Browsing by Author "Durdu, Murat"

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Annular Neutrophilic Dermatoses
(2023) Koska, Mahmut Can; Karada, Ayse Serap; Durdu, Murat; 37423267
Neutrophilic dermatoses (NDs) constitute a group of diseases characterized by sterile neutrophilic infiltrations. Many NDs usually present with infiltrated erythematous plaques, nodules, urticarial plaques, or pustules. Lesions may show variability, and atypical presentations may develop among NDs. Annular lesions have been reported in many NDs and may lead to diagnostic problems. Clinical features and histopathologic findings such as localization of the neutrophilic infiltrate, existence of other cell types, and absence of true vasculitis may be helpful to distinguish NDs. Some of these NDs are associated with infections, inflammatory diseases, and malignancies. In most NDs, systemic steroids and dapsone are very effective and usually first choices. Colchicine, antimicrobials such as doxycycline, tetracycline, and sulfapyridine, and other immunosuppressants such as cyclosporin, methotrexate, and mycophenolate mofetil have been used successfully in treating many NDs. Tumor necrosis factor alpha inhibitors have also been used successfully in treating many NDs. Janus kinase inhibitors are effective in CANDLE (chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature) syndrome, anakinra in neutrophilic urticarial dermatosis, and intravenous immunoglobulin in resistant pyoderma gangrenosum. We discuss the diagnosis and management of NDs that may present with annular lesions. (c) 2023 Elsevier Inc. All rights reserved.
Apoptotic Bodies due to Erythema Multiforme: Cytological, Histopathological and Immunofluorescence Findings
(2017) Durdu, Murat; 0000-0003-1247-3932; H-9068-2019
Chanarin Dorfman Syndrome: A Case Report
(2015) Ozkale, Yasemin; Erol, Ilknur; Canan, Oguz; Durdu, Murat
Chanarin Dorfman Syndrome is a multisystem inherited metabolic disorder associated with congenital ichthyosis and accumulation of lipid droplets in varios types of cells. Observation of lipid vacuoles in neutrophils (Jordan's anomaly) in peirpheral blood smears in patients with ichthyosis is diagnostic for Chanarin Dorfman Syndrome. Since the initial case was reported by Dorfman in 1974, nearly 50 cases have been reported in the literature, and the majority were from Middle East countries. In this report we presented a 5 year old patient who admitted to our hospital for creatine kinase elevation and diagnosed as Chanarin Dorfman Syndrome with clinical and laboratory findings.
Changing Concepts and Current Definition of Majocchi's Granuloma
(2020) Durdu, Murat; Kandemir, Hazal; Ilkit, Macit; de Hoog, G. Sybren; 31297666
Dermatophytic granuloma characterized by perifollicular granulomatous inflammation was first described by Domenico Majocchi and was later named after him, Majocchi's granuloma (MG). Although the initial description was related to a dermatophyte Trichophyton tonsurans, later reports linked MG to non-dermatophytes (Phoma, Aspergillus, Malbranchea), which led to a confusion of disease patterns caused by cutaneous pathogens and general opportunistic microorganisms. Furthermore, several causative agents of MG described in the literature were not confirmed as such. Our review addressed the following aspects: (1) significance of histopathological finding for MG diagnosis, (2) dermatophytes as exclusive agents of MG, (3) spectrum of etiological agents causing different types of invasive dermatophytic infections, and (4) treatment options.
