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Lupus erythematosus is an autoimmune disease that often affects the skin. Cutaneous manifestations are generally subdivided into different subtypes, including acute, subacute, and chronic courses. Management of lupus erythematosus cutaneous manifestations during pregnancy remains a clinical challenge until nowadays. To date, no recommendations have been published specifically for the treatment of this condition in pregnant women, so therapeutic strategies are mainly based on recommendations for general population and other rheumatologic and dermatologic diseases during pregnancy. This challenge is compounded by a lack of evidence‐based studies, as clinical trials in pregnant women are considered unethical in many circumstances, so data are often extrapolated from low‐evidence sources. The aim of this article consists in review currently evidence of treatment of lupus erythematosus cutaneous lesion in pregnant women. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus infection may be a contributing factor to monkeypox infection: analysis of a 42-case series. Clinical and epidemiological features of hospitalized and ambulatory patients with human monkeypox infection: a retrospective observational study in Portugal. Skin and mucosal lesions are the clinical hallmark of human mpox.[2] One of the largest mpox patient databases shows that 85% of patients presented a total of 20 lesions or fewer; 39% of patients presented with fewer than five lesions and up to 11% of patients with a single ulcer.[3] This claim is supported throughout the literature, with other mpox case series reporting up to 96% of patients with 20 or fewer skin lesions,[4] and up to 14.6% patients with a single ulcer.[5] Thus, even a patient presenting with a solitary skin lesion with mpox characteristics should be tested accordingly, to ensure optimal detection. [Extracted from the article]

Psoriasis is a chronic, inflammatory, immune-mediated, potentially disfiguring and disabling skin disorder, affecting over 100 million individuals worldwide. Calcipotriol plus betamethasone fixed-combination (0.005% Cal/0.064% BD) is the recommended topical treatment for psoriasis. However, topical treatments are associated to lack of efficacy and low adhesion rates due to poor cosmetic characteristics' formulations, and vehicle issues. To answer the need for improving patients' acceptability and adherence, an innovative Cal/BD aerosol foam formulation was developed for the topical treatment of adults with plaque psoriasis. Phase II and III clinical trials have consistently shown that the two-compound formulation is more effective and safer than its individual ingredients in the same vehicle. Cal/BD aerosol foam formulation has proved higher efficacy in clinical studies, and a pooled analysis of the main clinical studies has demonstrated that this does not occur at the safety profile expense. Furthermore, Cal/BD aerosol foam has shown a significantly improved efficacy compared with more traditional formulations, such as ointments, gels, and lotions. The improved efficacy and safety profile of this new formulation, together with the once-daily treatment, a more acceptable tolerability profile, and an early and rapid response, offers improved convenience and better acceptance over the twice- -daily applications required for the respective monotherapies, which may improve adherence to treatment, leading to faster and greater improvements in HR-QoL, representing a useful therapeutic option to the management of patients with plaque psoriasis. Further clinical investigations to explore the possibility of Cal/BD aerosol foam treatment ability to provide long-term psoriasis' management are required. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic inflammatory disease frequently seen in dermatologic practice. Although it is possible to control the majority of patients using only topical therapies, a significant percentage is refractory to these treatments, requiring systemic therapies. In these cases, one of the possible options is phototherapy. This paper details the various available therapeutic modalities of phototherapy in the treatment of psoriasis and the most frequently used protocols. [ABSTRACT FROM AUTHOR]

ABSTRACT [ABSTRACT FROM AUTHOR]

