Background and Design: Isotretinoin is a widely used retinoid for the treatment of many dermatological conditions notably in acne with many known side effects. This study aims to investigate the effects of isotretinoin on anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH) and total antral follicle count (TAFC) as the indicators of ovarian reserve (OR) and also aims to investigate the frequency of menstrual irregularities (MI).
Materials and Methods: Ninety-two reproductive women were included in this prospective controlled study. Study group is consisted of 32 healthy control, 29 low-dose (0.4-0.6 mg/kg/day mean: 0.56±0.06) and 31 high-dose isotretinoin received patients (0.7-1.1 mg/kg/day mean: 0.94±0.11). AMH, FSH and TAFC were evaluated before and at 6th month of treatment in the treatment group, while AMH and FSH levels were evaluated in the control group.
Results: Mean AMH level of treatment group at the 6th month of treatment was significantly lower than the level prior to treatment and that of the control group (p<0.001, p=0.013). Mean FSH level was increased, and TAFC level was decreased compared to pretreatment period (p=0,912, p=0,824). Seventeen patients (28.3%) had MI during treatment.
Conclusion: Although decrease in antral follicle numbers and increase in FSH levels were not significant, significant decreases in AMH levels may indicate the negative effect of isotretinoin on OR.

Background and Design: Acne vulgaris is a chronic inflammatory disease of pilosebaceous unit. Oral isotretinoin is the most effective agent that has been used for many years in acne treatment. The purpose of our study was to determine the side effects of the isotretinoin and to examine the correlation between these side effects, and age, gender and drug dose.
Materials and Methods: One hundred forty nine patients with moderate or severe acne vulgaris (age between: 14-34 years) using isotretinoin were included. Eight patients discontinued treatment for various reasons. Daily isotretinoin dose was started as less than 0.5 mg/kg/day. A cumulative dose of at least 120 mg/kg was targeted in all patients. The patients were assessed in terms of side effects on a monthly basis.
Results: Of the 141 patients who have completed the treatment, 106 (75.2%) were female and 35 (24.8%) were male. Cheilitis was seen in 100%, xeroderma in 66%, photophobia in 44.7%, mild epistaxis in 42.6%, and xerophthalmia in 36.9% of the patients. Lumbar pain was seen in 41.1%, myalgia in 29.1%, arthralgia in 19.1%, headache in 13.5% of the patients. Serum lipid levels increased in 20.6% of the patients, while liver enzyme levels increased in 7.8% of the patients. Myalgia and lumbar pain was more common in females (p=0.045, p=0.019, respectively). Patients who received higher than 0.5 mg/kg/day dose had more xerosis, myalgia and triggering acne complaints (p=0.004, p=0.001, p=0.012, respectively). Myalgia were found to be more common in patients who were older than 20 years old (p=0.003).
Conclusion: Because the use of isotretinoin is a long-lasting treatment method, patient compliance is of paramount importance. Knowing how frequent side effects will occur in different patients groups and informing the patients beforehand will increase patients’ confidence towards to physician and minimize the compliance problems.

Background and Design: Studies to investigate the change of skin moisture, sebum and pH properties in various physiological processes such as age, gender, pregnancy and menopause are limited. Menstrual cyle is a physiological process that causes changes in various organs and systems in the female body. In this study, possible changes in the moisture, sebum and PH values of the skin with menstrual cycle will be investigated. Thus, it is aimed to determine whether the hormonal changes that drive the menstrual cycle have observable effects on the skin.
Materials and Methods: In our study, the relationship of skin moisture, sebum and pH values of healthy skin with the menstrual cycle was investigated with the MPA-5 device. Fifty-one volunteer women aged 21-45, working at the faculty of medicine, and having regular periods were included the study. The measurement was done with MPA-5 device. In this study, the skin PH, humidity and sebum values of the participants were measured 6 times in total during two consecutive menstrual cycles, at the beginning of each cycle (early follicular phase), middle (late follicular phase) and end (midluteal phase). Humidity and PH were measured from 5 different points on the face (glabella, bilateral zygomatic protrusions on both cheeks, mentum on the chin and nose) and sebum was measured from the glabella as a single measurement.
Results: When the data obtained from the measurements were evaluated, there were no statistically significant differences in the moisture, sebum and PH values of the skin in accordance with the early follicular phase, late follicular phase and midluteal phase of the menstrual cycle. In addition, age, body mass index and smoking were compared with average sebum, moisture and pH values, and no statistically significant relationship was found.
Conclusion: The fact that hormonal changes in the menstrual cycle do not cause any changes in the moisture, sebum and pH values of the skin shows that it will not change the outcome of the period of menstrual cycle in the examination of patients, offering daily care products to patients and determining dermatopathological conditions. Clearer results can be obtained by conducting more detailed and long-term studies.

