Researcher:
Alper, Fatma Sibel

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Fatma Sibel

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Alper

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Alper, Fatma Sibel

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2018 - 201922020 - 20229

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    The efficacy of 308-NM excimer lamp in combination with topical tacrolimus cream in pediatric vitiligo
    (İzmir Bozyaka Eğitim ve Araştırma Hastanesi, 2021) Taşkın, Banu; Eken, Zahide Eriş; Taş, Betül; N/A; Alper, Fatma Sibel; Faculty Member; School of Medicine; 118467
    To investigate the clinical efficacy and safety of acombination of monochromatic 308-nm excimer lamp therapy and topical tacrolimus for the treatment of pediatric vitiligo. Materials and Method: A total of 37 vitiligo patches from 20 pediatric patients were included in the study. Treatment consisted of 308-nm excimer light therapy administered twice weekly for a total of 20 sessions with twice daily application of 0.03% tacrolimus cream. Demographic data, past medical history, treated areas, and responses were recorded and evaluated, retrospectively. The treatment areas were grouped as follows: head and neck, trunk, and upper and lower extremities. Treatment responses were clinically rated between 0 and 4 as follows: 0, no pigmentation; 1, 1 to 25% pigmentation; 2, 26 to 50% pigmentation; 3, 51 to 75% pigmentation; and 4, >75% pigmentation. İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi (Medical Journal of İzmir Hospital) 25 (4): 297-302, 2021 298 İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi (Medical Journal of İzmir Hospital) Results:After 20 treatments, ≥ 75%, 51-75%, 26-50%, and 1-25% pigmentation was observed in 24%, 14%, 16%, and 27% of the 37 vitiligo patches, respectively. Transient erythema lasting for less than 24 hours was observed in 19% of the cases. Conclusion: The tacrolimus and 308-nm excimer light therapy combination represent a safe and effective alternative for the treatment of patients with pediatric vitiligo. / Öz: Çalışmanın amacı pediyatrik vitiligo hastalarında monokromatik 308-nm Excimer lamba ve topical takrolimus kombinasyonunun klinik etkinliğini ve güvenliğini araştırmaktır. Gereç ve Yöntem:Çalışmaya 20 pediatrik hastaya ait 37 vitiligo patch dahil edildi. Lezyonlara günde iki kez takrolimus % 0.03 krem ile haftada iki kez, toplam 20 seans 308 nm excimer ışık tedavisi uygulandı. Hastaların demografik verileri, özgeçmişleri, tedavi yanıtları retrospektif olarak değerlendirildi. Tedavi alanları; baş ve boyun, gövde ve üst ve alt ekstremite olarak gruplandı. Tedavi yanıtları klinik olarak 0 ve 4 arasında; 0, pigmentasyon yok; % 1, 1 ila % 25 pigmentasyon; % 2, 26 ila% 50 pigmentasyon; 3, 51 ila 75% pigmentasyon; ve 4,>% 75 pigmentasyon şeklinde derecelendirildi. Bulgular:37 vitiligo yamasının topical tedavive 20 seans mikrofototerapi sonrasında sırasıyla% 24’ünde ≥% 75,% 14’ünde % 51-75,% 16’sında % 26-50 ve% 27'sinde % 1-25 oranında repigmentasyon gözlendi. Vakaların % 19'unda 24 saatten kısa süren geçici eritem görüldü. Sonuç:Takrolimus krem ve 308-nm excimer ışık tedavisi kombinasyonu, pediyatrik vitiligo hastalarının tedavisi için güvenli ve etkili bir alternatiftir.
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    Comparison of psoriasis area and severity index and physician’s global assessment in determining psoriasis severity
    (Kuwait Medical Association, 2021) Acar, Ayda; Bozkurt, Ada; Yenipazar, Gizem Kocabas; Ceylan, Can; Alper, Fatma Sibel; Faculty Member; School of Medicine; 118467
    Objective: In clinical studies, it is crucial to assess psoriasis severity accurately and with no substantial variation between different raters. The Psoriasis Area and Severity Index (PASI) and Physician Global Assessment (PGA) are the two most commonly used tools for the assessment of psoriasis severity. The aim of this study was to evaluate the intra-rater and inter-rater reliability of these methods and to determine whether inter-rater reliability is affected by rater experience. Design: An open uncontrolled study Setting: Dermatology Department of Ege University, Medical Faculty Subjects: Fifty-five patients with plaque psoriasis who were examined between 15 August 2012 and 15 November 2012 in the dermatology department of Ege University Interventions: Three dermatology residents with varying experience evaluated the patients individually using both the PASI and PGA for each patient (in that order). Main Outcome Measure: PASI and PGA Results: PASI and PGA scores showed high intra-rater correlation for all three residents. Inter-rater reliability for PASI was high between the most experienced and second most experienced resident and between the most experienced and least experienced resident. However, inter-rater reliability for PGA was high between the most experienced and second most experienced residents, but only moderate between the most experienced and least experienced resident. Conclusions: There were no significant interrater differences between PGA and PASI scores in our study. However, because PGA is more subjective and may be affected by rater experience, PASI is considered to be a more reliable method for assessing severity of psoriasis.