Chronic urticaria is a skin disorder with a very high impact on patients' quality of life. It has a prevalence between 7,8 and 22,3% with a higher incidence in women between 20 and 40 years old. The intensity of the itch, the anxiety caused by its recurrent nature and also the incapacity caused by the unpredictable exacerbations are among the factors that mostly impact patient's quality of life. Being a mast cell-driven disease, the most recent recommendations of the European Academy of Allergy and Clinical Immunology (EAACI), the EU-funded network of excellence, the Global Allergy and Asthma European Network (GA2LEN), the European Dermatology Forum (EDF), and the World Allergy Organization (WAO) suggest a symptomatic treatment for chronic urticaria, with very limited routine diagnostic measures being recommended. Non-sedating anti-histamines H1 (AHH1ns), in approved dose, are recommended as first line of treatment followed by the utilization of omalizumab, cyclosporine A or montelukast as add-on treatment in patients that do not respond to high doses AHH1ns. The treatment must continue until the patient is symptoms free, in the most possible safe manner. [ABSTRACT FROM AUTHOR]

Junctional epidermolysis bullosa is a group of inherited blistering diseases characterized by increased skin fragility, blisters and erosions after minor trauma, due to tissue cleavage at the dermal-epidermal junction. We report the case of a male Caucasian infant, born with erosions and tense blisters on the hands, abdomen and scalp. Immunoflurescence antigen mapping revealed paucity of collagen XVII immunolabelling, compatible with the diagnosis of non-Herlitz junctional epidermolysis bullosa. Molecular analysis of the COL17A1 gene revealed compound heterozygosity for two frameshift mutations. Family history was positive for a brother with a bullous dermatosis, who died from sepsis on the 3rd week of life without a definitive diagnosis that could enable precise risk estimation and prenatal diagnosis. We emphasize the importance of rapid referral to specialized centers, to provide early accurate diagnosis, adequate clinical management and prenatal diagnosis in subsequent pregnancies. [ABSTRACT FROM AUTHOR]

All patients only received NB-UVB therapy and topical treatment with betamethasone dipropionate 0.5 mg/g and calcipotriol 0.05 mg/g foam after phototherapy. The clinical spectrum of response to narrowband-UVB therapy in chronic plaque psoriasis: The lower limbs are the most difficult-to-treat body region Keywords: Phototherapy; Psoriasis; Ultraviolet Radiation EN Phototherapy Psoriasis Ultraviolet Radiation 529 531 3 09/20/23 20230901 NES 230901 DATA AVAILABILITY STATEMENT The databases generated and/or analyzed during the current study are not publicly available. [Extracted from the article]

We hypothesize that antiretroviral therapy in the context of HIV infection or Pre-Exposure Prophylaxis (PrEP) against HIV infection may offer some degree of protection against, at least, severe forms of SARS-CoV-2 infection. Even in a reference article where caution is advised when considering HIV-infected individuals to have lower risk of severe COVID-19, we can see that the patients undergoing antiretroviral treatment with TDF/FTC did not present poor outcomes [[9]]. We, thus, propose that further investigation should be carried to investigate the potential merits of common antiretrovirals in the treatment of early COVID-19 infection, or even as PrEP for this infection. [Extracted from the article]

Dear Editor, The SARS-CoV-2 pandemic raises questions about the treatment of chronic inflammatory dermatoses such as psoriasis with immunomodulatory/immunosuppressive therapies. Currently, solid data are insufficient to either support or exclude that patients under immunomodulatory/immunosuppressive therapies in the context of psoriasis have higher risk for infection or severe progression of COVID-19. After excluding current COVID-19 infection, the focus shifts to the possibility of patients acquiring this infection while under immunomodulator/immunosuppressant treatment, to unknown consequences. [Extracted from the article]

