Background: In vivo confocal microscopy is an imaging technique that has been applied to the stud... more Background: In vivo confocal microscopy is an imaging technique that has been applied to the study of the ocular surface. However, confocal microscopes dedicated to eye examination are routinely adopted only in ophthalmology reference centres and do not allow an examination of periocular tissue, nor a fluorescence examination. Methods: We applied for the first time the two in vivo confocal microscopes commonly used in dermatology (VivaScope ® 1500 and 3000, CALIBER, distributed in Europe by Mavig GmbH, Munich, Germany) to observe the cornea, the bulbar and tarsal conjunctiva, the eyelid margin, the lacrimal punctum and the palpebral skin of healthy volunteers. Tumoral, inflammatory and infectious diseases of the ocular mucosa and periocular skin from more than 200 patients were observed under the same microscopes. Both microscopes have a reflectance mode. VivaScope ® 1500 allows an additional fluorescent examination and its placement on the ocular surface was made possible by the creation of a special interface between the microscope and the ocular apparatus. Results: Thanks to its compact and flexible configuration, the handheld camera VivaScope ® 3000 allowed to access more easily to the ocular and periocular tissues. Diagnosis of benign and malignant tumors (melanoma, squamous cell carcinoma and basal cell carcinoma), as well as infectious and genetic disease (storage diseases), could be evocated. The detection of parasites (Demodex folliculorum) on eyelids was possible. Confocal images correlated well with conventional histopathology. The fluorescence examination of corneal squamous cell carcinoma by VivaScope 1500 was characterized by extravasation of fluorescein after intravenous injection. Conclusions: Confocal microscopes dedicated to the skin offer new perspectives for the diagnosis, optimization of treatments, and follow-up of the ocular diseases. They will allow dermatologists to examine conjunctival and eyelid tumors, as it is for skin or genital mucosa. In addition, thanks to some adaptations of the dermatological device VivaScope ® 1500, it is possible for the first time to perform a fluorsecnte examination of the ocular and peri-ocular tissue, opening a new era in the clinical imaging of the ocular surface. A new semiology remains to be learned.
In vivo reflektans konfokal mikroskopi (RKM) bir deri lezyonunu biyopsi gerektirmeksizin hücresel... more In vivo reflektans konfokal mikroskopi (RKM) bir deri lezyonunu biyopsi gerektirmeksizin hücresel düzeyde değerlendirmeye imkan veren bir tanı yöntemidir. Malign ve benign deri tümörlerinin ve inflamatuvar dermatolojik hastalıkların tanı ve takibinde invaziv olmayan yüksek çözünürlüklü görüntüleme sağlar. RKM son yıllarda tüm dünyada giderek artarak kullanılmaya başlanmıştır. RKM incelemesinde kullanılan standart terminoloji İngilizce olarak tanımlanmıştır. Bu çalışmada RKM kullanımında Türkçe terminoloji oluşturarak, ülkemizdeki dermatologların ortak bir dilde iletişim kurmasını sağlamak ve bu yeni tanı tekniğinin terminolojisine aşina olunması amaçlanmıştır. RKM konusunda tecrübeli altı dermatolog çalışmaya katıldı. İngilizce'de kullanılan RKM terminolojisi belirlendi ve Türkçe'ye çevrildi. Türkçe terimler ve tanımları her katılımcı tarafından gözden geçirildi ve grupta fikir birliği sağlandı. Son olarak filoloji bölümü terimlerin son halini inceledi ve çalışma sonuçlandırıldı. Çalışmanın sonucunda terimlerin tanımlamaları ve çevirileri belirlenerek Türkçe RKM terminolojisi oluşturuldu. Terimler ve açıklamaları görseller eşliğinde tabloda gösterildi. Oluşturulan Türkçe RKM terminolojisi, Türkçe konuşan dermatologların bulgularını homojen bir dilde tanımlamalarını sağlayacaktır. Anahtar Kelimeler: Reflektans konfokal mikroskopi, terminoloji, Türkçe terminoloji In vivo reflectance confocal microscopy (RCM) is a diagnostic method to examine a skin lesion at the cellular level in vivo without biopsy. It provides non-invasive, high resolution imaging for diagnosis and follow-up of malignant, benign skin tumors and inflammatory dermatologic diseases, and its use is spreading worldwide. Standard terminology which has been used in RCM was described earlier in the English language. This study aimed to propose a Turkish terminology for RCM to allow Turkish-speaking dermatologists to communicate in a homogeneous language and familiarize themselves with the terminology of this new diagnostic technic. Six Turkish-speaking dermatologists with RCM experience participated in the study. RCM terminology used in English was determined and translated into Turkish. Turkish terms and their definitions were reviewed by each participant and the consensus was provided in the group. Finally, philology department examined the last version of the terms and the study was finalized. The terms, definitions and the translations of the terms have been identified, and the Turkish RCM terminology has been created and shown. Turkish RCM terminology will provide Turkish-speaking dermatologists to describe their findings in a homogenous language.
