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Öğe Beyond Mohs surgery and excisions: A focused review of treatment options for subtypes of basal cell carcinoma(Wiley, 2021) Altun, Ece; Schwartzman, Gabrielle; Cartron, Alexander M.; Khachemoune, AmorBasal cell carcinoma (BCC) is the most common nonmelanoma skin cancer. It originates from undifferentiated cells in the basal cell layer of the epidermis or from the outer root sheath of the hair follicle. The most important factor in development of BCC is ultraviolet radiation. Surgery is considered the gold standard of treatment for BCC. However, nonsurgical options are available for individuals who are unsuitable for surgery. The purpose of this review is to summarize the efficacy and indications of alternative, nonsurgical treatments that can be used in the management of BCC. An extensive literature review was performed for the nonsurgical options for the treatment of BCC. Resources searched included PubMed and Google Scholars, limited to the years 1995 to 2020. Key words searched included BCC, destructive methods, photodynamic therapy (PDT), radiotherapy, topical medication, laser, hedgehog pathway inhibitors (HPIs). The most relevant results such as systematic reviews, randomized controlled trials, or comparative studies were selected to provide a summary for the most common nonsurgical methods used for treating BCC. Effective nonsurgical treatments for BCC include destructive methods (eg, curettage alone, cryosurgery, or electrodessication), PDT, topical medications, radiotherapy, laser, and HPIs. Nonsurgical therapeutic alternatives are safe and effective for the treatment of BCC. Factors such as tumor location, size, and histopathological subtype should be taken into consideration when selecting optimal treatment. In addition to clinical factors, cosmetic results and patient preference should be considered.Öğe Comparison of platelet-rich plasma efficacy with and without photoactivation in melasma: A randomized double-blind study(2024) Topaloğlu Demir, Filiz; Altun, EceBackground: Photoactivation has been suggested to enhance the efficacy of platelet-rich plasma (PRP) in conditions other than dermatological diseases. Aims: To evaluate the efficacy of photoactivated PRP (P-PRP) treatment for melasma by comparing it with non-photoactivated, classical PRP (C-PRP). Methods: The study consisted of 38 female patients diagnosed with melasma between April 2022 and May 2023. The patients were randomized into the P-PRP and C-PRP groups. Three sessions of P-PRP or C-PRP were applied to the patients at 2-week intervals. The Melasma Area and Severity Index (MASI) and Melasma Quality of Life Index (MELASQoL) scores were compared before and 2 weeks after treatment. Results: The median age was 38 years, and the median disease duration was 60 months. Clinically, 94.7% of the cases were centrofacial and 5.3% were malar. According to Wood's lamp examination, 55.3% of the cases were epidermal, 13.2% were dermal, and 31.6% were mixed-type. The median pre- and post-treatment scores were 14.5 and 9, respectively, for MASI and 36.5 and 17, respectively, for MELASQoL. The post-treatment MASI and MELASQoL scores of both groups significantly decreased (p < 0.001 for both). However, the intergroup difference was not significant. When all patients were evaluated together a moderate, positive, and significant relationship was detected between PRP and the pre- and post-treatment MASI and MELASQoL scores (r = 0.494 and p = 0.002). No side effects associated with PRP were observed. Conclusion: PRP is an effective and safe treatment method for melasma. Further studies are needed to evaluate the contribution of photoactivation to PRP treatment in melasma.Öğe Hand hygiene habits and hand eczema prevalence of healthcare workers during the COVID-19 pandemic(Inonu University Faculty of Medicine, 2022) Altun, Ece; Topaloğlu Demir, FilizAim: Hand hygiene has become an important building block in the prevention of the spread of coronavirus disease 2019 (COVID-19). The current study was conducted to determine the hand hygiene habits of healthcare workers and possible risk factors for hand eczema during the COVID-19 pandemic. Materials and Methods: The hand hygiene habits of healthcare personnel working at a university hospital since COVID-19 pandemic started were questioned between December 2020 and February 2021 and they were dermatologically examined to screen for hand eczema. Results: Of the 150 healthcare workers, 56 (37.3%) were doctors and 94 (62.7%) were nurses, and 40 (26.7%) were men and 110 (73.3%) were women. The rate of participants that reported washing their hands more frequently than 25 times daily was 46.0% (n=69), and the rate of disinfectant use was 59.3% (n=89). While 88 (58.7%) of the participants used a moisturizer daily, 62 (41.3%) did not use a moisturizer. Fifteen (10.0%) participants were diagnosed with hand eczema. Conclusion: There was an increase in the daily frequencies of hand washing and use of disinfectants during the COVID-19 pandemic, but our data did not reveal any statistically significant risk factor of hand eczema.