Abstract: It is shown that the relationship between the alkyl chain length of 3-alkyl-3′,4′,5,7 tetrahydroxyflavones (FnH) bearing alkyl chains of n =1, 4, 6, 10 carbons and their capacity to counter oxidative damage varies markedly with the nature of the biological system. In Cu2+-induced lipid peroxidation of low-density lipoprotein (LDL), the less hydrophobic short-chain F1H and F4H are probably located in the outer layer of LDL and parallel the reference flavonoid antioxidant, quercetin (Q) as effective inhibitors of lipid peroxidation. A marked inhibition of haemolysis induced in red blood cells (RBC) suspensions by the membrane-permeant oxidant, tert-butylhydroperoxide (t-BuOOH), is observed with F4H and F6H present at concentration in the micromolar range. However, F10H the most hydrophobic FnH is even more effective than Q against both haemolysis and lipid peroxidation as measured by malondialdehyde (MDA) equivalents. In oxidation of RBC by H2O2, at least 50 times more F6H and F10H than by t-BuOOH are required to only partly inhibit haemolysis and MDA production. The F1H, F4H and Q are found rather inactive under these conditions. At concentrations in the micromolar range, a marked protection against the cytotoxic effects of the t-BuOOH-induced oxidative stress in human skin NCTC 2544 keratinocytes is also exhibited by the four FnH antioxidants and is comparable to that of Q. Thus, the four FnH species under study may be considered as potent antioxidants which manifest complementary anti-oxidative actions in biological systems of markedly different complexity. [Copyright &y& Elsevier]

Photodynamic therapy (PDT) of skin tumors or pre-cancerous lesions and of age-related macular degeneration combines the administration of porphyrins or porphyrin precursors and illumination with red light at the diseased sites. Photosensitizers absorbing light beyond 630 nm where tissues have the highest transmittance produce singlet oxygen, a highly reactive activated oxygen species and a major cytotoxin. The PDT of age-related macular degeneration is performed with red laser light after i.v. injection of verteporfin (Visudyne®) a hydrophobic porphyrin carried by serum lipoproteins whose endocytosis leads to accumulation of the porphyrin in endothelial cells of choroidal neo-vessels. In the PDT of skin cancers, local synthesis of the photosensitizer occurs after topical application of the natural protoporphyrin IX precursor δ-aminolevulinic acid (or its ester forms) on the lesions. In all the cases, the photosensitizers should be rapidly excreted to avoid a long lasting skin photosensitivity. [ABSTRACT FROM AUTHOR]

In the minor fraction of HDL3 containing α-tocopherol (αTocOH), selective one-electron oxidation of Trp and Tyr residues of apolipoproteins A-I and A-II by •Br2- radical-anions produces the corresponding semioxidized species, TyrO• and •Trp. Repair of TyrO• by endogenous αTocOH generates the α-tocopheroxyl radical (αTocO•). Fast spectroscopic studies show that two populations representing 80% of αTocO• initially formed are repaired over several seconds with rate constants of 3.0 × 106 and 1.5 × 105 M-1 s-1 by quercetin bound to human serum albumin (HSA) at physiologically relevant concentration. Formation of HSA-bound quercetin radicals (•Qb) is observed. In the major fraction of HDL3 particles lacking αTocOH, TyrO• and •Trp are repaired by free and HSA-bound quercetin. In LDL particles which all contain αTocOH, αTocO• radicals are formed in the millisecond time scale by repair of TyrO• radicals produced in apolipoprotein B. Then, 75% of initial TocO are repaired over seconds by HSA-bound quercetin (rate constant: 2.0 × 106 M-1 s-1). HSA-bound quercetin can also repair •Trp radicals. In O2-saturated solutions, the fraction of αTocO• radicals (more than 50%) not repaired by superoxide radical-anions can be repaired by HSA-bound quercetin with formation of •Qb but to a much lesser extent in LDL than in HDL. [ABSTRACT FROM AUTHOR]

Photodynamic therapy (PDT) by porphyrins and related tetrapyrrole derivatives is an emerging new treatment modality of tumors of lung, eosophagus and skin and of age-related macular degeneration. Phase III clinical trials for other applications such as re-stenosis after angioplasty are also underway. Under systemic conditions, the transport of porphyrin photosensitizers by serum low density lipoproteins and their specific delivery to tumor cells and vasculature is a determinant of treatment effectiveness. However, this effectiveness can be improved by increasing the selectivity of the photosensitizer uptake by tumors and by using photosensitizers absorbing light in the 660–800 nm range where tissues have the highest transmittance. Another treatment showing great promise is the PDT of skin cancers after topical application of the protoporphyrin IX precursor delta-aminolevulinic acid (or its ester forms). In all the cases, the photosensitizers should be rapidly excreted to avoid a long lasting skin photosensitivity. [ABSTRACT FROM AUTHOR]

