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    Clinical practice guidelines for the diagnosis and treatment of cutaneous leishmaniasis in Turkey
    (WILEY, 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
    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.
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    Clinical practice guidelines for the diagnosis and treatment of scabies
    (Wiley, 2024) Uzun, Soner; Durdu, Murat; Yurekli, Aslan; Mulayim, Mehmet K.; Akyol, Melih; Velipasaoglu, Sevtap; Harman, Mehmet
    Scabies, caused by the Sarcoptes scabiei var hominis mite burrowing into the skin, is a highly contagious disease characterized by intense nocturnal itching. Its global impact is considerable, affecting more than 200 million individuals annually and posing significant challenges to healthcare systems worldwide. Transmission occurs primarily through direct skin-to-skin contact, contributing to its widespread prevalence and emergence as a substantial public health concern affecting large populations. This review presents consensus-based clinical practice guidelines for diagnosing and managing scabies, developed through the fuzzy Delphi method by dermatology, parasitology, pediatrics, pharmacology, and public health experts. The presence of burrows containing adult female mites, their eggs, and excreta is the diagnostic hallmark of scabies. Definitive diagnosis typically involves direct microscopic examination of skin scrapings obtained from these burrows, although dermoscopy has become a diagnostic tool in clinical practice. Treatment modalities encompass topical agents, such as permethrin, balsam of Peru, precipitated sulfur, and benzyl benzoate. In cases where topical therapy proves inadequate or in instances of crusted scabies, oral ivermectin is recommended as a systemic treatment option. This comprehensive approach addresses the diagnostic and therapeutic challenges associated with scabies, optimizing patient care, and management outcomes.
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    Epidemiology of Pemphigus in Turkey: One-year Prospective Study of 220 Cases
    (CROATION DERMATOVENEROLOGICAL SOC, 2017) Yayli, Savas; Harman, Mehmet; Baskan, Emel Bulbul; Karakas, Ayse Akman; Genc, Yeser; Turk, Bengu Gerceker; Demirsoy, Evren Odyakmaz; Gunasti, Suhan; Bilgili, Serap Gunes; Ilter, Nilsel; Ferahbas, Ayten; Savk, Ekin; Afsar, Fatma Sule; Aytekin, Sema; Kaya, Tamer Irfan; Hayta, Sibel Berksoy; Ozgen, Zuleyha; Gurel, Mehmet Salih; Caliskan, Ercan; Balci, Didem Didar; Gungor, Sule; Kapicioglu, Yelda; Ozuguz, Pinar; Aktan, Sebnem; Dogramaci, Asena; Kokcam, Ibrahim; Onsun, Nahide; Seckin, Deniz; Durdu, Murat; Dursun, Recep; Daye, Munise; Dilek, Nursel; Karabacak, Ercan; Temel, Asli Bilgic; Erdem, Cengizhan; Altun, Ece; Gungor, Dilek; Kartal, Demet; Akyol, Melih; Aksu, Esra Koku; Uzun, Soner
    Pemphigus is a group of rare and life-threatening autoimmune blistering diseases of the skin and mucous membranes. Although they occur worldwide, their incidence shows wide geographical variation, and prospective data on the epidemiology of pemphigus are very limited. Objective of this work is to evaluate the incidence and epidemiological and clinical features of patients with pemphigus in Turkey. All patients newly diagnosed with pemphigus between June 2013 and June 2014 were prospectively enrolled in 33 dermatology departments in 20 different provinces from all seven regions of Turkey. Disease parameters including demography and clinical findings were recorded. A total of 220 patients were diagnosed with pemphigus during the 1-year period, with an annual incidence of 4.7 per million people in Turkey. Patients were predominantly women, with a male to female ratio of 1:1.41. The mean age at onset was 48.9 years. Pemphigus vulgaris (PV) was the commonest clinical subtype (n= 192; 87.3%), followed by pemphigus foliaceus (n= 21; 9.6%). The most common clinical subtype of PV was the mucocutaneous type (n= 83; 43.2%). The mean Pemphigus Disease Area Index was 28.14 +/- 22.21 (mean +/- Standard Deviation). The incidence rate of pemphigus in Turkey is similar to the countries of South-East Europe, higher than those reported for the Central and Northern European countries and lower than the countries around the Mediterranean Sea and Iran. Pemphigus is more frequent in middle-aged people and is more common in women. The most frequent subtype was PV, with a 9-fold higher incidence than pemphigus foliaceus.