Cyprus is an island, located in the eastern part of the Mediterranean Sea, at the south of Turkey. There are mainly two communities living on the island, namely, Turkish Cypriots and Greek Cypriots. It was ruled by the Lusignan dynasty (1192 AD-1489 AD), Venetian domination (1489-1570), Ottoman Empire (1571-1878) and Britain (1878-1960). In 1960 Republic of Cyprus was founded by the Turkish and Greek Cypriot communities.
There was no dermatologist at the moment in the island. Dr Zihni Uzman, (born 1937, in Pedulla, Cyprus), after graduating from İstanbul University Faculty of Medicine, worked as a general practitioner in many villages of Cyprus between 1961-69. Noticing the need of a dermatologist in the island, he started his dermatology residency in the Dermatology & Venereology Department, in İstanbul University. He worked with Prof. Dr Cevat Kerim İncedayı, Prof. Dr. Osman Yemni, Prof. Dr. Nevzat Öke, Prof Dr Osman Lav, Prof Dr.Agop Kotogyan and Prof Dr Turkan Saylan, who have been the milestones in Turkish Dermatology. Then he returned the island and started to work as dermatologist in 1972 . But these times were hard times for the island because of the conflicts between two societies. The United Nations peacekeeping force arrived to the island in 1964 and after the war in 1974, two communities were separated. Politically North Cyprus has a unique status since 40 years. Since then, the northern part of the island has been ruled by its own government, which is only recognized by Turkey . This international isolation of newly formed government led to a lack of medical and health facilities among the Turkish Cypriot community.
Dr Zihni Uzman (Figure 1) worked as the only dermatologist in the government hospital in Turkish part (namely Dr. Burhan Nalbantoglu Hospital, Nicosia) until 1975. Turkish Red Cross kept sending dermatologists in case of a need until new dermatologists completed their residencies and came back to the island. After 1975, Dr. Rifat Bicen, Dr. Hasan Öztoprak, Dr. Jülide Çolakoğlu Ayberk and Dr. Özruhan Aygın joined and pionered the dermatology community .
. The first dermatologist Dr Zihni Uzman , 78 years old, still practicing dermatology in his office in Nicosia.
Development of Dermatology
In the beginning, dermatology and venereology service was supplied only as an outpatient clinic. There was no inpatient clinic until 1980. From the memoirs of Dr Uzman, it is learned that the first pemphigus patient caused a panic among the doctors of the hospital. In order to avoid the risk of secondary infections, the patient was put in quarantine in a small hospital which is 80 km away from the center . The inpatient clinic was opened after 1983, with the leadership of Dr Özruhan Aygın. At this time, a room with 2 beds in the internal medicine ward was used for the dermatology patients. After 1995, a dermatology clinic with inpatient beds and equipments was put on service. The effort of Dr Özruhan Aygın, who had served 34 years as the head of department until she retired in 2014, in the establishment and development of dermatology clinic is very valued. Cryotherapy applictions were iniated by Dr Kani Nalbant in 1990, and since then became a routine of the department. In 2009, a phototherapy unit was set up. The pioner in allergic dermatological diseases in the island is Dr Özalp Nasifoglu, who preffered to run his own clinic. He had set up an allergy unit, and performed the skin tests and immunotherapy applications. In 2013, a digital dermoscopy unit was established in Akçiçek Hospital, Kyrenia with the special efforts and grants of the North Cyprus Cancer Charity Trust.
Prior to 1985 dermatologists were mainly working in the central hospital. There were 4 health centers throughout the country and dermatologists who were alternately going these urban centers in the certain days of the week to offer outpatient dermatology services. During that time dermatologists in the island increased in number. Currently there are 19 dermatologists in the North Cyprus. Private sector mostly engages the cosmetic dermatology. Dr Nevruz Tuğcu, Dr Hanife Ezgi Erçal and Dr Ahmet Gürpınar have lasers in the private offices.
The dermatologists play an important role in the veneriel diseases. The case of North Cyprus is particularly interesting as it is one of the most popular destinations for casino tourism and entertainment, alongside to its sunny beaches . Before 1974, prostitution throughout Cyprus was performed primarily in licensed brothels . But after the de facto division of the island into two parts, the brothels in North Cyprus were closed, prostitution here became illegal and shifted to street level. During the 1990s, the number of foreign sex workers increased sharply and North Cyprus has become a target country for sex workers from Eastern Europe. In 2000 North Cyprus the Law of Nightclubs and Similar Establishments put regulations for the employment of foreign sex workers, confining the practice to licensed nightclubs and pubs, whose proprietors must seek work permits for their employees and observe the law’s regulations. Work permit for a sex worker require different health controls. The applicant is taken directly from the airport to the hospital ward where she is tested for a range of sexually transmitted diseases including HIV/AIDS, syphilis and gonorrhea. A positive test results in immediate deportation. If the tests are negative the woman is granted the work permit, but she is obliged thereafter to attend weekly check-ups for the infectious diseases . The venereology department in Dr Burhan Nalbantoğlu Government Hospital succesfully and dedicatedly continues to perform these controls since 1990's, in association with the gynecologists.
