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In rare cases, AGEP has been attributed to infections (e.g. parvovirus B19).[1] Moreover, drug-related cases of AGEP have been reported in COVID-19 patients and following COVID-19 vaccination.[[4], [6]] In those cases, it remains unclear whether AGEP was related to COVID-19 infection or to its treatment. Bacterial and fungal infections were ruled out by negative hemocultures and bacterial/fungal cultures from pustules, however fever could be explained by COVID-19 infection. However, on only one occasion the culprit drug was confirmed by patch tests.[8] Our patient had no skin reaction following her COVID-19 vaccines, nor during a previous COVID-19 infection. [Extracted from the article]

GA is an idiopathic non-infectious granulomatous skin disease with an annual incidence of 0.04% in the United States.[2] Skin lesions are mostly localized and self-resolving but disseminated GA (>=10 lesions) is present in 15% of those affected.[[1]] In contrast to localized GA, disseminated GA is often refractory to conventional treatments.[1] Finding an effective treatment remains difficult because the GA pathogenesis has not yet been fully elucidated. The efficacy of other JAK inhibitors, such as tofacitinib and upadacitinib, in the treatment of GA lesions has also been described (Table 1).[[3], [5], [7], [9]] This case underlines the favourable therapeutic potential of pathway-specific treatment of rare inflammatory diseases. In this table, we summarize prior case reports of GA treatment with JAK inhibitors and their outcome. [Extracted from the article]

This article discusses the use of pulsed dye laser (PDL) treatment for facial erythema in Netherton syndrome (NS), a rare genetic disorder characterized by atopic diathesis, ichthyosis linearis circumflexa (ILC), and hair shaft abnormalities. The patient in this case study, a 34-year-old male with NS, experienced persistent facial erythema that significantly impacted his emotional well-being. Previous treatments had been ineffective, so the patient consented to PDL treatment, which resulted in significant improvement after the first session. PDL proved to be a safe and effective treatment option for reducing facial erythema in NS, improving the patient's quality of life. [Extracted from the article]

Seventy per cent of EGR cases is associated with an underlying malignancy and treatment is directed at the cancer. In idiopathic cases of EGR, therapy with topical steroids seems more efficient.4 Treatment of pruritus with antihistamines is generally insufficient. As EGR usually antedates malignancy1 and in view of the personal and family history, immunosuppressive treatments like methotrexate were not started. [Extracted from the article]

Background: Chronic spontaneous urticaria (CSU) is characterized by the repeated occurrence of persistent hives and/or angioedema for ≥6 weeks, without specific external stimuli. H1‐antihistamines have long been the standard of care of CSU, but many patients remain uncontrolled even at 4× the approved dose. Add‐on therapy with omalizumab has proven effective in clinical trials, but little is known about omalizumab treatment in Belgium. Objective: To collect real‐world clinical data on omalizumab treatment in adults with CSU in Belgium. Methods: This was an observational, retrospective chart review of adults with CSU, who initiated omalizumab treatment between August 2014 and December 2016 (maximum 28 months follow‐up). Results: In total, 235 patients were included (median time from symptom onset to diagnosis, 5.4 months; median time from diagnosis to commencing omalizumab, 6.7 months). Treatments used before/after commencing omalizumab did not always adhere to guidelines; many patients (26.4%/11.1%) received first‐generation H1‐antihistamines, while 20.4% used omalizumab monotherapy after initiating treatment. The mean interval between omalizumab administrations was 4.8 (SD 1.7) weeks; 67.8% of patients had ≥1 interval prolongation and/or shortening. Mean baseline 7‐day Urticaria Activity Score (UAS7) was 32.0 (SD 6.05); this improved to 12.6 (SD 11.2) after 1 month of omalizumab. About 67.2% of patients reached UAS7 ≤ 6 (well controlled) during the study. A total of 87 patients stopped omalizumab and never restarted before the end of the observation period; the most prevalent reason was remission of symptoms (49.4% of patients), followed by lack of effect (12.6%), lost to follow‐up (6.9%) and adverse events (3.4%). Headache was the most common adverse event (n = 8/82). No anaphylaxis was reported. Conclusions: This study revealed that patients initiated on omalizumab in Belgium had severe CSU at baseline, and showed substantial improvements after 1 month of treatment. Greater adherence to the prescription of guideline‐recommended medications is needed for the treatment of CSU. [ABSTRACT FROM AUTHOR]

