Both intermittent and continuous low-dose isotretinoin regimens are very well tolerated and effective as classical regimens in the treatment of moderate acne vulgaris. However, a continuous low-dose regimen seems to be slightly superior in terms of patients' compliance to the treatment and lower risk of relapse.

Background and Design:Current studies link vitamin D deficiency with many autoimmune diseases. Alopecia areata (AA) is a common autoimmune dermatological disease. The aim of this study was to investigate the relationship between vitamin D levels and alopecia areata. Materials and Methods: 25-hydroxyvitamin D [25(OH)D] levels in 40 patients with alopecia areata and age, gender and skin phototypematched healthy controls were evaluated. Serum 25(OH)D levels were measured in all subjects and grouped as normal/sufficient (>30 ng/ml), insufficient (15-30 ng/ml) and deficient (<15 ng/ml). Results: Both the study and control groups were composed of 21 females and 19 males. The mean age was 31.23±7.34 (21-50) and 30. 58±7.19 (21-48), respectively. In the study group, 2.5% of patients (n=1) had normal, 15% (n=6) insufficient and 82.5% (n=33) of patients had deficient 25(OH)D levels. In the control group, 2.5% (n=1) of patients had normal, 25% (n=10) insufficient and 72.5% (n=29) of patients had deficient 25(OH)D levels. There was no statistically significant difference between the groups (p>0.05). In both groups 97.5% of patients had 25(OH)D levels below the normal range. Conclusion: Vitamin D levels in patients with AA were similar to those in the controls. This similarity may suggest that there is no relationship between vitamin D and AA. However, it may also indicate that the relationship between AA and Vitamin D is not via the level but vitamin D receptor (number and/or structure). (Turkderm 2015; 49: 50-3)

ÖzetRamsay-Hunt Syndrome (RHS) is a rare disease characterized by peripheral facial paralysis, cochleovestibular symptoms, skin lesions in the auricular canal and/or in the auricula and rarely skin lesions in the hard palate. The disease is also known as Herpes zoster oticus or herpes zoster cephalicus. Early diagnosis and antiviral treatment of peripheral nerve paralysis associated with higher rates of improvement. RHS, which is a rare disease in children should be considered in the differential diagnosis in children presenting with peripheral nerve palsy, erythema, vesicular lesions and/or ear pain. Here we presented a child case in which the first symptom was ear pain and facial palsy, followed by vesicular lesions in the ear pinna, and in the external auditory meatus. The patient recovered without squela of oral steroids and antiviral therapy. Key words: Facial paralysis, in children, Ramsay Hunt syndrome, Varisella zoster vırus AbstractHerpes zoster otikus veya herpes zoster sefalikus olarak da bilinen Ramsay-Hunt Sendromu (RHS); periferal fasiyal paralizi, auriküler kanal ve/veya aurikulada bazen de dilde, sert damakta, deri lezyonları ve kohleovestibüler semptomların izlendiği nadir bir hastalıktır. RHS, çocukluk çağında nadir bir hastalıktır. Erken tanı ve antiviral tedavi periferik sinir paralizisinde daha yüksek iyileşme oranlarıyla ilişkilidir. Periferik sinir felci, eritem, veziküler lezyonlar ve/veya kulak ağrısı ile başvuran çocuklarda ayırıcı tanıda akla gelmelidir.Burada ilk semptomu kulak ağrısı ve yüz felci olan, takiben kulak sayvanı, dış kulak yolunda veziküler lezyonları ortaya çıkan, oral steroid ve antiviral tedaviyle sekelsiz iyileşen bir çocuk hasta sunuldu. Anahtar kelimeler: Fasiyal paralizi, çocukluk çağı, Ramsay Hunt sendromu, Varisella zoster virüs Ramsay Hunt Sendromlu Bir Çocuk OlguRamsay Hunt Syndrome in a Child Case GirişHerpes zoster otikus veya herpes zoster sefalikus olarak da bilinen Ramsay-Hunt Sendromu (RHS); periferal fasiyal paralizi, auriküler kanal ve/veya aurikulada bazen de dilde, sert damakta deri lezyonları ve kohleovestibüler semptomların izlendiği nadir bir hastalıktır. Hastalık primer enfeksiyon sonrasında genikülat ganglionda latent kalmış Varisella zoster virus'un (VZV) reaktivasyonuyla ortaya çıkar. RHS, çocukluk çağında nadir bir hastalıktır. Periferik sinir felci, eritem, veziküler lezyonlar ve/veya kulak ağrısı ile başvuran çocuklarda ayırıcı tanıda akla gelmelidir. Erken tanı ve antiviral tedavi, periferik sinir paralizisinde daha yüksek iyileşme oranlarıyla ilişkilidir (1). Bu olgu bildirisinde ilk semptomu kulak ağrısı ve yüz felci olan, takiben kulak sayvanı, dış kulak yolunda veziküler lezyonları ortaya çıkan, oral steroid ve antiviral tedaviyle sekelsiz iyileşen bir çocuk hasta sunuldu.

Tularemia is a zoonotic infection caused by Francisella tularensis. Oropharyngeal tularemia is the most common form of disease in our country, which spreads by intake of contaminated water or food. We presented 3 oropharengeal tularemia cases with cutaneous signs. The patients with oral and/or pharangeal ulcers or sore throat, especially when the disease does not respond to beta lactam antibiotics, the skin of patient must be examined carefully and tularemia must be one of the differantial diagnosis.

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