Fotodinamik tedavi, aktinik keratoz, Bowen hastaligi, melanom disi deri kanserleri gibi epitelyal... more Fotodinamik tedavi, aktinik keratoz, Bowen hastaligi, melanom disi deri kanserleri gibi epitelyal prekanseroz ve kanseroz lezyonlarda etkili bir tedavi yontemidir. Isiga duyarlandirici madde ile isigin etkilesimi sonucu ortaya cikan reaktif oksijen ara urunlerinin hastalikli dokuyu tahrip etmesi prensibine dayanir. Buyuk plak tipi parapsoriasis, mikozis fungoidese donusebilen bir Iezyondur. Bu calismanin amaci buyuk plak tipi parapsoriasiste fotodinamik tedavinin etkinligini saptamaktir. Calisma kontrol grubu olmayan pilot calisma olarak yapilmistir. Bu amacla 70 yasindaki plak parapsoriasisli hasta tedavi edildi. Tedavi oncesinde histopatolojik ve klinik degerlendirme yapildi. Daha sonra lezyon, yerel 5- aminolevulinik asit uygulamasini takiben inkoherent isik kaynagi ile isinlanmak suretiyie tedavi edildi. Isinlama sirasinda 580-720 nm dalga boyunda kirmizi isik bandi kullanildi. Onsekiz aylik takip sonucu rekurrens bulgusu saptanmadi.
Background: Linear porokeratosis is characterized by linear hyperkeratotic papules and annular pl... more Background: Linear porokeratosis is characterized by linear hyperkeratotic papules and annular plaques arranged along the Blaschko lines. Objective: Here we report a case of linear porokeratosis and describe the dermoscopic features for the first time. Patients/materials and methods: Dermoscopic and histopathological features of the linear porokeratosis were evaluated. Results: In this report, we point out "the variation of the dermoscopic findings of linear porokeratosis in relevance to the age of the lesions". And we described new dermoscopic features like "the gray-brown pigment network-like appearance", "the reddish vascular network" in linear porokeratosis. Conclusion: The findings of this report may help to improve the diagnosis.
Amaç: Bu çalışmada Ege Üniversitesi Hastanesi veri tabanındaki 1992-2017 yılları arası melanom ta... more Amaç: Bu çalışmada Ege Üniversitesi Hastanesi veri tabanındaki 1992-2017 yılları arası melanom tanısı alan hastaların epidemiyolojik ve genel sağ kalım özelliklerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezinin özel eğitimli ve sertifikalı kanser kayıt elemanları tarafından CANREG-4 programı ile kaydedilen 1992-2017 yılları arasında Ege Üniversitesinde kayıtlı 1530 melanom tanılı hastanın verileri toplanmıştır. Kategorik değişkenler arası ilişki varlığı Ki-Kare yöntemiyle değerlendirilirken, gruplar arası nümerik değişkenler Tek Yönlü Varyans Analizi ve Tukey HSD Testi ile karşılaştırıldı. Sağ kalım üzerine kategorik değişkenlerin etkileri Kaplan Meier ve LogRank (Mantel-Cox) yöntemleri ile incelenirken, nümerik değişkenler için Cox- Regresyon analizi kullanıldı. Tüm Hipotez testleri 0,05 önem seviyesinde uygulandı. Bulgular: Bin beş yüz otuz melanom olgusunun %53,1’i erkek, %46,9’u kadındı. Yaş ortalaması 54,14±...
