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[LANGUAGE=”English”]Background and Design: Systemic retinoids are commonly used medications in dermatology and indicated in various skin disorders such as acne vulgaris and psoriasis. Data about the risk of Coronavirus disease-2019 (COVID-19) in patients using systemic retinoids are limited. Thus, this study aimed to investigate the risk of COVID-19 in patients undergoing systemic retinoid therapy.Materials and Methods: A total of 186 patients who have undergone systemic isotretinoin and acitretin therapy were recruited. Patients who presented to the dermatology clinic for various skin diseases, such as eczema, vitiligo, tinea, etc., who were not on systemic retinoid therapy, and who received topical medications comprised the control group. The development of COVID-19 in the retinoid therapy group and the control group was retrospectively reviewed using hospital database.Results: The mean age of the patients in the retinoid therapy group was 25.72±0.67 and that in the control group was 25.4±0.62. Moreover,165 patients received isotretinoin, and 21 patients received acitretin treatment. The isotretinoin dosage ranged from 0.5 to 0.8 mg/kg wheras the acitretin dosage ranged between 10 and 25 mg/day. Two patients (1.07%) in the retinoid therapy group and 8 (4.3%) patients in the control group were diagnosed with COVID-19. None of the patients receiving acitretin was diagnosed with COVID-19. COVID-19 diagnosis was established in the 2nd and 3rd months of isotretinoin treatment, and lung involvement was not observed. No significant difference regarding the number of COVID-19 cases and disease severity was found between the two groups (p=0.105; p=0.258, respectively).Conclusion: Isotretinoin and acitretin use was not associated with increased COVID-19 risk or disease severity. Systemic retinoids appear to be a safe treatment modality in the COVID-19 era.[LANGUAGE=”Turkish”]Amaç: Sistemik retinoidler dermatolojide akne vulgaris ve psoriazis gibi çeşitli hastalıklarda endike olan yaygın kullanılan tedavilerdir. Sistemik retinoid kullanan hastalarda Koronavirüs hastalığı-2019 (COVID-19) gelişimi riski ile ilgili çalışmalar kısıtlı sayıdadır. Çalışmanın amacı sistemik retinoid tedavisi alan hastalarda COVID -19 gelişimi riskini araştırmaktır.Gereç ve Yöntem: Sistemik izotretinoin ve asitretin tedavisi almakta olan 186 hasta çalışmaya alındı. Çeşitli dermatolojik hastalıkları (ekzema, vitiligo, tinea vs.) nedeniyle dermatoloji kliniğine başvurmuş topikal medikasyonlarla tedavi edilen ve sistemik retinoid tedavisi almayan 186 hasta kontrol grubu olarak alındı. Hastane verileri incelenerek sistemik retinoid tedavi grubunda ve kontrol grubunda COVID-19 gelişimi retrospektif olarak değerlendirildi.Bulgular: Retinoid tedavi grubundaki hastaların yaş ortalaması 25,72±0,67, kontrol grubundaki hastaların ise 25,4±0,62 olarak saptandı (p=0,27). Yüz altmış beş hasta isotretinoin, 21 hasta asitretin tedavisi almıştı. İzotretinoin dozu 0,5-0,8 mg/kg arasında, asitretin dozu ise 10-25 mg/kg arasında değişmekteydi. İzotretinoin almakta olan 2 hastada, kontrol grubundaki 8 hastada COVID-19 gelişimi izlendi. Asitretin kullanan hastaların hiçbirinde COVID-19 gelişimi görülmedi. COVID-19 tanısı izotretinoin tedavisinin 2. ve 3. ayında konuldu ve akciğer tutulumu saptanmadı. İki grup arasında COVID-19 gelişen olgu sayısı ve hastalık şiddetleri arasında istatistiksel olarak anlamlı fark bulunmadı (p=0,105; p=0,258).Sonuç: İzotretinoin ve asitretin kullanımı COVID-19 gelişimi riski ve hastalık şiddeti açısından risk artışı oluşturmamaktadır. COVID-19 sürecinde sistemik retinoid tedavileri güvenli tedavi modaliteleri olarak gözükmektedir.