Clinical and Cytologic Features of Antibiotic-Resistant Acute Paronychia
(2014) Durdu, Murat; Ruocco, Vincenzo; https://orcid.org/0000-0003-1247-3932; 24355264; H-9068-2019
Background: Acute paronychia usually is treated as a bacterial infection, but antibiotic-resistant acute paronychia may be caused by other infectious and noninfectious problems. Objective: We sought to describe the clinical, etiologic, cytologic, and therapeutic features of antibiotic-resistant acute paronychia. Methods: A retrospective review of medical records and cytology was performed in 58 patients (age, 1 month-91 years; 36 children and adolescents [62%] and 22 adults [38%]) who had antibiotic-resistant acute paronychias. Results: Causes of paronychia included bacteria (25 patients [43%]), viruses (21 patients [36%]), fungi (5 patients [9%]), drugs (3 patients [5%]), pemphigus vulgaris (3 patients [5%]), and trauma (1 patient [2%]). Diagnostic cytologic findings were noted in 54 patients (93%); no diagnostic cytologic findings were present with drug-induced (3 patients) or traumatic (1 patient) paronychia. The most common predisposing factors were the habits of finger-or thumb-sucking (14 patients [24%]) and nail-biting (11 patients [19%]). Complications included id reaction with erythema multiforme in 3 patients (5%). Limitations: Limitations include retrospective study design from 1 treatment center. Conclusion: Antibiotic-resistant acute paronychia may be infectious or noninfectious. Cytologic examination with Tzanck smear may be useful diagnostically and may prevent unnecessary use of antibiotics and surgical drainage.
Clinical and genetic characterization of a Chanarin Dorfman Syndrome patient born to diseased parents
(2018) Durdu, Murat; Missaglia, Sara; Moro, Laura; Tavian, Dainela; 0000-0003-1247-3932; 29843625; H-9068-2019
Background: Chanarin Dorfman Syndrome (CDS) is a rare autosomal recessive disorder characterized by ichthyosiform non-bullous erythroderma and variable involvement of the liver and the neuromuscular system. In CDS patients, the accumulation of neutral lipids inside cytoplasmic lipid droplets has been demonstrated in different tissues. To date, ninety families with this disease have been described worldwide; most of them are from Mediterranean countries. Case presentation: In this report, we describe a consanguineous Turkish family with typical features of CDS. The parents are first cousins and are both diseased. At the age of eight, their child presented CDS with non-bullous congenital ichthyosiform erythroderma, hepatosteatosis, hepatomegaly and ectropion. Electromyographic examination is compatible with myopathy. A five-year-old cousin of the child is also affected by CDS. She was born to non-affected consanguineous parents. Mutation analysis of the ABHD5 gene revealed the previously reported mutation, N209X, which is the most frequent in Turkish patients. Lipid vacuoles, also known as Jordan's anomaly, are detectable in their leucocytes. Conclusions: To the best of our knowledge, this is the first report of a CDS family in which both parents and their child are affected by CDS. To date, the child does not present a more severe clinical phenotype compared with those of his relatives or other CDS patients of the same age. These findings suggest that high levels of triacylglycerol accumulation, that may be supposed to be present in high amount inside the ooplasm, did not affect embryo development and foetal growth.
Clinical and Laboratory Features of Six Cases of Candida and Dermatophyte Folliculitis and a Review of Published Studies
(2016) Durdu, Murat; Guran, Mumtaz; Kandemir, Hazal; Ilkit, Macit; Seyedmousavi, Seyedmojtaba; https://orcid.org/0000-0003-1247-3932; 26337525; H-9068-2019
Although some studies have investigated the epidemiological characteristics of Malassezia folliculitis (MF), little is known about the clinical features and laboratory characteristics of folliculitis caused by other fungi. In this prospective study, 158 patients with folliculitis were identified, and cytological and mycological examinations were performed. The positive fungal cultures were confirmed using conventional methods, ITS sequencing and HWP1 analysis. Additionally, an in vitro antifungal susceptibility test was performed. Of 158 patients with folliculitis, 65 (41.1 %) were found to have fungal folliculitis. The most common (90.8 %) fungal folliculitis was MF. Non-MF fungal folliculitis was detected in 6 (9.2 %) patients. Four patients were diagnosed with dermatophytic folliculitis (Trichophyton rubrum in three patients and Arthroderma vanbreuseghemii in one patient), and two patients were diagnosed with Candida albicans folliculitis. Although only 5 of the 6 samples were found to be positive via a potassium hydroxide test, all May-Grunwald-Giemsa-stained samples were positive. Both of the C. albicans isolates demonstrated a susceptibility profile to itraconazole, and all four dermatophytes were susceptible to terbinafine. All six patients completely recovered with systemic and topical treatment. This study revealed that dermatophytes and C. albicans are the primary causative agents of non-Malassezia fungal folliculitis. We compared our findings with published reports on fungal folliculitis.