Amaç: Bu çalışmada Ege Üniversitesi Hastanesi veri tabanındaki 1992-2017 yılları arası melanom dı... more Amaç: Bu çalışmada Ege Üniversitesi Hastanesi veri tabanındaki 1992-2017 yılları arası melanom dışı malign deri kanseri tanısı alan hastaların epidemiyolojik ve demografik özelliklerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezinin özel eğitimli ve sertifikalı kanser kayıt elemanları tarafından CANREG 4 programı ile kaydedilen 1992-2017 yılları arasında Ege Üniversitesinde kayıtlı 8395 melanom dışı malign deri kanseri tanılı hastanın; tanı yaşı, cinsiyeti, tümörün histopatolojik tanısı, tümör yerleşim yeri, hastalık evresi ve uygulanan tedavi yöntemleri değerlendirilmiştir. Kategorik değişkenler arası ilişki varlığı Ki-Kare yöntemiyle değerlendirilirken, gruplar arası nümerik değişkenler Kruskal Wallis ve Dunn Testi ile karşılaştırıldı. Tüm Hipotez testleri 0,05 önem seviyesinde uygulandı.
Subacute cutaneous lupus erythematosus (SCLE) is an entity characterized by widespread polycyclic... more Subacute cutaneous lupus erythematosus (SCLE) is an entity characterized by widespread polycyclic lesions that heal without scarring. Skin lesions with marked ultraviolet sensitivity are distributed in an annular and/or psoriasiform configuration. Idiopathic thrombocytopenic purpura, which is an autoimmune disease (ITP), is mediated by a destructive immunoglobulin G antibody response to the platelets' membrane components. We report a case of subacute cutaneous lupus erythematosus initially manifested as thrombocytopenia, which was diagnosed as idiopathic thrombocytopenic purpura (ITP) and treated with splenectomy. Seven months later, development of cutaneous involvement followed the diagnosis of ITP. The clinical and histological features of the lesions were compatible with SCLE. Serological evaluations showed a negative anti-nuclear antibody test and an elevated anti-SSB/La antibody level. Symptoms for systemic involvement were negative. Although the clinical features such as photosensitivity, discoid rash, and thrombocytopenia were in favor of SLE, the patient did not fulfill the criteria of the American Rheumatism Association (ARA) for SLE.
Cutaneous leishmaniasis (CL) is an intracellular parasitic infectious skin disease with a chronic... more Cutaneous leishmaniasis (CL) is an intracellular parasitic infectious skin disease with a chronic self‐limited course. In vivo reflectance confocal microscopy (RCM) findings in CL have been described in only two cases of CL. We report another case with RCM findings; however to our knowledge, this is the first demonstration of Leishmania amastigotes in RCM imaging. A centrally eroded reddish nodular lesion with a diameter of 12 mm was observed on the leg of a 36‐years‐old male with a 1‐month history. On dermoscopy, a central yellowish crust, and irregularly distributed whitish opaque structures ranging in size and shape (round to polygonal) were observed. There were also irregular vessels mostly at the center and dotted/glomerular vessels at the periphery. On RCM, mild epidermal disarray with some scattered bright cells at the basal layer was observed. At the dermis, dense infiltration of polymorphic/roundish cells with heterogeneous reflectivity was seen. These large, mildly reflecting cells with fine granular structures in their cytoplasm were compatible with macrophages. Histopathology was concordant with CL. The Leishmania amastigotes seen as cytoplasmic granularity on RCM were the clue feature for the initial diagnosis.
A 24-year-old man was admitted to our outpatient clinic with lesions in a linear configuration. O... more A 24-year-old man was admitted to our outpatient clinic with lesions in a linear configuration. On dermatologic examination, widespread, dark brown, warty papules and plaques over an erythematous base, following Blaschko's lines, extended from the middle of the chest to the right arm. These lesions had been present on the chest since birth and had gradually extended during childhood. Recently, a nodular lesion had appeared in the pre-existing epidermal nevus in the middle part of the chest (Fig. 1). The nodular lesion was totally excised by a plastic surgeon. Pathologic examination of a section stained with hematoxylin and eosin revealed acanthosis and papillomatosis, as well as numerous sebaceous glands connected to the epidermis (Fig. 2). This histologic feature was compatible with nevus sebaceous. In addition, in the middle of the section, there was a tumor connected to the epidermis. Histologically, the tumor islands, composed of basaloid cells with mostly solid growth pattern, were compatible with basal cell carcinoma. There were also some features of nevus sebaceous, characterized by papillomatosis, and sebaceous glands attached to the epidermis were seen at the edge (Fig. 3). On systemic examination, there was no other developmental abnormality, except that the patient was mildly mentally retarded. There was no family history of a neurocutaneous disorder. All laboratory analyses were within normal limits.
