Researcher:
Yaylı, Savaş

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Savaş

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Yaylı

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Yaylı, Savaş

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2022 - 20237

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    Isotretinoin-induced inflammatory back pain and sacroiliitis in patients with moderate-to-severe acne vulgaris
    (Wiley, 2022) Civelek, Unzule Seyman; Selcuk, Leyla Baykal; Arica, Deniz Aksu; Capkin, Erhan; N/A; Yaylı, Savaş; Faculty Member; School of Medicine; Koç University Hospital; 151352
    Introduction: Isotretinoin has been reported to induce inflammatory back pain (IBP) and sacroiliitis in the patients with acne vulgaris. The aim of this study is to investigate the incidence of IBP and sacroiliitis in patients receiving isotretinoin treatment compared with oral antibiotics for acne vulgaris. Materials and Methods: A total of 201 patients with moderate-to-severe acne vulgaris who received isotretinoin (n = 100) or oral antibiotics (n = 101) were included in the study. All patients were monthly questioned for IBP symptoms during their treatment. Patients described IBP were also evaluated for sacroiliitis by c-reactive protein, sedimentation rate, HLAB27, and sacroiliac magnetic resonance imaging (MRI). Isotretinoin was discontinued in all patients diagnosed as sacroiliitis, and these patients were reevaluated after 3 months. Results: IBP was observed in 21 (10.4%), and sacroiliitis was detected in 11 (11%) patients on isotretinoin treatment; in oral antibiotic group, we did not observe IBP or sacroiliitis. The incidence of IBP and sacroiliitis differed significantly between the isotretinoin and oral antibiotic groups (p < 0.0001, p = 0.02). Complete regression was observed in the great majority of patients following cessation of isotretinoin. Conclusions: Our study is the largest prospective controlled study that investigated the incidence of sacroiliitis in patients receiving isotretinoin and compared with patients using oral antibiotics.
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    Frequency of skin cancer and evaluation of risk factors: a hospital-based study from Turkey
    (Wiley, 2022) Ferhatosmanoğlu, Arzu; Selçuk, Leyla Baykal; Arıca, Deniz Aksu; Ersoz, Şafak; Yaylı, Savaş; Faculty Member; School of Medicine; 151352
    Objectives: Skin cancers are the most common type of cancer with a significantly increasing incidence. The purpose of the study was to uncover the one-year frequency of melanoma and non-melanoma skin cancers (NMSC) and to determine the risk factors in the development of skin cancer. Methods: The study included 7396 people from all age groups admitted to the dermatology clinic between October 2020 and 2021. The sociodemographic characteristics, sun protection habits, chronic diseases, and drug and vitamin use were evaluated. Lesions with clinical suspicion of skin cancer were excised. Results: The frequency of skin cancer was found to be 2.7%, basal cell cancer (BCC) 1.2%, squamous cell cancer (SCC) 1.1%, malignant melanoma (MM) was 0.4%. Daily black tea consumption was found to be a risk factor for three type of skin cancer, BCC (p = 0.021), SCC (p = 0.006), and MM (p = 0.002), respectively. Obesity was observed as a risk factor for BCC (p = 0.005) and MM (p = 0.008). We found that having a history of alcohol use were an independent risk factor for all skin cancer types and BMI <30 for SCC. Vitamin D and supplemental drugs intake were observed as protective factors for BCC (p = 0.035, p = 0.007, respectively). Daily coffee consumption was determined as a protective factor for SCC (p < 0.001) and MM (p = 0.049). Conclusion: This study estimates the frequency of NMSC and melanoma. Also provides evidence to determine the risk factors and probably protective factors for the development of skin cancers.
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    New onset of pemphigus foliaceus following BNT162b2 vaccine
    (Wiley, 2022) Demirkesen, Cuyan; N/A; Yıldırıcı, Şebnem; Yaylı, Savaş; Vural, Seçil; Doctor; Faculty Member; Faculty Member; Koç University Hospital; School of Medicine; N/A; 151352; 189340
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    S2k guidelines on the management of paraneoplastic pemphigus/paraneoplastic autoimmune multiorgan syndrome initiated by the European Academy of Dermatology and Venereology (EADV)
    (John Wiley and Sons Inc, 2023) Antiga E.; Bech R.; Maglie R.; Genovese G.; Borradori L.; Bockle B.; Caproni M.; Caux F.; Chandran N.S.; Corrà A.; D'Amore F.; Daneshpazhooh M.; De D.; Didona D.; Dmochowski M.; Drenovska K.; Ehrchen J.; Feliciani C.; Goebeler M.; Groves R.; Günther C.; Handa S.; Hofmann S.C.; Horvath B.; Ioannidis D.; Jedlickova H.; Kowalewski C.; Kridin K.; Joly P.; Lim Y.L.; Marinovic B.; Maverakis E.; Meijer J.; Patsatsi A.; Pincelli C.; Prost C.; Setterfield J.; Sprecher E.; Skiljevic D.; Tasanen K.; Uzun S.; Van Beek N.; Vassileva S.; Vorobyev A.; Vujic I.; Wang G.; Wang M.; Wozniak K.; Zambruno G.; Hashimoto T.; Schmidt E.; Mascarò J.M.; Jr.; Marzano A.V.; Yaylı, Savaş; Faculty Member; School of Medicine; 151352
