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    Allergic sensitization in patients with pruritus sine materia in the absence of a somatic cause
    (Annals of Medical Research Publishing Inc, 2020) Pekmezci, Erkin
    Aim: Pruritus sine materia in the absence of a somatic cause is generally attributed to psychogenic factors, but it is also well known that psychological stress may affect skin through its impacts on immune response. In this three-year retrospective study we aimed to reveal the allergic sensitization of patients with chronic pruritus without a somatic cause. Material and Methods: Three hundred and sixty five male and female patients with widespread chronic pruritus between 6 and 75 years old were retrospectively recruited. In addition to routine hematologic examination, skin prick test and serum total IgE measurement were performed on each patient. Results: In cutaneous examination, the patients had no visible manifestation except self excoriations in some, and all had normal values in hematologic laboratory examination. Altogether 10% of patients had positive results for both skin prick test and serum total IgE, and 42% of patients had positive results for either skin prick test and/or serum total IgE, which may be regarded as a presentation of immediate type hypersensitivity. Conclusion: Considering the quite high positive ratios obtained for both skin prick test and serum total IgE, it may be encouraging to perform these tests routinely on the patients with pruritus sine materia, both for revealing a probable allergic tendency and for better handling the treatment modalities.
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    An unusual case of erythema annulare centrifugum involving face
    (Pakistan Association of Dermatologists, 2021) Pekmezci, Erkin; Küçükodacı, Zafer; Kutlubay, Zekayi
    Erythema annulare centrifugum (EAC) is a reactive figurate erythematous disease characterised by gyrate and annular plaques with erythema. The disease is generally known as involving the extremities and trunk, but sparing the face. We present a young male patient with recurring annular erythematous scaly lesions on his face, frequently in a year since four years, with no systemic involvement. Histologically, in addition to slight parakeratosis and spongiosis in the epidermis, there was superficial lymphocytic and histiocytic perivascular infiltration with the classic coat sleeve appearance of EAC in the dermis. Although uncommon, we suggest EAC should be considered in the differential diagnosis of relevant lesions on face.
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    Cutaneous metastases from breast carcinoma - multiple clinical presentations
    (Termedia Publishing House Ltd, 2021) Pekmezci, Erkin; Küçükodacı, Zafer; Kutlubay, Zekayi
    Cutaneous metastases usually appear as nonspecific groups of discrete, firm, painless nodules that emerge rapidly without any explanation. Some skin metastases may mimic specific dermatological conditions such as cutaneous cysts, dermatofibroma, granuloma teleangiectodes, hemangioma, herpes zoster eruptions, rapidly infiltrating plaques, alopecic patches, erysipelas and cellulitis [1].
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    Facial hypertrichosis in the course of isotretinoin treatment: four-year retrospective observation
    (2024) Pekmezci, Erkin
    Background: isotretinoin is a synthetic retinoid used in the treatment of acne. There are limited and inconsistent data about the effects of isotretinoin on hormones and hair growth. Aim: to investigate a probable connection, a single center four-year retrospective data of female acne patients who were treated with oral isotretinoin and developed facial hypertrichosis was reported. Methods: in the years 2019-2023, 327 female patients between 16-33 years of age (Mean ± Standard Deviation: 23.4 ± 4.7) were treated with 0.5-0.8 mg/kg/day isotretinoin, approximately for 6 months (6.2 ± 0.8). The patients who developed facial hypertrichosis were additionally analysed for dehydroepiandrosterone sulfate, prolactin and thyroid stimulating hormone values. Results: thirty one patients (9.5%) in all ages (22.9 ± 4.3) declared excessive hair growth on cheeks and/or chin during treatment. All declarations were between the 2nd and 4th months (2.6 ± 0.8). The mean values of analysed hormones were in normal ranges. Twenty seven of the thirty one patients (87%) stated that the excessive hair growth terminated completely at the end of 4th month (3.1 ± 0.7) after the cessation of the treatment, and the others declared it was diminished to a great extent. Conclusions: mainly due to normal mean values of the analysed hormones, it is hard to consider that the cause of hypertrichosis is hormonal irregularity. However, 9.5% is a considerable ratio. A more extensive prospective study should be performed to reveal the cause of this phenomenon.
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    Green tea extract exerts anabolic effects on extracellular matrix of the skin
    (Indian Pharmaceutical Association, 2020) Türkoğlu, Murat Metehan; Pekmezci, Erkin; Kılıç, Songül
    An in vitro trial was carried out to reveal the effects of an extract of Camellia sinensis (green tea extract) on the major extracellular matrix components of human skin. After preparing the green tea extract its phytochemical contents were analysed and its effects on gene expression of hyaluronan synthase 2, matrix metalloproteinase-9 and elastase in a human dermal fibroblast cell line were determined. Cell proliferation assay was performed using XTT reagent. Ribonucleic acid isolations were realized by using TRI reagent. Expressions of the relevant enzymes and a control enzyme glyceraldehyde-3-phosphate dehydrogenase were determined using RT-qPCR analysis. Green tea extract caused statistically significant upregulation of hyaluronan synthase-2 gene expression compared to untreated control cells. Also, as a positive outcome, the treatment resulted in significant downregulations of matrix metalloproteinase-9 and elastase gene expressions. Green tea extract was found to have substantial anabolic effects on hyaluronic acid, collagen and elastin. The results obtained in this study might partially explain the molecular basis of the health benefits and antiaging effects of Camellia sinensis on skin.