Background: Coronavirus disease-19 (COVID-19) pandemics has caused changes in the profile of the dermatology patients due to restrictions and changing conditions. Materials and Methods: Patients administered to dermatology outpatient clinic during years 2019 and 2020 were included to study. Demographic characteristics, admission dates and definitive diagnoses of the patients were obtained in the hospital automation system. Among the dermatological diagnoses, those that are likely to be affected by the pandemic were selected. Results: In 2019, 16107 patients administered to dermatology clinic while 5,887 patients administered in 2020 (p=0.00). The percentage of the patients diagnosed with scabies, contact dermatitis, pityriasis rosea (PR), telogen effluvium, zona zoster, alopecia areata and lichen planus increased in 2020 comparing with 2019 (p<0.05). The percentage of acne and psoriasis patients significantly decreased (p<0.05). When compared according to genders no significant difference in terms of percentages of male and female patients in scabies and PR was detected (p>0.05). The ratio of male patients with contact dermatitis, telogen effluvium, alopecia areata and lichen planus significantly increased (p<0.05). The percentage of female patients with zona zoster and psoriasis vulgaris significantly increased compared to prepandemic period (p<0.05). Conclusion: COVID-19 outbreak caused some changes in the distribution of some dermatological diseases. These changes give information about the effect of pandemic conditions on the administration of the patients to the hospital and the role of stress and COVID-19 as triggers of the diseases. Keywords: Comparison, Dermatology, Diagnoses, COVID-19 period

Observation: Tuberculosis verrucosa cutis is a rare form of tuberculosis and it is typically seen as a chronic verrucose plate. At the first stage treatment of disease, rifampicin, isoniazid, pyrazinamide and ethambutol are quite effective. However, side effects developing due to antituberculosis drugs can cause a significant level of morbidity and mortality. Cutaneous medicine reactions are among major side effects being widely observed. Serum sickness-like reaction is a rare immunologic disease that can develop as relating with medicines such as penicillins, cephalosporins and trimethoprimsulfamethoxazole. It is defined as type III hypersensitive reaction that classically develops against heterologous proteins. Its real mechanism could still not be fully understood. In this case presentation, we are introducing a female patient aged 28 who developed a serum sickness-like reaction following antituberculosis treatment.

Recently, a few case reports and clinical studies have been published that explore the association of Behçet’s Disease (BD) and vitiligo, with conflicting results. Genetic and immunological properties of BD and presence of autoantibodies support autoimmunity, but clinical features suggest autoinflammatory diseases. BD is thought to be a cornerstone between autoimmune and autoinflammatory diseases. On the other hand, vitiligo has been accepted as an autoimmune disease with associations of other autoimmune disorders and there is a possible role of autoimmunity in pathogenesis of the disease. Significant advances have been made understanding the pathogenesis and genetics of BD. However, it is worth presenting rare clinical variants for improving the clinical understanding of BD. Herein, we are presenting a case with diagnosis of both Behçet’s disease and vitiligo in same patient, which is a rare occurrence. Discussion and demonstrating the association of these two diseases may give rise to understanding similar and different aspects of autoimmunity and autoinflammatory pathogenesis of both diseases.

The COVID-19 pandemic dramatically disrupts health care for patients with chronic diseases including chronic spontaneous urticaria (CSU). As of now, it is unknown if the effects of the pandemic in CSU are different than in other chronic diseases. We also do not know, if different groups of CSU patients, for example female and male patients, are affected differently. To understand how CSU patients and subgroups are affected by the COVID-19 pandemic in their disease activity and control and treatment, using psoriasis as control. We analyzed 399 patients (450 visits) with CSU or psoriasis assessed during August 2019, i.e. before the pandemic, or August 2020, i.e. during the pandemic, for changes in disease activity, disease control, and the treatment they used, and how these changes are linked to age, gender, and disease duration. Male but not female patients with CSU had markedly increased disease activity during the pandemic. CSU patients' age or disease duration were not linked to changes. Male and female patients with psoriasis showed similar increases in disease activity and decreases in disease control. The rate of omalizumab treatment, during the pandemic, was unchanged in male patients and increased in female patients with CSU. The efficacy of omalizumab treatment, during the pandemic, was reduced in male patients but not female patients with CSU. Male but not female CSU patients, during the COVID-19 pandemic, show loss of disease control linked to loss of omalizumab efficacy. The reasons for this need to be investigated.

Netherton syndrome (NS, MIM256500) is an autosomal recessive disorder that includes ichthyosis linearis circumflexa and a predisposition to allergies, asthma, and eczema, with hypereosinophilia, trichorrhexis invaginata, and elevated serum IgE levels. The genetic bases of Netherton syndrome are mutations in the gene SPINK5, and the Lymphoepitheial Kazal type related inhibitor, a serine protease inhibitor, is encoded by SPINK. Here a case is presented which showed a probable splice site mutation in SPINK5, which was previously unknown in databases and the literature, to point out the misdiagnosis of Hyper IgE Syndrome in the early presentation of the phenotype. This case highlights that a genetic test can be critical for identifying NS. The finding of underlying mutations contributes to the understanding of Netherton syndrome and is instrumental in indicating a specific therapy. Notably, treatment with acitretin has significantly improved both the ichthyosis linearis circumflexa and eczema in our patient.