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    Comparison of psoriasis area and severity index and physician's global assessment in determining psoriasis severity
    (Kuwait Medical Association, 2021) Acar, Ayda; Bozkurt, Ada; Yenipazar, Gizem Kocabaş; Ceylan, Can; Alper, Fatma Sibel; Faculty Member; School of Medicine; Koç University Hospital; 118467
    Objective: In clinical studies, it is crucial to assess psoriasis severity accurately and with no substantial variation between different raters. The Psoriasis Area and Severity Index (PASI) and Physician Global Assessment (PGA) are the two most commonly used tools for the assessment of psoriasis severity. The aim of this study was to evaluate the intra-rater and inter-rater reliability of these methods and to determine whether inter-rater reliability is affected by rater experience. Design: An open uncontrolled study Setting: Dermatology Department of Ege University, Medical Faculty Subjects: Fifty-five patients with plaque psoriasis who were examined between 15 August 2012 and 15 November 2012 in the dermatology department of Ege University Interventions: Three dermatology residents with varying experience evaluated the patients individually using both the PASI and PGA for each patient (in that order). Main Outcome Measure: PASI and PGA Results: PASI and PGA scores showed high intra-rater correlation for all three residents. Inter-rater reliability for PASI was high between the most experienced and second most experienced resident and between the most experienced and least experienced resident. However, inter-rater reliability for PGA was high between the most experienced and second most experienced residents, but only moderate between the most experienced and least experienced resident. Conclusions: There were no significant interrater differences between PGA and PASI scores in our study. However, because PGA is more subjective and may be affected by rater experience, PASI is considered to be a more reliable method for assessing severity of psoriasis.
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    COVID-19-related oral mucosa lesions among confirmed SARS-CoV-2 patients: a systematic review
    (Wiley, 2022) Erbaş, Gizem S.; Botsali, Ayşenur; Arı, Canan; Erden, Nihan; Taşkın, Banu; Alper, Fatma Sibel; Vural, Seçil; Undergraduate Student; Doctor; Faculty Member; Faculty Member; N/A; School of Medicine; School of Medicine; School of Medicine; N/A; N/A; 118467; 189340
    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for coronavirus disease 2019 (COVID-19), which manifests as a flu-like respiratory infection affecting multiple organ systems, including the gastrointestinal system, central nervous system, cardiovascular system, skin, and mucosa. In this review, we investigated the literature on specific manifestations of COVID-19 in the oral mucosa. An online literature search in PubMed, Scopus, Google Scholar, and Medline was conducted to retrieve relevant studies on confirmed COVID-19 patients with oral mucosa findings published between December 31, 2019, and April 07, 2021. After an independent review by two authors, 39 articles considering 59 laboratory-confirmed cases of SARS-CoV-2 infection were included in the final analysis. The most common finding, reported in 29 patients (43.9%), was Kawasaki-like syndrome. In addition, oral ulcers including aphthous, hemorrhagic, and necrotic ulcers were reported in 24 patients (36.3%). Other lesions reported included pustules, macules, bullae, maculopapular enanthema, and erythema multiforme-like lesions. Concomitant skin lesions were present in 60.6% of patients. Fever was reported in 86.2% of patients. Forty-eight patients (76.1%) were hospitalized. Loss of taste and smell was present in 30.8% of the patients. A comprehensive understanding of the dermatologic manifestations of COVID-19 can improve and facilitate patient management and referrals.