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    Long duration single pulse intense pulsed light application in erythematotelangiectatic rosacea: An instrumental retrospective study
    (Annals of Medical Research Publishing Inc, 2020) Pekmezci, Erkin
    Aim: Erythematotelangiectatic rosacea is a challenging condition due to poor therapeutic options. Treatment with intense pulsed light is partially effective after numerous sessions. Regarding the ‘thermal relaxation time’ principle and characteristic histopathology of erythematotelangiectatic rosacea, dilated capillaries and venules throughout the dermis, we proposed that directly targeting the largest vessels available by applying a long duration single pulse intense pulsed light mode, should decrease the mean number of treatment sessions to obtain a significant outcome. Material and Methods: Eighty seven erythematotelangiectatic rosacea patients who completed the proposed one month apart, four times consequtive intense pulsed light treatments with 25 ms pulse duration, single pulse and 10 J/cm2 fluence in the years of 2017-2019 were recruited retrospectively. Instrumental evaluations and self-assessment scorings were performed during the treatment period. Results: No adverse effect was recorded. Instrumentally evaluated results revealed a significant erythema quenching effect obtained at the end of 2nd treatment session (p=0.0011). Considering the decrease in erythema, both the instrumental and self-assessment values were found extremely significant after the 4th session, compared to initial values (p<0.0001, for both). Conclusion: Considering the fast improvement recorded, intense pulsed light therapy with long pulse duration, single pulse, and low fluence may present a time saving and effective treatment option in erythematotelangiectatic rosacea patients with varied levels of severity. Also, the satisfactory outcome obtained by directly targeting the largest vessels available beginning from the initiation of therapy period, may be regarded as an indicator of the practicability of an identical mode of intense pulsed light treatment in diverse clinical presentations of erythematotelangiectatic rosacea.
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    The use of radio-wave surgery: An underestimated method for small hyperpigmented flat or macular lesions on face
    (Wiley, 2022) Pekmezci, Erkin
    Background: Although choosing the appropriate treatment method is relatively easy for papular or protuberant lesions, for small macular lesions it may not be so, because they are generally percepted as mild lesions by the patient and she/he usually has the anxiety of final disfigurement which may result esthetically worse than the original one. It is reasonable to choose the method which will reveal the least scar formation and lowest recurrence rate with cost-effectiveness, in removal of superficial small macular lesions for cosmetic purposes. Methods: Fifty-six male and female patients with small hyperpigmented flat or macular lesions, less than or equal to 5 mm diameter on their face, who referred to hospital dermatology clinic for removal and received an interventional therapy with a radio-wave surgery unit in the years 2018-2019 were retrospectively recruited. Besides the observation of scar formation and residual erythema, 3-month recurrence rates were also analyzed. Results: At the end of 3 months, there was no scar on any lesion site. Mild erythema was detected on 15 lesion sites out of a total of 218 (6.9%).The total recurrence rate was 7.7%. The mean age of the patients with at least one recurrence was significantly greater than the patients with no recurrence, and the lesions greater than 3 mm were more prone to recur than the lesions less than or equal to 3 mm. Conclusion: Although no method of lesion removal can warrant a scarless result without recurrence, for benign macular hyperpigmented lesions of the face up to 5 mm in diameter, radio-wave surgery may be preferred due to both its minimal scar formation and recurrence rate, in addition to its cost-effectiveness.
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    Urtica dioica extract downregulates the gene expression of 5?-RII in hacat cells: Possible implications against androgenic skin diseases
    (NLM (Medline), 2023) Pekmezci, Erkin; Türkoğlu, M.
    Urtica dioica (Ud) is a perennial plant of temperate climate regions and has been reported therapeutic activity against benign prostate hyperplasia, mainly due to its 5-alpha-reductase (5?-R) inhibition feature, which has been singly shown only in prostatic tissues until now. Also considering its use in traditional medicine against some dermatological problems and hair loss, we performed an in-vitro study to reveal its 5?-R inhibition activity in skin cells whether this plant may have a therapeutic potential against androgenic skin diseases. After the preparation of Ud leaf extract and determination of non-cytotoxic concentration, cultured HaCaT cells were treated with the plant extract. RNA isolations were carried out from both non-treated and treated cell groups. cDNA synthesis was performed using gene specific primers of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) as reference gene and 5?-R type II (5?-RII) as study material. Gene expressions were determined by real time reverse transcription quantitative polymerase chain reaction analysis. Results were represented as 'Target/GAPDH Fold Change'. Results of gene expression analysis showed that plant extract caused statistically significant downregulation of 5?-RII gene expression (p=0.0021) in treated cells, compared to untreated control cells, and ended up with 0.5873±0.0586 fold change. This study is the first one showing the suppression of 5?-RII gene expression on skin cells with unmixed or solitary Ud extract. With the currently reported anti-androgenic activity in HaCaT cells, it can be suggested that Ud has a solid scientific base and may have a promising future in cosmetic dermatology, and new product development against androgenic skin diseases.