Browsing by Author "Onsun, Nahide"
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Item Characteristics and risk profile of patients with psoriasis included in the Turkish national registry PSR-TR(Wiley, 2017-10) Onsun, Nahide; Dizman, Didem; Özkaya, Dilek Bıyık; Erkılıç, A. C.; Özarmağan, G.; Gürer, M. A.; Başkan, Emel Bülbül; Uludağ Üniversitesi/Tıp Fakültesi/Deri ve Zührevi Hastalıklar Anabilim Dalı.; 0000-0002-0144-3263; AAH-1388-2021Item Efficacy, safety and drug survival of conventional agents in pediatric psoriasis: A multicenter, cohort study(Wiley, 2016-10-28) Ergün, Tülin; Seckin, Gençosmanoğlu Dilek; Alpsoy, Erkan; Sarıcam, Merve Hatun; Salman, Andaç; Onsun, Nahide; Sarıöz, Abdullah; Bülbül, Başkan Emel; Uludağ Üniversitesi/Tıp Fakültesi/Dermatoloji Anabilim Dalı.; 6602518817The data on long-term efficacy, safety and drug survival rates of conventional systemic therapeutics in pediatric psoriasis is lacking. The primary aim of this study is to investigate acitretin, methotrexate, cyclosporin efficacy, safety and drug survival rates in pediatric patients as well as predictors of drug survival. This is a multicenter study including 289 pediatric cases being treated with acitretin, methotrexate and cyclosporin in four academic referral centers. Efficacy, adverse events, reasons for discontinuation, 1, 2- and 3-year drug survival rates, and determinants of drug survival were analyzed. A 75% reduction of Psoriasis Area and Severity Index score or better response rate was obtained in 47.5%, 34.1% and 40% of the patients who were treated with acitretin, methotrexate and cyclosporin, respectively. One-year drug survival rates for acitretin, methotrexate and cyclosporin were 36.3%, 21.1% and 15.1%, respectively. The most significant determinant of drug survival, which diminished over time, was treatment response whereas arthritis, body mass index and sex had no influence. Although all three medications are effective and relatively safe in children, drug survival rates are low due to safety concerns at this age group. Effective disease control through their rational use can be expected to improve survival rates.Item Prevalence of obesity in paediatric psoriasis and its impact on disease severity and progression(Wiley, 2017) Ergün, Tülin; Gençosmanoğlu, Dilek Seçkin; Karakoç, Aydıner Elif; Salman, Andaç; Tekin, Burak; Alpsoy, Erkan; Cakıroğlu, Aylın; Onsun, Nahide; Bülbül, Emel Baskan; Uludağ Üniversitesi/Tıp Fakültesi/Dermatoloji Anabilim Dalı.; 6602518817Background/Objectives: The current literature suggests there is a possible connection between paediatric psoriasis and obesity. However, there is a paucity of research on the influence of increased adiposity on the severity of paediatric psoriasis and disease progression. We aimed to compare the prevalence of being overweight or obese in paediatric psoriasis patients and controls and assess the potential impact of being overweight/obese on disease severity and progression of disease. Methods: This multicentre prospective case-control study included 289 psoriasis patients (aged < 18 years) treated and followed up by one of the four university hospitals in Turkey. The control group consisted of 151 consecutive age-matched and sex-matched children who lacked a personal or family history of psoriasis. The participants' characteristics, psoriasis-related parametres (e.g., initial subtype, psoriasis area and severity index, presence of psoriatic arthritis) and body mass index were determined. Results: The difference between the prevalence of being overweight/obese among psoriatics (28%) and the control group (19%) was significant (P = 0.024). Being overweight/obese had no significant impact on disease severity and unresponsiveness to topical treatment. Within a median follow-up time of 12 months, 23% of our patients with localised disease at disease onset progressed to generalised disease. The impact of being overweight/obese on disease progression was found to be non-significant; however, disease duration was found to have a significant impact on disease progression (P = 0.026). Conclusions: Although it is not associated with disease severity and course, increased bodyweight may be a health problem for psoriatic children.Item The risk of tuberculosis in patients with psoriasis treated with anti-tumor necrosis factor agents(Wiley, 2015-05) Ergün, Tülin; Seçkin, Dilek; Onsun, Nahide; Özgen, Züleyha; Ünalan, Pemra; Alpsoy, Erkan; Karakurt, Sait; Bülbül, Emel Başkan; Uludağ Üniversitesi/Tıp Fakültesi/Deri ve Zührevi Hastalıklar Anabilim Dalı.; 0000-0002-0144-3263; AAH-1388-2021; 43760921800BackgroundTumor necrosis factor-alpha (TNF-) antagonist treatment is associated with 1.6 to 27 times higher risk of tuberculosis (TB). ObjectiveTo find TB incidence of psoriasis patients treated with TNF- antagonists and define risk factors related with this condition in a country with moderately high risk of TB. MethodsThree hundred seventy psoriasis patients treated by anti-TNF agents in four referral centers were included. The data on the characteristics of the patients, TB history, tuberculosis skin test results, anti-TNF agent type and exposure time, localization of TB, and isoniazide prophylaxis state were analyzed. ResultsFour patients (1.08%) developed TB, three pulmonary and one gastrointestinal, 2-23months after initiating anti-TNF agents. Other than the patient with gastrointestinal TB, who was using methotrexate and corticosteroid concomitantly, none had contributing risk factors for TB. Two patients developed pulmonary TB in spite of chemoprophylaxis. Three patients with pulmonary TB completely recovered following antiTB treatment whereas patients with gastroinrestinal TB developed renal failure. LimitationsThe major limitation of the study is the lack of a diseased control group, which enables us to compare the risk of psoriatics with that of patients having other inflammatory diseases. ConclusionTuberculosis is a rare but a severe complication of anti-TNF treatment and may develop in spite of chemoprophylaxis. The risk of TB in psoriasis patients in the present study is comparable to literature mostly based on rheumatology patients.Item Treatment profile of patients with moderate-to-severe psoriasis included in the Turkish national registry PSR-TR(Wiley, 2017-11) Onsun, Nahide; Dizman, Didem; Özkaya, Dilek Bıyık; Erkılıç, A. C.; Özarmağan, G.; Gürer, M. A.; Başkan, Emel Bülbül; Uludağ Üniversitesi/Tıp Fakültesi/Dermatoloji Anabilim Dalı.; 0000-0002-0144-3263; AAH-1388-2021