Clinical Practice Guidelines for The Diagnosis and Treatment of Cutaneous Leishmaniasis in Turkey
(2018) Uzun, Soner; Gurel, Mehmet S.; Durdu, Murat; Akyol, Melih; Karaman, Bilge Fettahlioglu; Aksoy, Mustafa; Aytekin, Sema; Borlu, Murat; Dogan, Esra Inan; Dogramaci, Cigdem Asena; Kapicioglu, Yelda; Akman-Karakas, Ayse; Kaya, Tamer I.; Mulayim, Mehmet K.; Ozbel, Yusuf; Toz, Seray Ozensoy; Ozgoztasi, Orhan; Yesilova, Yavuz; Harman, Mehmet; https://orcid.org/0000-0003-1247-3932; 29663351; H-9068-2019
Background Cutaneous leishmaniasis ( CL) is a vector- born parasitic disease characterized by various skin lesions that cause disfiguration if healed spontaneously. Although CL has been endemic for many years in the southern regions of Turkey, an increasing incidence in nonendemic regions is being observed due to returning travelers and, more recently, due to Syrian refugees. Thus far, a limited number of national guidelines have been proposed, but no common Turkish consensus has emerged. Objectives The aim of this study was to develop diagnostic and therapeutic guidelines for the management of CL in Turkey. Methods This guideline is a consensus text prepared by 18 experienced CL specialists who have been working for many years in areas where the disease is endemic. The Delphi method was used to determine expert group consensus. Initially, a comprehensive list of items about CL was identified, and consensus was built from feedback provided by expert participants from the preceding rounds. Results Evidence- based and expert- based recommendations through diagnostic and therapeutic algorithms according to local availability and conditions are outlined. Conclusion Because CL can mimic many other skin diseases, early diagnosis and early treatment are very important to prevent complications and spread of the disease. The fastest and easiest diagnostic method is the leishmanial smear. The most common treatment is the use of local or systemic pentavalent antimony compounds.
Cytologic Findings of Eosinophilic Dermatoses: a Retrospective Analysis of 88 Patients
(2016) Durdu, Murat; 0000-0003-1247-3932; H-9068-2019
Objectives: Eosinophilic skin infiltration may develop as a result of a variety of infectious, inflammatory, and neoplastic diseases. To distinguish these diseases histopathologic examination is usually considered. So far, only a few studies have investigated cytologic findings of some eosinophilic diseases. In this retrospective study, our aim was to define the cytologic findings of eosinophilic dermatoses and to develop an algorithmic approach based on the cytologic findings. Methods: Patients who applied to the dermatology polyclinic through January 2010 to January 2015 could not be diagnosed only by clinical examination were further evaluated with May-Grunwald-Giemsa-stained preparations by a dermatologist. Patients with abundant eosinophils in microscopic examination were included in this study. After routine cytologic examination additional staining was also performed in some of these patients. The final diagnosis was established according to their clinical laboratory and histopathologic findings. Results: Over a 5-year period, 88 of 3.214 patients (2.7%) who underwent cytologic examination at our center had plenty of eosinophils. According to the final diagnoses, 44 lesions (50%) were spongiotic dermatitis, 17 lesions (19.3%) were infectious diseases, 13 lesions (14.8%) were autoimmune bullous, 11 lesions (12.5%) were idiopathic eosinophilic diseases, and 3 lesions (3.4%) were granulomatous diseases. Conclusion: Cytologic examination of people with eosinophilic skin diseases cytologic findings accompanying eosinophils could help for diagnosis of some diseases.