Four polyhydroxylated 2-styrylchromones, structurally related to flavones and cinnamic acid, have been studied. An SC derivative with OH groups only at positions 3′ and 4′ on the styryl moiety and another SC bearing an additional OH group at position 5 on the benzopyrone ring were more potent inhibitors of the Cu2+-induced peroxidation of LDL than the flavonoid quercetin. Fluorescence and absorption spectroscopies suggested that one LDL particle may bind 40 SC molecules. A pulse radiolysis study in pH 7 buffered micellar solutions of neutral TX100 and positively charged CTAB demonstrated that one-electron oxidation by ⋅Br2-, ⋅O2- and tryptophan radicals (⋅Trp) depends strongly on the micellar microenvironment. All SCs were readily oxidized by ⋅O2- in CTAB micelles (rate constants: 6–18×106 M-1 s-1). In TX100 micelles only the SC derivative with OH groups in position 3′ and 4′ reacted with ⋅O2- (rate constant: 1.1×106 M-1 s-1). In CTAB, electron transfer to ⋅Trp radicals was observed for all SCs with rate constants ≥3.2×107 M-1 s-1. In TX100 micelles, this reaction occurred solely with the derivative bearing OH groups only at positions 3′ and 4′. [Copyright &y& Elsevier]

We recently reported that, depending on its concentration, urate is either a pro-or an antioxidant in Cu2+-induced low-density lipoprotein (LDL) oxidation. We also previously demonstrated an antioxidant synergy between urate and some flavonoids in the Cu2+-induced oxidation of diluted serum. As a result, the effect of the flavonoid quercetin on the Cu2+-induced oxidation of isolated LDL has been studied either in the presence or absence of urate. We demonstrate that, like urate, quercetin alone, at low concentration, exhibits a pro-oxidant activity. The pro-oxidant behavior depends on the Cu2+ concentration but it is not observed at high Cu2+ concentration. When compared with urate, the switch between the pro- and the antioxidant activities occurs at much lower quercetin concentrations. As for urate, the pro-oxidant character of quercetin is related to its ability to reduce Cu2+ with the formation of semioxidized quercetin and Cu+ with an expected yield larger than that obtained with urate owing to a more favorable redox potential. It is also shown that the pro-oxidant activity of urate can be inhibited by quercetin. An electron transfer between quercetin and semioxidized urate leading to the repair of urate could account for this observation as suggested by recently published pulse radiolysis data. It is anticipated that the interactions between quercetin­Cu2+­LDL and urate, which are tightly controlled by their respective concentration, determine the balance between the pro- and antioxidant behaviors. Moreover, as already observed with other antioxidants, it is demonstrated that quercetin alone behaves as a pro-oxidant towards preoxidized LDL. [ABSTRACT FROM AUTHOR]