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    Recommendations on the use of systemic treatments for urticaria and atopic dermatitis during the COVID-19 pandemic: statement of Dermatoallergy Working Group of the Turkish Society of Dermatology
    (Istanbul Assoc. of Dermatology and Venerology, 2019) Salman, Andaç; Atakan, Nilgün; Başkan, Emel Bülbül; Borlu, Murat; Canpolat, Filiz; Erdem, Teoman; Erdem, Yasemin; Gül, Ülker; Kartal, Selda Pelin; Koca, Rafet; Küçük, Özlem Su; Öğretmen, Zerrin; Özkaya, Esen; Sarıcaoğlu, Hayriye; Şavk, Ekin; Taşkapan, Oktay; Utaş, Serap; Alper, Fatma Sibel; Kocatürk Göncü, Özgür Emek; Faculty Member; Faculty Member; School of Medicine; 118467; 217219
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    Lichen planopilaris restricted to the vitiliginous skin on the leg
    (Wiley-Hindawi, 2021) Erbaş, Gizem; Demirkesen, Cüyan; Alper, Fatma Sibel; Memet, Bachar; Vural, Seçil; Faculty Member; Doctor; Faculty Member; School of Medicine; N/A; School of Medicine; Koç University Hospital; 118467; N/A; 189340
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    The Turkish guideline for the diagnosis and management of atopic dermatitis-2018
    (Deri ve Zührevi Hastalıklar Derneği, 2018) Ertam, İlgen; Su, Özlem; Sarıcaoğlu, Hayriye; Karadağ, Ayşe Serap; Demirsoy, Evren Odyakmaz; Borlu, Murat; Alper, Fatma Sibel; Faculty Member; School of Medicine; 118467
    Background and Design: Atopic dermatitis (AD) has a complicated etiopathogenesis and difficulties in diagnosis and treatment from time to time. Because of the disease which different approaches can be seen rationalize the need for an algorithm for the diagnosis, classification, etiopathogenesis, diagnostic tests and therapeutic approach. Therefore, authors from Dermatoallergy Working Group of the Turkish Society of Dermatology aimed to create an AD guideline for the diagnosis, treatment and followup. Materials and Methods: Each section of the guideline has been written by a different author. The prepared sections were evaluated in part by e-mail correspondence and have taken its final form after revision in the last meeting held by the participation of all authors. Results: The guideline includes the diagnosis, classification, etiopathogenesis, diagnostic tests and therapeutic approach of AD. Lesions show age-related morphology and distribution. There are no in vivo/in vitro tests that have high sensitivity and specificity that can be used to identify AD and trigger factors. The first step of treatment consists of moisturizers, topical corticosteroids and calcineurin inhibitors, respectively. Moisturizers are used therapeutically in all forms of AD. Topical corticosteroids are the first agents to be used when moisturizers are inadequate. Topical calcineurin inhibitors should be used in lesions resistant to corticosteroids, for proactive treatment, special areas. Antimicrobials agents and antiseptics should only be added to treatment when clinical signs of infection are present. and in topical treatment-resistant cases, second-line treatment is phototherapy or oral cyclosporine. The biologic agent, dupilumab, is promising in the treatment of severe AD. Conclusion: AD is a disease that can be challenging for the physician in terms of treatment and follow-up. Depending on evidence-based data (and individual experiences), this guideline will have a leading role in the diagnosis and treatment of AD and help the physician to overcome the challenges in the management. / Amaç: Atopik dermatit (AD), tanı ve tedavisinde zaman zaman zorluklar yaşanan bir hastalıktır. Farklı yaklaşımların görülebildiği bir hastalık olması, hastalığın tanı, sınıflama, etiyopatogenez, tanısal testler ve tedavi yaklaşımları açısından bir algoritma içerisinde değerlendirilmesi gerekliliğini doğurmuştur. Bu amaçla Türk Dermatoloji Derneği Dermatoallerji Çalışma Grubu içerisinde yer alan yazarlar, AD tanı ve tedavisinde kanıta dayalı bir yol gösterici olması açısından bu AD kılavuzunu oluşturmayı hedeflemişlerdir. Gereç ve Yöntem: Kılavuz, her bölümü ayrı bir yazar tarafından yazılacak biçimde planlanmış; Kılavuzun ana hatları belirlendikten sonra yazarlar tarafından hazırlanan bölümler e-posta yazışmaları ile diğer yazarlar tarafından da değerlendirilmiştir ve bir araya gelinerek yapılan toplantıda tartışılmıştır. Son olarak, kılavuz tümüyle gözden geçirilerek hazır hale getirilmiştir. Bulgular: Kılavuz, tanım, patogenez, klinik bulgular, tanı, ayırıcı tanı, skorlama sistemleri, tanıda deri testleri ve tedavi yaklaşımlarını içermektedir. Günümüzde AD tanısında ve tetikleyici faktörlerin ortaya konulmasında kullanılabilecek sensitivite ve spesifitesi yüksek, uygulanması kolay in vivo/in vitro test bulunmamaktadır. Tedavinin ilk basamağını sırasıyla nemlendiriciler, topikal kortikosteroidler (TKS) ve kalsinörin inhibitörleri oluşturur. Nemlendiriciler AD'nin tüm formlarında tedavide kullanılır. Nemlendiricilerin yetersiz kaldığı durumlarda ilk kullanılacak ajanlar TKS'lerdir. TKS’lere dirençli lezyonlarda, uzun süreli kortikosteroid kullanımında, proaktif tedavide ve belli bölgelerde ise topikal kalsinörin inhibitörleri tercih edilmelidir. Antimikrobiyal ajanlar ve antiseptikler sadece klinik olarak enfeksiyon bulgularının olduğu durumlarda tedaviye eklenmelidir. Topikal tedavinin yanıtsız kaldığı durumlarda ikinci basamak tedavide fototerapi ve oral siklosporin yer alır. Ülkemizde henüz ruhsat almamış olan biyolojik ajan dupilumab şiddetli ve dirençli AD tedavisinde ümit vermektedir. Sonuç: AD hekimler için tanı, tedavi ve izlem açısından güçlükler yaratabilen bir hastalıktır. Olabildiğince kanıta dayalı verilerden yola çıkarak hazırlanan bu kılavuz, AD’li olgularda tanı ve tedavi yaklaşımlarının yönlendirilmesinde yol gösterici olacak ve hekimlerin bu süreçlerde yaşadıkları zorlukların aşılmasına katkı sağlayacaktır.