    Background: Paraneoplastic pemphigus (PNP), also called paraneoplastic autoimmune multiorgan syndrome (PAMS), is a rare autoimmune disease with mucocutaneous and multi-organ involvement. PNP/PAMS is typically associated with lymphoproliferative or haematological malignancies, and less frequently with solid malignancies. The mortality rate of PNP/PAMS is elevated owing to the increased risk of severe infections and disease-associated complications, such as bronchiolitis obliterans. Objectives: These guidelines summarize evidence-based and expert-based recommendations (S2k level) for the clinical characterization, diagnosis and management of PNP/PAMS. They have been initiated by the Task Force Autoimmune Blistering Diseases of the European Academy of Dermatology and Venereology with the contribution of physicians from all relevant disciplines. The degree of consent among all task force members was included. Results: Chronic severe mucositis and polymorphic skin lesions are clue clinical characteristics of PNP/PAMS. A complete assessment of the patient with suspected PNP/PAMS, requiring histopathological study and immunopathological investigations, including direct and indirect immunofluorescence, ELISA and, where available, immunoblotting/immunoprecipitation, is recommended to achieve a diagnosis of PNP/PAMS. Detection of anti-envoplakin antibodies and/or circulating antibodies binding to the rat bladder epithelium at indirect immunofluorescence is the most specific tool for the diagnosis of PNP/PAMS in a patient with compatible clinical and anamnestic features. Treatment of PNP/PAMS is highly challenging. Systemic steroids up to 1.5 mg/kg/day are recommended as first-line option. Rituximab is also recommended in patients with PNP/PAMS secondary to lymphoproliferative conditions but might also be considered in cases of PNP/PAMS associated with solid tumours. A multidisciplinary approach involving pneumologists, ophthalmologists and onco-haematologists is recommended for optimal management of the patients. Conclusions: These are the first European guidelines for the diagnosis and management of PNP/PAMS. Diagnostic criteria and therapeutic recommendations will require further validation by prospective studies.
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    Retrospective analysis of methylprednisolone treatment alone and in combination with methotrexate in patients with extensive alopecia areata
    (Wiley, 2022) Altun, Ece; Arıca, Deniz Aksu; Selçuk, Leyla Baykal; Bahadır, Sevgi; N/A; Yaylı, Savaş; Faculty Member; School of Medicine; Koç University Hospital; 151352
    Alopecia 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.
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    A new screening tool for psoriatic arthritis in psoriasis patients: TurPAS
    (BMJ Publishing Group, 2022) Ayan, G.; Hatemi, G.; Can, G.; Bektas, M.; Ozdede, A.; Akdogan, N.; Yalici-Armagan, B.; Solak, E. Oksum; Yazici, S.; Adisen, E. Ozsoy; Atakan, N.; Baskan, E. Bulbul; Borlu, M.; Engin, B.; Hamuryudan, V.; Inanc, M.; Kiraz, S.; Onen, F.; Kalyoncu, U.; N/A; Yaylı, Savaş; Faculty Member; School of Medicine; 151352
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    PublicationOpen Access
    Updated S2 K guidelines for the management of bullous pemphigoid initiated by the European Academy of Dermatology and Venereology (EADV)
    (Wiley, 2022) Borradori, L.; Van Beek, N.; Feliciani, C.; Tedbirt, B.; Antiga, E.; Bergman, R.; Boeckle, B. C.; Caproni, M.; Caux, F.; Chandran, N. S.; Cianchini, G.; Daneshpazhooh, M.; De, D.; Didona, D.; Di Zenzo, G. M.; Dmochowski, M.; Drenovska, K.; Ehrchen, J.; Goebeler, M.; Groves, R.; Guenther, C.; Horvath, B.; Hertl, M.; Hofmann, S.; Ioannides, D.; Itzlinger-Monshi, B.; Jedlickova, J.; Kowalewski, C.; Kridin, K.; Lim, Y. L.; Marinovic, B.; Marzano, A.; Mascaro, J. -M.; Meijer, J. M.; Murrell, D.; Patsatsi, K.; Pincelli, C.; Prost, C.; Rappersberger, K.; Sardy, M.; Setterfield, J.; Shahid, M.; Sprecher, E.; Tasanen, K.; Uzun, S.; Vassileva, S.; Vestergaard, K.; Vorobyev, A.; Vujic, I.; Wang, G.; Wozniak, K.; Zambruno, G.; Zillikens, D.; Schmidt, E.; Joly, P.; Yaylı, Savaş; Faculty Member; School of Medicine; 151352
    Background: Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disease of the skin and mucous membranes. This disease typically affects the elderly and presents with itch and localized or, most frequently, generalized bullous lesions. A subset of patients only develops excoriations, prurigo-like lesions, and eczematous and/or urticarial erythematous lesions. The disease, which is significantly associated with neurological disorders, has high morbidity and severely impacts the quality of life. Objectives and methodology: the Autoimmune blistering diseases Task Force of the European Academy of Dermatology and Venereology sought to update the guidelines for the management of BP based on new clinical information, and new evidence on diagnostic tools and interventions. The recommendations are either evidence-based or rely on expert opinion. The degree of consent among all task force members was included. Results: treatment depends on the severity of BP and patients' comorbidities. High-potency topical corticosteroids are recommended as the mainstay of treatment whenever possible. Oral prednisone at a dose of 0.5 mg/kg/day is a recommended alternative. In case of contraindications or resistance to corticosteroids, immunosuppressive therapies, such as methotrexate, azathioprine, mycophenolate mofetil or mycophenolate acid, may be recommended. The use of doxycycline and dapsone is controversial. They may be recommended, in particular, in patients with contraindications to oral corticosteroids. B-cell-depleting therapy and intravenous immunoglobulins may be considered in treatment-resistant cases. Omalizumab and dupilumab have recently shown promising results. The final version of the guideline was consented to by several patient organizations. Conclusions: the guidelines for the management of BP were updated. They summarize evidence- and expert-based recommendations useful in clinical practice.