Browsing by Author "Seckin, D."

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    Clinicopathological features, MCPyV status and outcomes of Merkel cell carcinoma in solid-organ transplant recipients: a retrospective, multicentre cohort study
    (2022) Ferrandiz-Pulido, C.; Gomez-Tomas, A.; Llombart, B.; Mendoza, D.; Marcoval, J.; Piaserico, S.; Baykal, C.; Bouwes-Bavinck, J.N.; Racz, E.; Kanitakis, J.; Harwood, C.A.; Cetkovska, P.; Geusau, A.; Del Marmol, V; Masferrer, E.; Cano, C.Orte; Ricar, J.; de Oliveira, W.R.; Salido-Vallejo, R.; Ducroux, E.; Gkini, M.A.; Lopez-Guerrero, J.A.; Kutzner, H.; Kempf, W.; Seckin, D.; 35607918
    Background The proportion of Merkel cell carcinomas (MCCs) in solid-organ transplant recipients (SOTR) harbouring Merkel cell polyomavirus (MCPyV) is unknown, as are factors affecting their outcomes. Objective To describe clinicopathological features of MCC in SOTR, investigate the tumoral MCPyV-status and identify factors associated with tumour outcomes. Methods Retrospective, international, cohort-study. MCPyV-status was investigated by immunohistochemistry and polymerase chain reaction. Results A total of 30 SOTR and 44 consecutive immunocompetent patients with MCC were enrolled. SOTR were younger at diagnosis (69 vs. 78 years, P < 0.001). Thirty-three percent of SOTR MCCs were MCPyV-positive vs. 91% of immunocompetent MCCs (P = 0.001). Solid-organ transplantation was associated with an increased cumulative incidence of progression (SHR: 3.35 [1.57-7.14], P = 0.002), MCC-specific mortality (SHR: 2.55 [1.07-6.06], P = 0.034) and overall mortality (HR: 3.26 [1.54-6.9], P = 0.002). MCPyV-positivity and switching to an mTOR inhibitor (mTORi) after MCC diagnosis were associated with an increased incidence of progression (SHR: 4.3 [1.5-13], P = 0.008 and SHR: 3.6 [1.1-12], P = 0.032 respectively) in SOTR. Limitations Retrospective design and heterogeneity of SOTR cohort. Conclusions MCPyV appears to play a less prominent role in the aetiopathogenesis of MCC in SOTR. SOTR have a worse prognosis than their immunocompetent counterparts and switching to an mTORi after the diagnosis of MCC does not improve progression.
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    Cutaneous Atypical Papular CD8+Lymphoproliferative Disorder at Acral Sites in A Renal Transplant Patient
    (2017) Baykal, C.; Buyukbabani, N.; Seckin, D.; Ekinci, A. Polat; Yilmaz, Z.; Kempf, W.; 29055067
    A 20-year-old woman presented with a 2-month history of an acute symmetrical eruption, manifesting as asymptomatic ill-defined erythematous macules and hyperkeratotic papules on the palms. The patient was a renal transplant recipient, and the lesions had developed 2months post-transplantation. Histologically, the eruption shared features of a reactive inflammatory condition called papular eruption of atypical CD8+ lymphocytes as well as primary cutaneous acral CD8+ T-cell lymphoma (a provisional indolent entity in the new World Health Organisation classification of lymphoid neoplasms, 2016). The latter disorder has been described to occur at acral sites in immunocompetent patients, whereas the former has previously been described only in patients infected with human immunodeficiency virus. The lesions in our patient healed after topical treatment with corticosteroids and alteration of immunosuppressive therapy, supporting the role of immunosuppression in this case. We classified our patient's condition as lying in the spectrum of the aforementioned two conditions, but the relationship between both diseases remains to be clarified. Awareness of these unusual conditions may prevent the use of unnecessary aggressive therapies in similar patients.