Dermatologists as Community Leaders
Dermatologists have assumed leadership roles and tasks in a variety of areas within the community in North Cyprus. Dr Ata Öncel Onar, being a strong figure among healthcare workers, has served as the representative of the health union (Tıp-İŞ) in the founder parliement in 1984. Also, Dr Ruhsan Tuğyan is an important figure in the political arena. During her 2 term of represantary in the parliement, she put great effort and leadership on the formation of "family law". Dr. Yücel Atakara is also known for his dedicated efforts for Alsancak region. He served as the president of the municipality of Alsancak for many years(1). One of the interesting dermatologists is Dr Hasan Öztoprak, who also have specialisation in otolaryngology and serves for the patients of both specialties in his private office in Guzelyurt (Morphou ) area.
Until 2008 there were no academic medical institute in North Cyprus. The first medical faculty was initiated in Near East University (NEU) in 2008 and the university hospital in 2010. NEU- Faculty of Medicine, with regard to its quality of education, educational staff, infrastructure, laboraties equipped with latest technology and modern educational hospital facilities, was accepted to World Health Organization (WHO) Avicenna Group . The medical faculty accepts international students all around the world. The dermatology and venereology department was established with the efforts of Ascociate Professor Dr Aslı Kaptanoglu in 2010. Dr Didem Mullaaziz joined the team in 2013 (Figures 2 and 3). The department fully performs all dermatological activities and equipped with allergy tests, phototherapy unit, cryotherapy, digital dermoscopy, mole mapping, dermato-cosmetic surgery unit and lasers. Also, full support is supplied by the other departments of the university such as in infectious diseases (bacteriology and micology lab), genetic (e.g: PCR) and pathology (immunohistochemistry and immunoflorescein dyes). In addition to daily clinical practice and teaching dermatology to the medical students, the dermatologists make research in experimental, clinical and public health areas, as well as conducting continuing medical education activities such as sessions of case discussions, and seminars [6-10]. Due to the lack of academic staff in number, the department does not accept residents yet.
Figure 2. Dr Didem Mullaaziz, teaching skin patch test to the medical students.
Asc Prof Dr Aslı F Kaptanoglu and Dr Didem Mullaaziz working with digital dermoscopy.
Cyprus Turkish Association of Dermatology Venereology and Cosmetology (CTA-DVC)was established in 2013 with the presidency of Dr Sibel Tozaki, who is the head of the dermatology department of the government hospital. The association have also members of Turkish Cyriots who are working all around the world. CTA-DVC still maintains institutionalization efforts until now, and has not organized a meeting yet.
- http://www.unficyp. org
- Kaptanoğlu AF, Süer K, Diktaş H, Hinçal E (2013) Knowledge, attitudes and behaviour towards sexually transmitted diseases in Turkish Cypriot adolescents. Cent Eur J Public Health 21: 54-58. [Crossref]
- Güven-Lisaniler F, Rodríguez L, Uğural S (2005) Migrant sex workers and state regulations in North Cyprus. Womens Stud Int Forum 28: 79-91.
- Kaptanoglu AF Hinçal E (2012) Sun Protection in the North Cyprus Turkish Population: Knowledge, Attitude and Behaviors of Elementary School Children and Their Families. Turkdem 46: 121-129.
- Kaptanoglu AF, Mullaaziz D, Suer K. Facial and Periorbital Cellulitis due to Skin Peeling with Jet Stream by an Unauthorized Person. Case Rep Dermatol Med 529153. [Crossref]
- Kaptanoglu AF, Uncu M, Ozyurt S, Hincal E (2013) Effect of isotretinoin on prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT). J Dermatolog Treat 24: 272-274. [Crossref]
- Kaptanoglu AF, Arca T, Sargon MF, Kilinc K (2013) Protective effect of dexamethasone on fetal rat skin in experimental intrauterine ischaemia/reperfusion injury. Clin Exp Dermatol 38: 396-402. [Crossref]
- Kaptanoğlu AF, Özkum D, Ada E (2012) Ancient to Recent Skin Care in Turkish Cypriots: Bitter-Orange Blossom Water. J Turk Acad Dermatol 6: 1261.