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    Use of biological agents
    (Galenos Yayınevi, 2022) Koç, Erol; Alper, Fatma Sibel; Faculty Member; School of Medicine
    Biological agents are used to treat psoriasis in patients who do not respond to conventional systemic therapies such as cyclosporine, acitretin, methotrexate, phototherapy/photochemotherapy, or for whom these therapies are contraindicated. Patients who will use these agents are selected based on the eligibility criteria for biological agents. Patients are assessed at regular intervals with relevant laboratory parameters before and during the treatment. Patients should be assessed particularly for tuberculosis, malignancies, congestive heart failure, demyelinating diseases, and infections. All necessary vaccinations should be completed before starting the treatment, if possible. Live vaccines should be avoided during the treatment, and patients who require surgical intervention should be assessed for postoperative infection risk on a case-to-case basis, and the treatment should be suspended if deemed necessary. / Biyolojik ajanlar siklosporin, asitretin, metotreksat veya fototerapi/fotokemoterapi gibi geleneksel sistemik tedavilere yanıt vermeyen ya da bu tedavilerin kontrendike olduğu durumlarda psoriasis tedavisinde kullanılırlar. Bu ajanları kullanacak hastalar biyolojik ajan için uygunluk ölçütlerine göre belirlenir. Hastalar tedavi öncesinde ve tedavi süresince uygun laboratuvar parametreleri ile belirli aralıklarla dğerlendirilirler. Hastalar özellikle tüberküloz, maligniteler, konjestif kalp yetmezliği, demiyelinizan hastalıklar ve enfeksiyonlar açısından değerlendirilmelidir. Tedaviye başlamadan önce mümkünse gerekli olan tüm aşılar yaptırılmalıdır. Tedavi esnasında canlı aşı yapılmamalı, cerrahi müdahale gerektiren hastalar postoperatif enfeksiyon riski açısından olgu bazlı değerlendirilerek gerekli görülen durumlarda tedaviye ara verilmelidir.
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    Recommendations on the use of systemic treatments for urticaria and atopic dermatitis during the COVID-19 pandemic: statement of Dermatoallergy Working Group of the Turkish Society of Dermatology
    (Galenos Yayınevi, 2020) Salman, Andaç; Atakan, Nilgün; Başkan, Emel Bülbül; Borlu, Murat; Canpolat, Filiz; Erdem, Teoman; Erdem, Yasemin; Gül, Ülker; Kartal, Selda Pelin; Koca, Rafet; Küçük, Özlem Su; Öğretmen, Zerrin; Özkaya, Esen; Sarıcaoğlu, Hayriye; Savk, Ekin; Taşkapan, Oktay; Utas, Serap; Alper, Fatma Sibel; Kocatürk Göncü, Özgür Emek; Faculty Member; Faculty Member; School of Medicine; N/A; 217219
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    Etanercept
    (Galenos Yayınevi, 2022) Alper, Fatma Sibel; Faculty Member; School of Medicine
    Etanercept is a recombinant human receptor fusion protein that suppresses, as a contestant, the interaction of TNF-alpha with cell surface receptors. It received FDA approval in 1999 to be used in children older than 2 years for the treatment of juvenile idiopathic arthritis. In September 2004, it received approval for the treatment of patients with moderate to severe psoriasis who do not respond to conventional systemic treatments or for whom these therapies are contraindicated or intolerable. / Etanersept, TNF-alpha’nın hücre yüzey reseptörleri ile etkileşimini yarışmacı olarak baskılayan rekombinant insan reseptör füzyon proteinidir. Juvenil idiyopatik artritte iki yaş üstü için 1999 yılında FDA onayı almıştır. Eylül 2004’te ise sistemik konvansiyonel tedavilere yanıt vermeyen, bu tedavilerin kontrendike olduğu veya tolere edilemediği orta-şiddetli psoriasis hastalarının tedavisi için onay almıştır ve aralıklı tedavide de etkindir.