As the international refugee crisis has reached new proportions (BMJ, 355, 2016 and i5412), survivors of torture increasingly present in treating physicians with an array of acute or chronic skin lesions. Physicians should be aware of common presentations and likely differential diagnoses in order to avoid mislabelling or under‐recognizing torture. Survivors of torture also frequently suffer from psychological sequelae, such as post‐traumatic stress disorder, and appropriate referrals are essential in order to improve recovery trajectory. Skin sequelae are the most common physical findings of torture. Not all skin lesions seen in tortured survivors are due to perpetrator inflicted injuries, and many dermatological conditions can mimic lesions typical of torture, as can scars as a result of folk remedies or cultural practices specific to geographical regions. Medical documentation of torture includes injury and lesion description. While forensic dermatology and other forensic specialties use an injury description taxonomy, and the standard dermatologic taxonomy uses an anatomic description, they are complementary sciences for lesions inflicted by torture. This results in an opportunity for learning across disciplines in order to improve evidence documentation for survivors of torture. This article describes features of common skin lesions consistent with torture, including their clinical appearances, differential diagnoses, patterns of injury and appropriate clinical descriptions. Linked article: A. Morrone. J Eur Acad Dermatol Venereol 2019; 33: 1199–1200. https://doi.org/10.1111/jdv.15724 [ABSTRACT FROM AUTHOR]

In our patient skin patch testing with mesalazine was negative, but the complete resolution without subsequent flares strongly point towards a mesalazine-induced glossitis in our patient. One year after stopping mesalazine the patient had no recurrence of UC, eosinophilia or tongue swelling. A 74-year-old male, with a four-year history of ulcerative colitis (UC) treated with mesalazine, presented with episodic cheek and progressive tongue swelling respectively since 27 months. [Extracted from the article]

Relapsing symmetric livedo reticularis in a patient with COVID-19 infection During the Coronavirus 2019 (COVID-19) pandemic, several associated skin conditions were reported in infected patients, including, urticaria,1 exanthema,1 erythema multiforme,2 chickenpox-like vesicles,1 pityriasis rosea,3 erythema nodosum like Sweet's syndrome,4 symmetrical drug-related intertriginous and flexural exanthema,5 petechial rash,6 vasculitic purpura,7 acro-ischaemia/necrosis,6 Kawasaki disease2 and chilblain lesions.6 We present a 57-year-old man with cough, dyspnoea, headache, myalgia arthralgia, fever up to 38.7 °C and abdominal pain worsening over 8 days. Livedo was not blanching on pressure and typical clinical signs of vasculitis, like purpura, (asymmetric) LRC or skin necrosis were absent. [Extracted from the article]

Lightening skin tone is an ancient and well-documented practice, and remains common practice among many cultures. Whitening agents such as corticosteroids, tretinoin and hydroquinone are medically applied to effectively lighten the skin tone of hyperpigmented lesions. However, when these agents are used cosmetically, they are associated with a variety of side-effect. Alternative agents, such as arbutin and its derivatives kojic acid and nicotinamide have been subsequently developed for cosmetic purposes. Unfortunately, some cosmetics contain whitening agents that are banned for use in cosmetic products. This article provides an overview of the mode of action and potential side-effects of cosmetic legal and illegal whitening agents, and the pattern of use of these types of products. Finally, an EU analysis of the health problems due to the presence of illegal products on the market is summarized. [ABSTRACT FROM AUTHOR]

Minimizing tuberculosis risk in patients receiving anti-TNF therapy. Annual screening for patients at risk for exposure to tuberculosis (e.g. patients travelling to endemic areas) has previously been suggested.3-5 This case shows that it is important to always include tuberculosis in the differential diagnosis of ulcerated or indurated oral lesions in patients treated with TNF- blockers. Patients treated with TNF- blockers have an increased risk of reactivating latent tuberculosis (TB). [Extracted from the article]

Background The BRAF-inhibitor vemurafenib, used in patients with metastatic melanoma, induces multiple cutaneous side-effects. Objective The aim of this work was to evaluate the development of palmoplantar fibromatosis in a population of patients treated with the BRAF inhibitor vemurafenib. Methods Between April 2011 and February 2013, we initiated a treatment with vemurafenib in 53 patients with an unresectable stage IIIC or stage IV melanoma. The patients were followed-up on a regular base to monitor possible side-effects. Results A plantar or palmar fibromatosis was observed in five of 53 patients treated with vemurafenib. In four of these patients other risk factors for the development of palmoplantar fibromatosis were absent. Conclusion The BRAF-inhibitor vemurafenib might induce palmoplantar fibromatosis. [ABSTRACT FROM AUTHOR]

Positive patch testing with omeprazole in Stevens-Johnson syndrome: a case report Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening cutaneous reactions, caused by a delayed-type hypersensitivity reaction to medication.1 Proton pump inhibitors (PPIs) are among the most commonly prescribed medications worldwide with a large proportion of non-evidence-based applications.2 A 69-year-old man, known with arterial hypertension and gout, was started on 64 mg methylprednisolone for a chronic inflammatory demyelinating polyneuropathy. For SJS/TEN caused by PPIs, a positive patch test result was observed in 40% of patients.7 To our knowledge, this is the first case of SJS caused by omeprazole, confirmed by patch testing. [Extracted from the article]

The article presents a case study of a 63-year-old male patient who was suffering from malaise, asthenia and hyponatremia and was diagnosed with the paraneoplastic systemic lupus erythematosus disorder which was associated with an oat cell tumour in his lungs. Details regarding his therapeutic proceedings are presented, which comprised of carboplatin and etoposide drug chemotherapy.