Pyogenic granuloma is a common, benign, vascular lesion of the skin and mucous membranes which is... more Pyogenic granuloma is a common, benign, vascular lesion of the skin and mucous membranes which is a simulator of amelanotic/hypomelanotic melanoma and other tumours. To determine the diagnostic significance of dermoscopic structures and patterns associated with pyogenic granulomas in a large series of cases. Digital dermoscopic images of histopathologically proven cases of 122 pyogenic granulomas and 140 other tumours (28 amelanotic melanomas, seven melanoma metastases, 22 basal cell carcinomas and 83 other tumours) were collected from university hospitals in Spain, Italy, Austria and Turkey. The frequency, sensitivity, specificity, positive predictive value, negative predictive value, intraobserver agreement and interobserver agreement of the dermoscopic structures and patterns associated with pyogenic granulomas were calculated. Vascular structures were observed in 45% of pyogenic granulomas (sensitivity of 45·1% and specificity of 17·9%; both P < 0·001). Seven exclusive patterns were made up from the combination of the structures 'reddish homogeneous area' (RHA), 'white collarette' (WC), 'white rail lines' (WRL) and 'vascular structures' (VS). The pattern composed of RHA, WC and WRL showed the highest sensitivity (22·1%; P < 0·001) and a specificity of 100% (P < 0·001) for pyogenic granulomas. Two other patterns (RHA + WC and RHA + WC + WRL + VS) showed 100% specificity when compared with melanoma (P < 0·001 and P < 0·05, respectively). Even though some dermoscopic patterns are useful in the recognition of pyogenic granulomas, dermoscopy is not a substitute for histology, mostly when vessels are present, as melanoma cannot be ruled out.
Regular dermatological examination for patients with dysplastic nevi is indicated. However, the l... more Regular dermatological examination for patients with dysplastic nevi is indicated. However, the literature on whether those patients should also be examined by ophthalmologists or not regarding a relation between suspicious lesions for ocular melanoma and cutaneous dysplastic nevi is limited. In this study, we aimed to compare the findings of a single ophthalmologic examination between the group of patients with multiple atypical nevi with at least one histopathologically proven dysplastic nevus and another group without atypical nevi. We examined the eyes of
Journal of The European Academy of Dermatology and Venereology, Jul 1, 2006
A case with a pigmented skin lesion that was diagnosed as a blue naevus on clinical and dermoscop... more A case with a pigmented skin lesion that was diagnosed as a blue naevus on clinical and dermoscopic grounds and histopathologically confirmed as a dermatofibroma is presented. By means of this case, we define dermatofibroma as a new exception for ‘homogeneous blue pigmentation’ on dermoscopy.
A 43-year-old man with Fitzpatrick skin type III presented to our clinic with an asymptomatic les... more A 43-year-old man with Fitzpatrick skin type III presented to our clinic with an asymptomatic lesion on the left ear that had been present for a few months. The physical examination revealed an umbilicated grayish papule that was 3 mm 3 2 mm in diameter (Fig 1, A).
Dermatofibrosarcoma protuberans is a slowly progressive, locally aggressive fibroblastic tumor wh... more Dermatofibrosarcoma protuberans is a slowly progressive, locally aggressive fibroblastic tumor which can be misdiagnosed in the early stage. Reflectance confocal microscopic features of dermatofibrosarcoma protuberans has been scarcely described in the literature. We described the dermoscopic and reflectance confocal microscopic findings of 12 × 15 cm sized tumoral lesion of 45-year-old man.
Spitzoid melanom, klinik ve histopatolojik olarak tan› konmas› oldukça güç olan nadir bir melanom... more Spitzoid melanom, klinik ve histopatolojik olarak tan› konmas› oldukça güç olan nadir bir melanom alt tipidir. Melanomun çocuklarda oldukça nadir görülmesi nedeniyle literatürde çocukluk ça¤›nda görülen Spitzoid melanomlar›n özelliklerine dair bilgi oldukça k›s›tl›d›r. Burada Spitzoid melanom saptanan 10 yafl›nda bir çocuk olgu sunulmufltur. Bu olgu vesilesiyle klinik ve dermoskopik özellikler karakteristik olmad›kça, hasta çocuk bile olsa, vasküler lezyon ay›r›c› tan›s›nda melanomun mutlaka ak›lda tutulmas› gereklili¤i vurgulanm›flt›r.