Cytology in the Diagnosis of Dermatological Diseases: Tzanck Smear
(2016) Durdu, Murat; 0000-0003-1247-3932; H-9068-2019
Cytology is a simple, quick, reliable, and inexpensive diagnostic method based on the investigation of characteristic features of individual cells. In this diagnosis method, cellular materials are obtained by scraping method, slit-skin smear, touch smear or fine needle aspiration method according to the types of skin lesions. Obtained materials are immediately spread onto microscopic slide as a thin layer. Slides were stained with various cytological dyes, and examined under the light microscope. Until today, dermatological cytology has been used in the diagnosis of various erosive-vesiculobullous, pustular, granulomatous, and tumoral skin lesions. In this review article, the sampling methods for dermatological cytology were described, and the cytologic findings of skin diseases which could provide a rapid diagnosis were discussed.
Dermatolojik hastalıkların tanısında üç farklı telesitoloji yönteminin tanısal güvenilirliği
(Başkent Üniversitesi Tıp Fakültesi, 2014) Ertürk Özdemir, Emel; Durdu, Murat
Sitoloji, pek çok eroziv-vezikülobüllöz, tümöral ve granülomatöz hastalıkta kullanılan kolay, hızlı, ucuz ve tekrarlanabilir bir tanı yöntemidir. Sitolojinin uygulanabildiği tüm hastalıklarda değerlendirme yapabilmek için deneyim gerekir. Günümüzde teknolojik gelişmelerle preparatlar doğrudan inceleme olanağı olmayan uzaktaki deneyimli kişiler tarafından değerlendirilebilmekte ve bu işlemler telesitoloji olarak adlandırılmaktadır. Dermatoloji dışında diğer sistem hastalıkların tanısında telesitoloji ile ilgili çalışmalar yapılmasına rağmen dermatolojik hastalıklarda uygulanmamıştır. Bu çalışmada dermatolojik hastalıkların tanısında üç farklı telesitoloji yönteminin tanısal güvenilirliğinin değerlendirilmesi amaçlanmıştır. Çalışmaya Başkent Üniversitesi Tıp Fakültesi Deri ve Zührevi Hastalıkları Kliniği’ne Temmuz 2012 ile Mart 2013 tarihleri arasında başvuran ve Tzanck yayma testi yapılan hastalar alındı. Alınan bu örnekler 4 farklı dermatolog tarafından değerlendirildi. Sitolojik örneklerin alınması, klinik, sitolojik ve gerekli laboratuvar bulguları eşliğinde kesin tanıların konulması Dermatolog A tarafından yapıldı. Kesin tanı konulan hastaların sitolojik örnekleri mikroskopik görüntülerin fotoğraflanması, videomikroskopi ve eşzamanlı dinamik dijital mikroskopi yöntemleri ile sırası ile Dermatolog B, Dermatolog C ve Dermatolog D tarafından değerlendirildi. Telesitolojik tanıların birbirleri ve kesin tanılar ile uyumu istatistiksel olarak değerlendirildi. Sitolojik inceleme yapılan toplam 84 (44’ü [%52.4] erkek ve 40’ı [%47.6] kadın) hasta çalışmaya dahil edildi. Hastaların 49 (%58.3)’u enfeksiyöz hastalıklar, 31 (%36.9)’i tümöral hastalıklar, 3 (%3.6)’ü spongiotik dermatit ve 1 (%1.2)’i genodermatozlar grubunda yer aldı. Her üç telesitoloji yönteminin tüm hastalıklar üzerindeki tanısal güvenilirliği çok iyi derecede bulundu. Hastalık alt gruplarına göre tümoral hastalıklarda eşzamanlı dinamik dijital mikroskopi yönteminin tanısal güvenilirliği çok iyi derecede iken diğer yöntemlerinki iyi derecede idi. Çalışmamızın sonuçları göstermiştir ki dermatolojik hastalıkların tanısında üç farklı telesitoloji yöntemi güvenilir olmakla birlikte tümoral hastalıklarda en güvenilir yöntem eşzamanlı dinamik dijital mikroskopidir.