Öğe Leukocytoclastic vasculitis after COVID-19 vaccination(Wiley, 2022) Altun, Ece; Kuzucular, ElifLeukocytoclastic vasculitis (LCV) is the vasculitis of small vessels. In this report, we describe a 38-year-old male patient who presented to our outpatient clinic with a 1-week history of rash on his lower extremities that had started 4 days after receiving the Pfizer-BioNTech SARS-CoV-2 vaccine. A diagnosis of LCV was made based on clinical and histopathological findings. The patient was treated with antihistamines and prednisolone, after which improvement was observed in the lesions. With this paper, we aim to raise awareness concerning the possibility of LCV development after COVID-19 vaccination.Öğe Occupational facial dermatoses related to mask use in healthcare professionals(Wiley, 2022) Altun, Ece; Topaloğlu Demir, FilizBackground Mask use can lead to facial dermatoses due to factors, such as hyperhydration, seborrhea, high humidity caused by sweating, and the occlusive effect of the mask. Aim We investigated mask-related facial dermatoses in healthcare personnel who, since the beginning of the COVID-19 pandemic, had to wear a mask for long hours. Methods In this study, healthcare professionals working at Medipol Mega University Hospital since the beginning of the pandemic were screened for facial dermatoses between December 2020 and February 2021 with a dermatological examination and interview. Results Of the 101 healthcare professionals, 51 (50.5%) were doctors and 50 (49.5%) nurses, and 36 (35.6%) were male and 65 (64.4%) were female. All the participants had been actively working at the hospital for 35-46 weeks since the beginning of the pandemic and wearing N95 or surgical masks for an average of 6-13 h a day. During the dermatological examination, the most common facial dermatosis was acne, which was observed in 55.4% (n = 56) of the cases. Of the 56 acne cases, 41.1% (n = 23) had acne in their history, while 58.9% (n = 33) had new-onset acne. Being female, using a N95 surgical mask compared to surgical mask, and the daily average duration of mask use were determined as risk factors for acne development due to mask use. Conclusions The use of masks, more frequently N95, caused both an increase in existing acne and the development of new acne.Öğe Retrospective analysis of methylprednisolone treatment alone and in combination with methotrexate in patients with extensive alopecia areata(Wiley, 2022) Altun, Ece; Yaylı, Savaş; Aksu Arıca, Deniz; Baykal Selçuk, Leyla; Bahadır, SevgiAlopecia areata (AA) is a chronic autoimmune disorder that primarily affects the hair follicle. Systemic corticosteroids and methotrexate (MTX) are among the therapeutic options in severe cases. This study aimed to show whether the combination therapy of methylprednisolone (MP) and MTX was superior to MP alone in the management of extensive AA. A total of 26 patients with extensive AA, 14 treated with MP alone and 12 treated with the combination of MP and MTX, were retrospectively evaluated in terms of gender, age, severity of disease, clinical characteristics, disease duration, dose and duration of medications, therapy response, and side effects. Of the 26 patients with extensive AA, 14 were male and 12 were female, and the average age was 17.02 +/- 10.70 years. All patients had more than 50% hair loss, 23 had extensive multifocal AA, and three had alopecia totalis. A total of 14 patients were treated with MP alone (starting dose: 0.3-0.5 mg/kg, maximum 32 mg/day), and 12 were treated with MP + MTX (starting dose: 5-15 mg/week, maximum 20 mg/week). A total of 12 of the 14 patients (85.7%) who were treated with MP alone showed a complete response, with the response rate of the patients who showed more than 50% response being 92.85%. Seven of the 12 patients (58.3%) who were treated with MP + MTX achieved complete healing, and all patients on this regimen had more than 50% treatment response. Our results showed that the combination therapy of MP and MTX was not superior to MP alone in the management of extensive alopecia areata.Öğe The most common pediatric and adult dermatology patient complaints in a month of the COVID-19 pandemic in Turkey(Wiley, 2020) Altun, EceSevere acute respiratory syndrome coronavirus 2 is the coronavirus strain that causes coronavirus disease 2019 (COVID-19). The World Health Organization (WHO) has designated the ongoing COVID-19 outbreak a Public Health Emergency of International Concern. WHO declared COVID-19 as a pandemic on 11 March 2020. During the pandemic and lockdown period, many dermatologic clinics were temporarily closed in Turkey as well as all over the world. Taking the necessary precautions, the hospital continued to examine all emergent and elective patients who applied to our dermatology clinic. We investigated the most common reasons for admission of pediatric and adult patients who were admitted to our outpatient clinic between 30 March and 30 April 2020, the period with the highest number of COVID-19 patients in Turkey. In children and adult age groups, the most common reason for admission was acne (N: 10 [16.4%] and N: 89 [20.9%], respectively). Of the 99 acne patients, 70 (70.7%) were using systemic isotretinoin and applied to our clinic to repeat the prescription or continue the agent. The number of pediatric patients admitted to the dermatology department drastically reduced during the lockdown period, which was attributed to the curfew for children in the country.