Background: In vivo confocal microscopy is an imaging technique that has been applied to the stud... more Background: In vivo confocal microscopy is an imaging technique that has been applied to the study of the ocular surface. However, confocal microscopes dedicated to eye examination are routinely adopted only in ophthalmology reference centres and do not allow an examination of periocular tissue, nor a fluorescence examination. Methods: We applied for the first time the two in vivo confocal microscopes commonly used in dermatology (VivaScope ® 1500 and 3000, CALIBER, distributed in Europe by Mavig GmbH, Munich, Germany) to observe the cornea, the bulbar and tarsal conjunctiva, the eyelid margin, the lacrimal punctum and the palpebral skin of healthy volunteers. Tumoral, inflammatory and infectious diseases of the ocular mucosa and periocular skin from more than 200 patients were observed under the same microscopes. Both microscopes have a reflectance mode. VivaScope ® 1500 allows an additional fluorescent examination and its placement on the ocular surface was made possible by the creation of a special interface between the microscope and the ocular apparatus. Results: Thanks to its compact and flexible configuration, the handheld camera VivaScope ® 3000 allowed to access more easily to the ocular and periocular tissues. Diagnosis of benign and malignant tumors (melanoma, squamous cell carcinoma and basal cell carcinoma), as well as infectious and genetic disease (storage diseases), could be evocated. The detection of parasites (Demodex folliculorum) on eyelids was possible. Confocal images correlated well with conventional histopathology. The fluorescence examination of corneal squamous cell carcinoma by VivaScope 1500 was characterized by extravasation of fluorescein after intravenous injection. Conclusions: Confocal microscopes dedicated to the skin offer new perspectives for the diagnosis, optimization of treatments, and follow-up of the ocular diseases. They will allow dermatologists to examine conjunctival and eyelid tumors, as it is for skin or genital mucosa. In addition, thanks to some adaptations of the dermatological device VivaScope ® 1500, it is possible for the first time to perform a fluorsecnte examination of the ocular and peri-ocular tissue, opening a new era in the clinical imaging of the ocular surface. A new semiology remains to be learned.
In vivo reflektans konfokal mikroskopi (RKM) bir deri lezyonunu biyopsi gerektirmeksizin hücresel... more In vivo reflektans konfokal mikroskopi (RKM) bir deri lezyonunu biyopsi gerektirmeksizin hücresel düzeyde değerlendirmeye imkan veren bir tanı yöntemidir. Malign ve benign deri tümörlerinin ve inflamatuvar dermatolojik hastalıkların tanı ve takibinde invaziv olmayan yüksek çözünürlüklü görüntüleme sağlar. RKM son yıllarda tüm dünyada giderek artarak kullanılmaya başlanmıştır. RKM incelemesinde kullanılan standart terminoloji İngilizce olarak tanımlanmıştır. Bu çalışmada RKM kullanımında Türkçe terminoloji oluşturarak, ülkemizdeki dermatologların ortak bir dilde iletişim kurmasını sağlamak ve bu yeni tanı tekniğinin terminolojisine aşina olunması amaçlanmıştır. RKM konusunda tecrübeli altı dermatolog çalışmaya katıldı. İngilizce'de kullanılan RKM terminolojisi belirlendi ve Türkçe'ye çevrildi. Türkçe terimler ve tanımları her katılımcı tarafından gözden geçirildi ve grupta fikir birliği sağlandı. Son olarak filoloji bölümü terimlerin son halini inceledi ve çalışma sonuçlandırıldı. Çalışmanın sonucunda terimlerin tanımlamaları ve çevirileri belirlenerek Türkçe RKM terminolojisi oluşturuldu. Terimler ve açıklamaları görseller eşliğinde tabloda gösterildi. Oluşturulan Türkçe RKM terminolojisi, Türkçe konuşan dermatologların bulgularını homojen bir dilde tanımlamalarını sağlayacaktır. Anahtar Kelimeler: Reflektans konfokal mikroskopi, terminoloji, Türkçe terminoloji In vivo reflectance confocal microscopy (RCM) is a diagnostic method to examine a skin lesion at the cellular level in vivo without biopsy. It provides non-invasive, high resolution imaging for diagnosis and follow-up of malignant, benign skin tumors and inflammatory dermatologic diseases, and its use is spreading worldwide. Standard terminology which has been used in RCM was described earlier in the English language. This study aimed to propose a Turkish terminology for RCM to allow Turkish-speaking dermatologists to communicate in a homogeneous language and familiarize themselves with the terminology of this new diagnostic technic. Six Turkish-speaking dermatologists with RCM experience participated in the study. RCM terminology used in English was determined and translated into Turkish. Turkish terms and their definitions were reviewed by each participant and the consensus was provided in the group. Finally, philology department examined the last version of the terms and the study was finalized. The terms, definitions and the translations of the terms have been identified, and the Turkish RCM terminology has been created and shown. Turkish RCM terminology will provide Turkish-speaking dermatologists to describe their findings in a homogenous language.
