mediated autoallergic and IgG-mediated autoimmune, were defined based on the response patterns to omalizumab. However, the coexistence of IgE and IgG autoantibodies in a subset of patients might complicate the prediction of the treatment outcomes. This study aimed to evaluate the effectiveness and safety of omalizumab in CSU patients, focusing on the factors predicting the response patterns. Methods: This was a retrospective cross-sectional single-center study investigating CSU patients treated with omalizumab for at least 6 months between September 2015 and February 2023. Patients were evaluated regarding demographics, clinical findings, baseline laboratory parameters, treatment outcomes, and side effects. Early and late responders were defined depending on the time for response, within or after 3 months, respectively. Results: Among 82 patients, 75 (91.5%) responded to omalizumab during the first 6 months, classified as early (n = 51) and late responders (n = 24). The IgG anti-thyroid peroxidase (anti-TPO)/total IgE ratio was an independent predictor for determining the speed of response (p < 0.05). Of 29 patients who discontinued omalizumab, 19 (65.5%) experienced relapse with a good response to retreatment (n = 18/19, 94.7%). Early responders relapsed more frequently than late responders (77.3% vs. 28.6%) (p < 0.05). Only mild side effects were observed in a minority of patients (n = 8/82, 9.8%). Conclusion: Omalizumab is an effective and safe treatment in CSU. The IgG anti-TPO/total IgE ratio seems a valuable tool to predict the early and late responders, the former having a higher possibility of relapse upon drug withdrawal.