Background and Design: The aim of this study was to determine the dermatological problems and demographic characteristics of the Syrian asylum seekers admitting to our outpatient clinic.
Materials and Methods: In this study, the data of the Syrian patients who were examined at the clinic of dermatology outpatient between 2014-2018 were analyzed retrospectively.
Results: Total of 767 Syrian patients with mean age of 22.57±14.9 years were included in the study. There were 472 female and 295 male patients. Infections and infestations were the most common disease groups observed in both female and male patients across all cases. Scabies was the most common disease in all cases and men. However, in women the most common disease was acne vulgaris. Evaluation of diagnoses based on age groups and years showed that the most common disease group was infection and infestations in 0-18, 19-40, 41-60 age groups and in all years, and dermatitis and eczema in patients over the age of 60. The most common disease was scabies for 0-18 and 41-60 age groups, acne vulgaris in 19-40 age group and pruritus in over-60 age group; scabies was the most common disease in 2014 and 2015, and acne vulgaris in 2016 and 2017. Evaluation based on years showed that the prevalence of infectious dermatological disease was significantly decreased whereas the prevalence of diseases other than infectious dermatological diseases were significantly increased (p<0.05).
Conclusion: In our study, it was determined that the most common disease groups were infection and infestations and the most common disease was scabies. These results reveal that asylum seekers are under the threat of infectious dermatological diseases. However, it is also observed that this risk is significantly reduced over the time they have been living in our country.

Background and Design: Psoriasis nail involvement is clinically similar to onychomycosis. Especially subungual hyperkeratosis and onycholysis are also common in both nail diseases. These two diseases may be seen separetely or together. The aim of this study was to compare the frequency of onychomycosis with control group in patients with psoriasis and to determine the factors predisposing to onychomycosis in patients with psoriasis.
Materials and Methods: The study included 43 patients with psoriasis who were admitted to Ýstanbul Medipol Mega University, Clinic of Dermatology between 2017 and 2018 and 43 control patients who did not have psoriasis and had nail dystrophy. Participants who received systemic corticosteroid, methotrexate, cyclosporine, and systemic antifungal treatment 4 months ago and who received topical antifungal treatment 4 weeks ago were excluded from the study. The nail samples were examined histochemically with periodic acid-Schiff (PAS) stain.
Results: Onychomycosis was detected in 11 patients with psoriasis (25.6%) (hand and/or foot), while in 17 patients (39.5%) in control group. There was no statistically significant difference between two groups (p=0.170). In control group, toe nail onychomycosis was significantly higher than in the psoriatic group (p=0.024). It was noteworthy that onychomycosis was statistically significant in the group with high educational level and low Psoriasis Area Severity Index (p<0.05 and p=0.021, respectively).
Conclusion: In this study, we determined that nail psoriasis is not a risk factor for onychomycosis by histopathological examination of fungal samples with PAS staining.

Pachydermoperiostosis (PDP) is a primary hypertrophic osteoarthropathy which can result in a coarse facial appearance. In this study we present treatment results of a case in which a simple skin excision and periosteal anchoring was used to treat frontal skin thickening in a patient with PDP.

Adult Still's disease is a rare, acute systemic inflammatory disease characterized by a sudden rising fever, arthralgia/arthritis, neutrophilic leukocytosis and a typical salmon-colored macular or maculopapular rash associated elevated fever. Recently, atypical skin lesions with broad spectrum clinical features and distinctive histopathological findings have been reported in a rare case with active disease. Herein, we report an unusual case of Adult Still disease was presented and the characteristic features of atypical disease were highlighted.

Lupus erythematosus profundus (LEP), is a rare form of, chronic cutaneous LE, also called lupus erythematosus panniculitis. LEP is characterized by subcutaneous fatty tissue involvement spesifically in patients with LE. Before systemic LE was diagnosed, very few reports reported the presence of lesions of lupus erythematosus profundus. The rare manifestations of the disease are remarkable with the unusual features of the cases. A 43-year-old female patient diagnosed with bilateral periorbital LEP was presented and the literature was reviewed. Significant clinical improvement was achieved in the patient who was given systemic hydroxychloroquine and topical pimecrolimus therapy. This report suggests that asymptomatic periorbital erythema and edema may develop as a manifestation of LEP.