Fotodinamik tedavi, aktinik keratoz, Bowen hastaligi, melanom disi deri kanserleri gibi epitelyal... more Fotodinamik tedavi, aktinik keratoz, Bowen hastaligi, melanom disi deri kanserleri gibi epitelyal prekanseroz ve kanseroz lezyonlarda etkili bir tedavi yontemidir. Isiga duyarlandirici madde ile isigin etkilesimi sonucu ortaya cikan reaktif oksijen ara urunlerinin hastalikli dokuyu tahrip etmesi prensibine dayanir. Buyuk plak tipi parapsoriasis, mikozis fungoidese donusebilen bir Iezyondur. Bu calismanin amaci buyuk plak tipi parapsoriasiste fotodinamik tedavinin etkinligini saptamaktir. Calisma kontrol grubu olmayan pilot calisma olarak yapilmistir. Bu amacla 70 yasindaki plak parapsoriasisli hasta tedavi edildi. Tedavi oncesinde histopatolojik ve klinik degerlendirme yapildi. Daha sonra lezyon, yerel 5- aminolevulinik asit uygulamasini takiben inkoherent isik kaynagi ile isinlanmak suretiyie tedavi edildi. Isinlama sirasinda 580-720 nm dalga boyunda kirmizi isik bandi kullanildi. Onsekiz aylik takip sonucu rekurrens bulgusu saptanmadi.
Background: Linear porokeratosis is characterized by linear hyperkeratotic papules and annular pl... more Background: Linear porokeratosis is characterized by linear hyperkeratotic papules and annular plaques arranged along the Blaschko lines. Objective: Here we report a case of linear porokeratosis and describe the dermoscopic features for the first time. Patients/materials and methods: Dermoscopic and histopathological features of the linear porokeratosis were evaluated. Results: In this report, we point out "the variation of the dermoscopic findings of linear porokeratosis in relevance to the age of the lesions". And we described new dermoscopic features like "the gray-brown pigment network-like appearance", "the reddish vascular network" in linear porokeratosis. Conclusion: The findings of this report may help to improve the diagnosis.
Amaç: Bu çalışmada Ege Üniversitesi Hastanesi veri tabanındaki 1992-2017 yılları arası melanom ta... more Amaç: Bu çalışmada Ege Üniversitesi Hastanesi veri tabanındaki 1992-2017 yılları arası melanom tanısı alan hastaların epidemiyolojik ve genel sağ kalım özelliklerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezinin özel eğitimli ve sertifikalı kanser kayıt elemanları tarafından CANREG-4 programı ile kaydedilen 1992-2017 yılları arasında Ege Üniversitesinde kayıtlı 1530 melanom tanılı hastanın verileri toplanmıştır. Kategorik değişkenler arası ilişki varlığı Ki-Kare yöntemiyle değerlendirilirken, gruplar arası nümerik değişkenler Tek Yönlü Varyans Analizi ve Tukey HSD Testi ile karşılaştırıldı. Sağ kalım üzerine kategorik değişkenlerin etkileri Kaplan Meier ve LogRank (Mantel-Cox) yöntemleri ile incelenirken, nümerik değişkenler için Cox- Regresyon analizi kullanıldı. Tüm Hipotez testleri 0,05 önem seviyesinde uygulandı. Bulgular: Bin beş yüz otuz melanom olgusunun %53,1’i erkek, %46,9’u kadındı. Yaş ortalaması 54,14±...