Dermoscopic and Cytological Findings in Scleromyxedema
(DERMATOLOGY PRACTICAL & CONCEPTUAL, 2023) Tehci, Tugba; Senyurt, Elif Burcu; Durdu, Murat; Errichetti, Enzo
Diagnosis and Treatment for Nonsurgical Basal Cell Carcinoma Diseases
(2016) Durdu, Murat; 0000-0003-1247-3932; H-9068-2019
Diagnostic Reliability of The Tzanck Smear in Dermatologic Diseases
(2014) Eryilmaz, Aydolu; Durdu, Murat; Baba, Mete; Yildirim, Fatma E.; https://orcid.org/0000-0001-6554-519X; https://orcid.org/0000-0003-1247-3932; https://orcid.org/0000-0001-6801-8491; 23557278; AAK-5324-2021; H-9068-2019; HGU-2777-2022; C-4705-2014
Background The Tzanck smear is a simple, easily applicable, rapid, and inexpensive test for the diagnosis of erosive vesiculobullous, tumoral, and granulomatous diseases. The diagnostic accuracy of the Tzanck smear is known, but its diagnostic reliability has been evaluated only in herpetic infections and basal cell carcinoma. Objectives The aim of this study was to evaluate the diagnostic reliability of the Tzanck smear in erosive vesiculobullous, tumoral, and granulomatous diseases. Methods Patients evaluated by Tzanck smear at Bakent University Faculty of Medicine, Department of Dermatology, between February 2009 and July 2010, were included. Three dermatologists were involved in the study. Dermatologist A performed a clinical dermatologic examination, took the smear material, made a clinical diagnosis, and compared the clinical and cytological diagnoses. Dermatologists B and C evaluated the smears. Agreement between the latter two dermatologists on the cytological diagnoses was determined. Results In 500 patients, a total of 272 (54%) erosive vesiculobullous, 190 (38%) tumoral, and 38 (8%) granulomatous lesions were diagnosed. The diagnostic reliability of the Tzanck smear was reasonably substantial (=0.59) for all types of lesions, substantial for erosive vesiculobullous (=0.79) and granulomatous (=0.68) lesions, and moderate (=0.50) for tumoral lesions. Conclusions The Tzanck smear may be used for the evaluation of erosive vesiculobullous and granulomatous lesions with brief training. However, the evaluation of tumoral lesions by Tzanck smear requires more experience.
Diagnostic Value of Telecytology in Tertiary Teledermatological Consultation: A Retrospective Analysis of 75 Cases
(2016) Durdu, Murat; Harman, Mehmet; https://orcid.org/0000-0003-1247-3932; 26873118; H-9068-2019
Background The addition of dermatoscopic images to clinical images is reported to increase the diagnostic value of teledermatology. No study has investigated the contribution of telecytology to teledermatology. We aimed to assess the diagnostic accuracy of telecytology in tertiary teledermatological evaluation. Methods The study included 75 patients for whom no diagnosis could be established at face-to-face clinical examinations and cytological evaluations, who therefore consulted with a dermatologist experienced in cytology through the store-and-forward method. Telecytological diagnosis was then compared with the final diagnosis, and diagnostic accuracy was calculated. Results In the past 2 years, 75 patients (38 [50.7%] female, 37 [49.3%] male) were evaluated by telecytology. According to definitive diagnoses, 31 patients (41.3%) had erosive-vesiculobullous, 25 (33.3%) had tumoral, and 19 (15.8%) had granulomatous disease. Diagnostic accuracy of telecytology was 90.7%. Limitations Our study was a retrospective study, and cytological images were evaluated by one dermatologist only; therefore, no reliability analysis could be performed. Conclusion This study revealed that the cytological images should be used in tertiary teledermatological evaluation. Further studies should therefore be carried out to investigate the diagnostic value of different telecytological methods.
Dramatic response to colchicine treatment in acne fulminans patients with cytological hemophagocytosis: A case series of 12 patients
(2022) Durdu, Murat; Tehci, Tugba; Karadag, Ayse Serap; https://orcid.org/0000-0003-1247-3932; 36156836
Acne fulminans is a severe form of acne with a sudden onset, rapid ulceration of the lesions, and some systemic symptoms, with or without systemic symptoms. These papulopustular lesions, whose pathogenesis is not fully understood, may exacerbate with systemic isotretinoin or may be a component of some autoinflammatory syndromes. It is recommended to control these sudden pustular attacks with systemic steroids or anti-inflammatory drugs. Here, in 12 patients with acne fulminans who developed exacerbation during systemic isotretinoin treatment and whose cytological examination revealed hemophagocytosis, colchicine treatment was started in addition to low-dose isotretinoin treatment, and a very good response was obtained to this treatment approach that did not contain systemic corticosteroids.