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    Cutaneous Lymphoproliferative Disorders in Organ Transplant Recipients: Update 2014
    (2014) Seckin, D.; 25068227
    Post-transplant lymphoproliferative disorders (PTLD) are lymphoid or plasmacytic proliferations that develop after solid organ, bone marrow or stem cell transplantation. PTLD are the leading cause of cancer-related mortality and graft loss in both pediatric and adult solid organ transplant recipients (ORT). These disorders comprise a spectrum ranging from usually EBV-driven, mostly B-cell polyclonal proliferations to B- and T-cell lymphomas indistinguishable from their counterparts occurring in immunocompetent individuals. PTLD usually present in extranodal sites; isolated skin involvement of PTLD is rare. A recent multicenter European case series showed that primary cutaneous T-cell PTLD are more common than primary cutaneous B-cell PTLD, and along with its folliculotropic variant, mycosis fungoides (MF) is the most frequent form of posttransplant primary cutaneous T-cell lymphoma (CTCL). This case series also disclosed that primary cutaneous CD30+ lymphoproliferative disorders is the second most common posttransplant CTCL subtype, indicating that the spectrum of primary CTCL in OTR is similar to that in the general population. However, in contrast with the immunocompetent individuals, the prognosis of primary cutaneous CD30+ anaplastic large T-cell lymphoma is worse than posttransplant MF and than its counterpart in the general population which has an excellent prognosis. The recent case series indicated that the spectrum of primary cutaneous B-cell PTLD differs significantly from cutaneous B-cell lymphoma in the general population, with a predominance of EBV-associated forms. Currently, the best therapeutic intervention(s) for primary cutaneous PTLD remains unknown.
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    N-Acetylcysteine in the Treatment of Trichotillomania: Remarkable Results in Two Patients
    (2016) Ozcan, D.; Seckin, D.; 0000-0002-7450-6886; 27146087; AAQ-6649-2021
    BackgroundThe management of trichotillomania is challenging. The limited efficacy and side-effects of pharmacological medications and difficulty in long-term maintenance of behavioural therapies necessitates alternative treatment options. A dysregulated glutamatergic system has been implicated in the pathophysiology of trichotillomania. A limited number of reports indicate that N-acetylcysteine (NAC), a glutamate modulator, may be a promising treatment for this disorder. ObjectivesWe report two patients with trichotillomania for whom treatment with NAC was successful. MethodsThe first patient was a 30-year-old female, and the second patient was a 14-year-old girl, both who were diagnosed with trichotillomania and prescribed NAC (1200 mg/d, p.o.). ResultsHair pulling behaviour subsided within 2 months and 2 weeks of initiating NAC in the first and second patient, respectively. Complete hair regrowth was observed after 4 and 6 months of NAC treatment in the first and second patient, respectively. No side-effects related to NAC were noted. ConclusionNAC could be a well-tolerated and effective treatment option for trichotillomania.
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    Painful skin lesions and squamous cell carcinoma predict overall mortality risk in organ transplant recipients: a cohort study
    (2017) Seckin, D.; Oh, C.C.; Hofbauer, G.F.L.; Serra, A.L.; Harwood, C.A.; Mitchell, L.; Proby, C.M.; Olasz, E.B.; Mosel, D.D.; Piaserico, S.; Fortina, A.B.; Geusau, A.; Jahn-Bassler, K.; Gerritsen, M. J. P.; Gulec, A.T.; Cetkovska, P.; Ricar, J.; Imko-Walczuk, B.; Debska-Slizien, A.; Bavinck, J. N. Bouwes; 28012178
    BackgroundOrgan transplant recipients (OTRs) have a highly increased risk of cutaneous squamous cell carcinomas (SCCs). Sensation of pain in cutaneous tumours is a powerful patient-reported warning signal for invasive SCCs in OTRs. ObjectivesTo investigate the impact of painful vs. painless skin lesions and SCC vs. other skin lesions on the overall mortality risk in OTRs. MethodsWe followed 410 OTRs from 10 different centres across Europe and North America between 2008 and 2015. These patients had been enrolled in an earlier study to define clinically meaningful patient-reported warning signals predicting the presence of SCC, and had been included if they had a lesion requiring histological diagnosis. Cumulative incidences of overall mortality were calculated using Kaplan-Meier survival analysis, and risk factors were analysed with Cox proportional hazard analysis. ResultsThere was an increased overall mortality risk in OTRs who reported painful vs. painless skin lesions, with a hazard ratio (HR) of 16 [95% confidence interval (CI) 097-27], adjusted for age, sex and other relevant factors. There was also an increased overall mortality risk in OTRs diagnosed with SCC compared with other skin lesions, with an adjusted HR of 17 (95% CI 10-28). Mortality due to internal malignancies and systemic infections appeared to prevail in OTRs with SCC. ConclusionsWe suggest that OTRs have an increased overall mortality risk if they develop painful skin lesions or are diagnosed with cutaneous SCC.
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    Pemphigus Herpetiformis: Six Additional Cases with an Emphasis on Eczema-Like Features and The Diagnostic Utility of Tzanck Smears
    (2016) Durdu, M.; Seckin, D.; https://orcid.org/0000-0003-1247-3932; 25545200; H-9068-2019
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    Pigmentary Demarcation Lines of Pregnancy in Two Caucasian Women
    (2015) Purnak, S.; Ozcan, D.; Seckin, D.; 0000-0002-7450-6886; 25065483; AAQ-6649-2021