Amaç: Bu çalışmada Ege Üniversitesi Hastanesi veri tabanındaki 1992-2017 yılları arası melanom dı... more Amaç: Bu çalışmada Ege Üniversitesi Hastanesi veri tabanındaki 1992-2017 yılları arası melanom dışı malign deri kanseri tanısı alan hastaların epidemiyolojik ve demografik özelliklerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezinin özel eğitimli ve sertifikalı kanser kayıt elemanları tarafından CANREG 4 programı ile kaydedilen 1992-2017 yılları arasında Ege Üniversitesinde kayıtlı 8395 melanom dışı malign deri kanseri tanılı hastanın; tanı yaşı, cinsiyeti, tümörün histopatolojik tanısı, tümör yerleşim yeri, hastalık evresi ve uygulanan tedavi yöntemleri değerlendirilmiştir. Kategorik değişkenler arası ilişki varlığı Ki-Kare yöntemiyle değerlendirilirken, gruplar arası nümerik değişkenler Kruskal Wallis ve Dunn Testi ile karşılaştırıldı. Tüm Hipotez testleri 0,05 önem seviyesinde uygulandı.
Subacute cutaneous lupus erythematosus (SCLE) is an entity characterized by widespread polycyclic... more Subacute cutaneous lupus erythematosus (SCLE) is an entity characterized by widespread polycyclic lesions that heal without scarring. Skin lesions with marked ultraviolet sensitivity are distributed in an annular and/or psoriasiform configuration. Idiopathic thrombocytopenic purpura, which is an autoimmune disease (ITP), is mediated by a destructive immunoglobulin G antibody response to the platelets' membrane components. We report a case of subacute cutaneous lupus erythematosus initially manifested as thrombocytopenia, which was diagnosed as idiopathic thrombocytopenic purpura (ITP) and treated with splenectomy. Seven months later, development of cutaneous involvement followed the diagnosis of ITP. The clinical and histological features of the lesions were compatible with SCLE. Serological evaluations showed a negative anti-nuclear antibody test and an elevated anti-SSB/La antibody level. Symptoms for systemic involvement were negative. Although the clinical features such as photosensitivity, discoid rash, and thrombocytopenia were in favor of SLE, the patient did not fulfill the criteria of the American Rheumatism Association (ARA) for SLE.
Cutaneous leishmaniasis (CL) is an intracellular parasitic infectious skin disease with a chronic... more Cutaneous leishmaniasis (CL) is an intracellular parasitic infectious skin disease with a chronic self‐limited course. In vivo reflectance confocal microscopy (RCM) findings in CL have been described in only two cases of CL. We report another case with RCM findings; however to our knowledge, this is the first demonstration of Leishmania amastigotes in RCM imaging. A centrally eroded reddish nodular lesion with a diameter of 12 mm was observed on the leg of a 36‐years‐old male with a 1‐month history. On dermoscopy, a central yellowish crust, and irregularly distributed whitish opaque structures ranging in size and shape (round to polygonal) were observed. There were also irregular vessels mostly at the center and dotted/glomerular vessels at the periphery. On RCM, mild epidermal disarray with some scattered bright cells at the basal layer was observed. At the dermis, dense infiltration of polymorphic/roundish cells with heterogeneous reflectivity was seen. These large, mildly reflecting cells with fine granular structures in their cytoplasm were compatible with macrophages. Histopathology was concordant with CL. The Leishmania amastigotes seen as cytoplasmic granularity on RCM were the clue feature for the initial diagnosis.
A 24-year-old man was admitted to our outpatient clinic with lesions in a linear configuration. O... more A 24-year-old man was admitted to our outpatient clinic with lesions in a linear configuration. On dermatologic examination, widespread, dark brown, warty papules and plaques over an erythematous base, following Blaschko's lines, extended from the middle of the chest to the right arm. These lesions had been present on the chest since birth and had gradually extended during childhood. Recently, a nodular lesion had appeared in the pre-existing epidermal nevus in the middle part of the chest (Fig. 1). The nodular lesion was totally excised by a plastic surgeon. Pathologic examination of a section stained with hematoxylin and eosin revealed acanthosis and papillomatosis, as well as numerous sebaceous glands connected to the epidermis (Fig. 2). This histologic feature was compatible with nevus sebaceous. In addition, in the middle of the section, there was a tumor connected to the epidermis. Histologically, the tumor islands, composed of basaloid cells with mostly solid growth pattern, were compatible with basal cell carcinoma. There were also some features of nevus sebaceous, characterized by papillomatosis, and sebaceous glands attached to the epidermis were seen at the edge (Fig. 3). On systemic examination, there was no other developmental abnormality, except that the patient was mildly mentally retarded. There was no family history of a neurocutaneous disorder. All laboratory analyses were within normal limits.
