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Öğe Cutaneous findings in patients with primary Sjogren's syndrome(Springer, 2007) Soy, Mehmet; Piskin, SueleymanSjogren's syndrome (SS) is an autoimmune disease that is characterized by exocrine gland involvement. It is reported that the skin is affected in nearly half of SS patients. Cutaneous manifestations consist of xerosis, angular cheilitis, eyelid dermatitis, pruritus, cutaneous vasculitis (frequently manifesting as palpable purpura), and erythema annulare. Most of them are nonspecific and less severe than the oral, ocular, or musculoskeletal symptoms. We present two patients with primary SS who have many cutaneous manifestations including erythema annulare and pernio-like lesions and review the literature about this topic.Öğe CUTANEOUS INFECTION CAUSED BY ALTERNARIA ALTERNATA IN AN IMMUNOCOMPETENT HOST(Ankara Microbiology Soc, 2009) Guercan, Saban; Piskin, Sueleyman; Kilic, Haluk; Temelli, Baksel Ay; Yalcin, OemerHuman infections caused by Alternaria alternata are more frequently reported in immunosupressive hosts. In this report, a rarely seen cutaneous infection, caused by A.alternata in an immunocompetent patient was presented. The patient (71 years-old, male) was admitted to the dermatology unit with complaints of an erythematous and squamatous lesion of 5 cm diameter on left malleolar region. The case was evaluated as immunocompetent based on the normal serum total immunoglobulin and complement levels, anti-HIV negativity, and no known underlying disease. A number of Alternaria spp. conidia and hypha were seen in the microscopical examination of KOH treated cutaneous scrapings of the lesion obtained in two different days. Fungal cultures of the skin scrapings yielded the growth of a fungus identified as A.alternata. Although fungal elements were not detected in haematoxylene-eosin stained smears of the skin biopsy, A.alternato was again isolated in the culture of the biopsy specimen. The identification of the fungus was confirmed by a reference center (Mycology Section of Scientific Institute of Public Health, Belgium) and it was integrated to BCCM/IHEM collection under accession number IHEM 22598. Antifungal susceptibility test efforts failed due to a problem in the preparation of fungal suspension. Oral itraconazole (200 mg/day) and bifonazole cream was used for the treatment and the lesion regressed after the 19(th) day of the therapy. The treatment was continued with oral and local terbinafine for two weeks and the patient fully recovered. Since A.alternata was demonstrated both in the skin scrapings and tissue biopsy through microscopic examination and culture, it was evaluated as the causative agent of skin infection rather than colonization. This was the first A.alternato infection in an immunocompetent patient in the light of the current literature.Öğe Joint and nail involvement in Turkish patients with psoriatic arthritis(Springer Heidelberg, 2008) Soy, Mehmet; Karaca, Nuran; Umit, Elif Ufur; Bes, Cemal; Piskin, SueleymanPsoriatic arthritis is an autoimmune, chronic, systemic inflammatory disorder characterized by the association of arthritis with psoriasis. In this paper, we explore the characteristics of joint and nail involvement in Turkish patients with psoriatic arthritis. Forty patients with psoriasis (M/F, 18/22) and 49 (M/F, 25/24) subjects with psoriatic arthritis were included in the study. Clinical characteristics of the patients were recorded. The distribution of the subjects with arthritis: (according to the clinical and radiological findings): polyarticular, 65%; oligoarticular, 23%; isolated axial involvement, 7.7%; arthritis mutilans, 3.8%; sacroiliitis, 19%. Nail involvement was significantly higher among patients with arthritis; i.e., 91 versus 32%; (P < 0.05). There were no correlation between the skin involvement pattern and the arthritis type (P > 0.05). Nevertheless, no relation was observed between the psoriasis duration and arthritis (P > 0.05). Nail involvement is a frequent feature of the psoriatic arthritis which may be a useful finding for differential diagnosis of psoriatic arthritis from other inflammatory arthropathies.Öğe Multiple Red-Brown Macules in Legs of a Child(Ortadogu Ad Pres & Publ Co, 2010) Piskin, Sueleyman; Arican, Oezer; Uzunali, Erol; Yalcin, Oemer[Abstract Not Available]Öğe Susceptibility to Atherosclerosis in Patients with Psoriasis and Psoriatic Arthritis as Determined by Carotid-Femoral (Aortic) Pulse-Wave Velocity Measurement(Ediciones Doyma S A, 2009) Soy, Mehmet; Yildiz, Mustafa; Uyanik, Mehmet Sevki; Karaca, Nuran; Guefer, Goekhan; Piskin, SueleymanIntroduction and objectives. In this study we analyzed the susceptibility to atherosclerosis of patients with psoriasis and psoriatic arthritis (PsA) by determining the femoral-carotid pulse wave velocity (PWV), which is a measure of the viscoelastic properties of blood vessels. Methods. The study included 25 patients with psoriasis (age 18-63 years; 13 male), of whom nine had arthritis, as well as 39 sex- and age-matched healthy control subjects (age 24-70 years, 25 male). The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, body mass index (BMI) and waist-to-hip ratio (WHR) of all participants were recorded and, in patients, skin lesions were assessed using the psoriasis area and severity index (PASI). Arterial distensibility was determined by automatic carotid-femoral PWV measurement using the Complior Colson device. Results. Mean PWV, SBP and DBP were significantly higher in psoriatic patients than in control subjects (P=.036, P<.001, and P=.005, respectively). In PsA patients, the mean WHR, SBP, DBP and PWV were all significantly higher than in control subjects (P=.001, P=.031, P=.001, and P=.014, respectively). Conclusions. The carotid-femoral PWV is increased in patients with psoriasis and PsA.