Efficacy and Safety of Diphenylcyclopropenone Alone or in Combination with Anthralin in the Treatment of Chronic Extensive Alopecia Areata: A Retrospective Case Series
(2015) Durdu, Murat; Ozcan, Deren; Baba, Mete; Seckin, Deniz; 0000-0002-7450-6886; 0000-0003-1247-3932; 25653027; AAQ-6649-2021; H-9068-2019; HGU-2777-2022
Background: Some patients with chronic extensive alopecia areata (AA) may be refractory to topical immunotherapy. Combination therapy is recommended for such patients. Efficacy and safety of a combination therapy with diphenylcyclopropenone (DPCP) and anthralin in chronic extensive AA is unknown. Objective: We sought to determine whether the combination therapy of DPCP and anthralin is superior to DPCP alone in chronic extensive AA. Methods: We retrospectively analyzed the efficacy, side effects, and relapse rates of DPCP (alone or with anthralin) in chronic extensive AA. Results: A total of 47 patients (22 were treated only with DPCP, and 25 with DPCP and anthralin for at least 30 weeks) were evaluated. Complete hair regrowth was observed in 36.4% and 72% of the patients who received DPCP and combination therapy, respectively (P = .01). Hair regrowth duration was shorter with combination therapy (P = .01). Regrowth rates of the eyebrows, eyelashes, and beard in patients on combination therapy were higher than those in patients on DPCP (P = .01). Side effects such as folliculitis, hyperpigmentation, and staining of skin, hair, and clothes were more common in combination therapy group. Limitations: The retrospective design and small number of patients are limitations. Conclusion: Combination therapy with DPCP and anthralin is superior to DPCP alone in chronic extensive AA.
Filler Reactions: Case Report and Review of the Literature
(2017) Durdu, Murat; Bozca, Cansu; Kocer, Nazim Emrah; 0000-0003-1247-3932; 0000-0002-5943-9283; H-9068-2019; AAM-5436-2021
A gradual increasing interest in cosmetic procedures and the implementation of these practices by non-physicians have led to the development of various complications. Some of these complications are transient, while others require severe systemic treatments, and some may be life-threatening. These complications cause depression and isolated from society. In this article, three different reactions in the light of literature data due to the application of vitamins E, which are not fillers, have been presented and reactions of filler substances and treatment approaches are reviewed.
First Terbinafine-Resistant Trichophyton indotineae Isolates with Phe397Leu and/or Thr414His Mutations in Turkey
(2023) Durdu, Murat; Kandemir, Hazal; Karakoyun, Ayse Sultan; Ilkit, Macit; Tang, Chao; de Hoog, Sybren; https://orcid.org/0000-0003-1247-3932; 36656402; H-9068-2019
Fungal infections of the skin, nails, and hair caused by dermatophyte species continue to be a worldwide concern. The increase in terbinafine-resistant superficial dermatophytosis has become a major concern over the last decade. In this report, we presented two cases of infection with terbinafine-resistant Trichophyton indotineae, the first diagnosis of this species in Turkey. One patient exhibited erythematous pruritic patches and plaques in the inguinal and gluteal regions, while the other patient showed annular erythematous scaly plaques in the bilateral posterior thigh and gluteal regions. One patient harbored a CD36 mutation. Both strains harbored the same amino acid substitution in the squalene epoxidase gene, whereas one isolate had another unknown mutation. Clinical improvement was observed with resveratrol treatment in the patient with the CD36 mutation but not in the other patient.
Fungal Fluorescence in Hematoxylin Eosin Stained Sections
(2017) Durdu, Murat; 0000-0003-1247-3932; H-9068-2019