Omalizumab is a recombinant humanized anti-Ig E monoclonal antibody used as the third line treatment of chronic spontaneous urticaria (CSU). We report four patients with severe antihistamine-resistant CSU, who developed angioedema, anaphylaxis and/or flare up of urticaria at different times following omalizumab therapy.

Amaç: Birçok ülkede, hasta kayıt sistemlerinde (HKS) ilaçların etkin takiplerinin yapılabilmesi amacıyla, sistemik ve biyolojik ajan tedavileri alan hastalara ait bilgiler de dahil edilmiştir. Literatür bilgilerine dayalı olarak Türkiye’de psoriasise özel HKS olmadığı bilinmektedir. Burada psoriasise özel olarak ilk kez kullanılan HKS’nin sunulması amaçlanmıştır. Yöntemler: Psoriasis Takip Sistemi (PSORTAKSİS), Kayseri Sağlık Uygulama ve Araştırma Merkezi (KSUAM) Dermatoloji Kliniği tarafından hazırlanmış ve KSUAM Bilgi İşlem Merkezi tarafından hastane otomasyon sistemine entegre edilmiştir. PSORTAKSİS, 01 Ekim 2016 tarihinden itibaren KSUAM Dermatoloji Kliniği Kronik Deri Hastalıkları Polikliniği’nde, hastalık şiddeti ya da tedavi farklılıkları gözetilmeksizin tüm psoriasis hastalarının takibinde kullanılmaktadır. Bulgular: PSORTAKSİS hastaların demografik verileri, klinik bulguları, laboratuvar çıktıları ve tedavi bilgilerinin kaydedilmesini sağlayan ana ve alt sekmelerinden oluşmaktadır. Sonuç: HKS, tedavi seçenekleri oldukça çok olan ve ayrıntılı takip gerektiren psoriasis için önemlidir. İlaçların güvenli ve etkin kullanılmasının yanı sıra HKS epidemiyolojik ve klinik çalışmalar için bilgiler sağlar. KSUAM Dermatoloji Kliniği’nde bir yıla yakın zamandır PSORTAKSİS kullanılmaktadır. Türkiye’de ilk uygulama olan PSORTAKSİS’in geliştirilmesi ve ülke çapında yaygınlaştırılması önemli ve gerekli bir katkı sağlayacaktır.

BACKGROUND/AIMS:Many studies have focused on the epidemiological features of adult and childhood psoriasis. However, only a few studies have been conducted to demonstrate the clinical and demographic characteristics of pediatric psoriasis in Turkey. This study aimed to determine clinical, demographic, and treatment characteristics of childhood psoriasis in a multicenter series.MATERIALS and METHODS:This study was conducted in four different centers that are located in four cities of Turkey between June 2016 and June 2020. The demographic parameters, possible triggering factors (emotional stress, physical trauma, infection, and medication), and clinical characteristics (psoriasis type, psoriasis area severity index, involved areas, nail involvement, joint involvement, subjective symptoms, disease duration, last treatments and duration of use, and history of accompanying diseases) of pediatric patients with psoriasis were retrospectively analyzed.RESULTS:A total of 150 patients from four different centers were enrolled in the study, of whom 71 (47.30%) were males and 79 (52.70%) were females, with a mean age of 13.71±4.2 years (age range: 1–18 years). A family history of psoriasis was determined in 20 (13.33%) patients. Possible triggering factors included emotional stress (n=90, 60%), physical trauma (n=21, 14%), infection (n=14, 9.33%), and medication (n=1, 1.67%). The most common area of involvement was the trunk (n=69, 46%) followed by the scalp (n=42, 28%), hand (n=20, 13.33%), and face (n=19, 12.67%). The prevalence of clinical types was as follows: plaque (n=125,83.33%), guttate (n=10, 6.67%), palmoplantar (n=7, 4.67%), inverse (n=6, 4%), and pustular (n=2, 1.33%) psoriasis. Nail and joint involvement were observed in 30 (20%) and 15 (10%) patients, respectively. The last treatments received included topical treatment (n=101, 67.33%), phototherapy (n=23, 15.33%), acitretin (n=16, 10.67%), methotrexate (n=9, 6%), and cyclosporine (n=1, 0.67%).CONCLUSION:In our cohort, the clinical types and treatments used for childhood psoriasis were similar to those of other studies, but the rate of family history was lower, whereas the incidence of emotional stress was higher. Addressing the psychological impacts of psoriasis along with its physical aspects may provide better treatment outcomes.