Aslı AKIN BELLİ, Asude KARA POLAT, Volkan KARAKUŞ

HEMATOLOJİ KLİNİĞİNE BAŞVURAN HASTALARDA DERMATOLOJİK BULGULARIN DEĞERLENDİRİLMESİ: 2 YILLIK KESİTSEL BİR ÇALIŞMA

AmaçHematolojik hastalıklardaki deri bulgularının sıklığı ile ilgili ülkemizden bildirilen az sayıda çalışma bulunmaktadır. Bu çalışma ile hastanemiz Hematoloji polikliniğinde takip edilen hastalardaki dermatolojik bulguların prevalansını incelemeyi amaçladık.Gereç ve YöntemŞubat 2014-Haziran 2016 tarihleri arasında hastanemiz Hematoloji polikliniğinde takip edilen 217 hastayı içeren kesitsel bir çalışma yürütüldü. Hematolojik hastalık tanıları, hastalık süresi, takip süresi, dermatoloji konsültasyonu ile elde edilen dermatolojik muayene verileri ve diğer malignite varlığı hasta dosya kayıtlarından retrospektif olarak incelendi.Bulgularİki yüz on yedi hastanın (102 kadın, 115 erkek) yaş ortalaması 63.06±14.7 yıl bulundu. Ortalama hematolojik hastalık süresi 27.98±35.9 ay ve hastalık takipsüresi ise 12.21±6.65 ay olarak saptandı. En sık görülen deri bulguları sırasıyla purpura (%95 GA, %7.4- %16.1), pruritus (%9.7; %95 GA, %6-%13.8) ve viralenfeksiyonlar (%5.1; %95 GA, %2.3-%8.3) şeklinde saptandı. Miyelodisplastik sendromlu iki hastada talidomid ve deferasirox ile ilişkili vaskülitik ilaç reaksiyonu gözlendi. Spesifik kutanöz infiltrasyonlardan, kutane lösemi kronik lenfositik lösemili bir hastada; granülositik sarkom ise akut miyeloid lösemili bir hastada saptandı.SonuçSıklıkla immunsuprese olan ve çoklu ilaç kullanımına sahip hematoloji hastalarında, deri bulguları oldukça sık görülmekte olup geniş bir çeşitliliğe sahiptir. Hematolojik hastalıkların deri bulguları ciddi bir enfeksiyonun, ilaç reaksiyonunun veya hastalığın deriye yayılımının göstergesi olabileceğinden, bu hastalıkların teşhis ve tedavisi prognostik öneme sahiptir.

EVALUATION OF DERMATOLOGICAL FINDINGS IN PATIENTS ADMITTED TO THE HEMATOLOGY CLINIC: A 2-YEAR CROSS-SECTIONAL STUDY

Objective There are a few studies regarding the frequency of skin findings in hematological diseases reported from our country. We aimed to investigate the prevalence of dermatological findings in patients who were followed up at the Hematology outpatient clinic of our hospital with this study. Materials and Methods A cross-sectional study involving 217 patients who were followed up at the Hematology outpatient clinic of our hospital between February 2014-June 2016 was conducted. Hematologic disease diagnoses, disease duration, follow-up period, dermatological examination data obtained with dermatology consultation, and presence of any other malignancy were retrospectively reviewed from the patient file records. Results Of 217 patients (102 female, 115 male), the mean age was 63.06±14.7 years. The mean duration of hematologic disease was 27.98±35.9 months and the mean duration of disease follow-up was 12.21±6.65 months. The most common skin findings were purpura (95% GA, 7.4%-16.1%), pruritus (9.7%, 95% GA, 6%-13.8%), and viral infections (5.1%, 95% GA, 2.3%-8.3%), respectively. In two patients with myelodysplastic syndrome, thalidomide- and deferasirox-associated vasculitic drug reactions were observed. From specific cutaneous infiltrations, cutaneous leukemia was found in a patient with chronic lymphocytic leukemia and granulocytic sarcoma in a patient with acute myeloid leukemia. Conclusion Skin findings are quite common and have a wide variety in hematologic patients with frequent immunsupression and multiple drug use. Because skin findings of hematologic diseases can be a sign of serious infection, drug reaction, or cutaneous spread of the disease, diagnosis and treatment of these diseases have prognostic significance.

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