Pyogenic granuloma is a common, benign, vascular lesion of the skin and mucous membranes which is... more Pyogenic granuloma is a common, benign, vascular lesion of the skin and mucous membranes which is a simulator of amelanotic/hypomelanotic melanoma and other tumours. To determine the diagnostic significance of dermoscopic structures and patterns associated with pyogenic granulomas in a large series of cases. Digital dermoscopic images of histopathologically proven cases of 122 pyogenic granulomas and 140 other tumours (28 amelanotic melanomas, seven melanoma metastases, 22 basal cell carcinomas and 83 other tumours) were collected from university hospitals in Spain, Italy, Austria and Turkey. The frequency, sensitivity, specificity, positive predictive value, negative predictive value, intraobserver agreement and interobserver agreement of the dermoscopic structures and patterns associated with pyogenic granulomas were calculated. Vascular structures were observed in 45% of pyogenic granulomas (sensitivity of 45·1% and specificity of 17·9%; both P < 0·001). Seven exclusive patterns were made up from the combination of the structures 'reddish homogeneous area' (RHA), 'white collarette' (WC), 'white rail lines' (WRL) and 'vascular structures' (VS). The pattern composed of RHA, WC and WRL showed the highest sensitivity (22·1%; P < 0·001) and a specificity of 100% (P < 0·001) for pyogenic granulomas. Two other patterns (RHA + WC and RHA + WC + WRL + VS) showed 100% specificity when compared with melanoma (P < 0·001 and P < 0·05, respectively). Even though some dermoscopic patterns are useful in the recognition of pyogenic granulomas, dermoscopy is not a substitute for histology, mostly when vessels are present, as melanoma cannot be ruled out.
Regular dermatological examination for patients with dysplastic nevi is indicated. However, the l... more Regular dermatological examination for patients with dysplastic nevi is indicated. However, the literature on whether those patients should also be examined by ophthalmologists or not regarding a relation between suspicious lesions for ocular melanoma and cutaneous dysplastic nevi is limited. In this study, we aimed to compare the findings of a single ophthalmologic examination between the group of patients with multiple atypical nevi with at least one histopathologically proven dysplastic nevus and another group without atypical nevi. We examined the eyes of
Journal of The European Academy of Dermatology and Venereology, Jul 1, 2006
A case with a pigmented skin lesion that was diagnosed as a blue naevus on clinical and dermoscop... more A case with a pigmented skin lesion that was diagnosed as a blue naevus on clinical and dermoscopic grounds and histopathologically confirmed as a dermatofibroma is presented. By means of this case, we define dermatofibroma as a new exception for ‘homogeneous blue pigmentation’ on dermoscopy.
A 43-year-old man with Fitzpatrick skin type III presented to our clinic with an asymptomatic les... more A 43-year-old man with Fitzpatrick skin type III presented to our clinic with an asymptomatic lesion on the left ear that had been present for a few months. The physical examination revealed an umbilicated grayish papule that was 3 mm 3 2 mm in diameter (Fig 1, A).
Dermatofibrosarcoma protuberans is a slowly progressive, locally aggressive fibroblastic tumor wh... more Dermatofibrosarcoma protuberans is a slowly progressive, locally aggressive fibroblastic tumor which can be misdiagnosed in the early stage. Reflectance confocal microscopic features of dermatofibrosarcoma protuberans has been scarcely described in the literature. We described the dermoscopic and reflectance confocal microscopic findings of 12 × 15 cm sized tumoral lesion of 45-year-old man.
Spitzoid melanom, klinik ve histopatolojik olarak tan› konmas› oldukça güç olan nadir bir melanom... more Spitzoid melanom, klinik ve histopatolojik olarak tan› konmas› oldukça güç olan nadir bir melanom alt tipidir. Melanomun çocuklarda oldukça nadir görülmesi nedeniyle literatürde çocukluk ça¤›nda görülen Spitzoid melanomlar›n özelliklerine dair bilgi oldukça k›s›tl›d›r. Burada Spitzoid melanom saptanan 10 yafl›nda bir çocuk olgu sunulmufltur. Bu olgu vesilesiyle klinik ve dermoskopik özellikler karakteristik olmad›kça, hasta çocuk bile olsa, vasküler lezyon ay›r›c› tan›s›nda melanomun mutlaka ak›lda tutulmas› gereklili¤i vurgulanm›flt›r.
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Papers by Fezal Ozdemir