The 1:1 complex of copper (II) and human serum albumin (HSA) slowly reacts with radiolytically generated • O 2 - radical-anion at a rate constant of 6.1×10 6 M -1 s -1 . Absorbance and fluorescence spectroscopies demonstrate that addition of an equimolar portion of quercetin (QH 2 ) to the solution of the copper (II)-HSA complex induces a relocalization of the copper resulting in a ternary copper (II)-QH 2 -HSA complex. This form of quercetin slowly oxidizes in air-saturated solutions. A 10-fold excess urate, a plasma antioxidant, cannot displace copper (II) bound to HSA. In N 2 O-saturated solutions the ternary complex form of QH 2 can repair the urate radical with a rate constant of 2.7×10 6 M -1 s -1 by an electron transfer reaction similar to that observed in the absence of copper (II). In O 2 -saturated solutions and in the absence of copper, HSA-bound QH 2 fails to repair the urate radical because of the fast competitive reaction of • O 2 - with urate radicals. However, addition of equimolar copper (II) restores the electron transfer from QH 2 to the urate radical. These contrasting results are tentatively explained either by an enhanced reactivity of copper (II) with • O 2 - in the ternary complex or by direct production of quercetin radicals via a copper-catalyzed reduction of the • O 2 - radicals by QH 2 . [ABSTRACT FROM AUTHOR]

Https://doi.org/10.1093/ced/llad113 Dear Editor, We present the case of a patient who developed alopecia areata (AA) 2 months after starting treatment with inclisiran. Alopecia areata as another immune-mediated disease developed in patients treated with tumour necrosis factor- blocker agents. The patient denied a personal or family history of atopy, AA or autoimmune diseases, as well as recent infections, new medication, travel or major life stressors. [Extracted from the article]

We reported earlier that urate may behave as a pro-oxidant in Cu2+ -induced oxidation of diluted plasma. Thus, its effect on Cu2+ -induced oxidation of isolated low-density lipoprotein (LDL) was investigated by monitoring the formation of malondialdehyde and conjugated dienes and the consumption of urate and carotenoids. We show that urate is antioxidant at high concentration but pro-oxidant at low concentration. Depending on Cu2+ concentration, the switch between the pro- and antioxidant behavior of urate occurs at different urate concentrations. At high Cu2+ concentration, in the presence of urate, superoxide dismutase and ferricytochrome c protect LDL from oxidation but no protection is observed at low Cu2+ concentration. The use of Cu2+ or Cu+ chelators demonstrates that both copper redox states are required. We suggest that two mechanisms occur depending on the Cu2+ concentration. Urate may reduce Cu2+ to Cu+ , which in turn contributes to &formmu0; formation. The Cu2+ reduction is likely to produce the urate radical (UH·– ). It is proposed that at high Cu2+ concentration, the reaction of UH·– radical with &formmu1; generates products or intermediates, which trigger LDL oxidation. At low Cu2+ concentration, we suggest that the Cu+ ions formed reduce lipid hydroperoxides to alkoxyl radicals, thereby facilitating the peroxidizing chain reaction. It is anticipated that these two mechanisms are the consequence of complex LDL–urate–Cu2+ interactions. It is also shown that urate is pro-oxidant towards slightly preoxidized LDL, whatever its concentration. We reiterate the conclusion that the use of antioxidants may be a two-edged sword. [ABSTRACT FROM AUTHOR]

Selective oxidative damage to apolipoprotein B in LDL can be effected radiolytically by •Br[sub 2][sup -] radicals. Twenty-seven Trp residues constitute major primary sites of oxidation, but two-thirds of oxidized Trps (•Trp) that are formed are repaired by intramolecular electron transfer from Tyr residues with formation of phenoxyl radicals (TyrO•). Analysis of •Trp and TyrO• transient absorbance changes suggests that other apolipoprotein B residues, probably Cys, are oxidized. LDL-bound quercetin can efficiently repair this damage. Absorption studies show that a LDL particle has the capacity to bind ∼10 quercetin molecules through interaction with apolipoprotein B. The repair occurs by intramolecular electron transfer characterized by a rate constant of 2 × 10³ s[sup -1]. In contrast, rutin, a related flavonoid which does not bind to LDL, cannot repair oxidized apolipoprotein B. Urate is a hydrophilic plasma antioxidant which displays synergistic antioxidant properties with flavonoids. Urate radicals produced by •Br[sub 2][sup -] can also be repaired by LDLbound quercetin. This repair occurs with a reaction rate constant of 6.8 × 10[sup 7] M[sup -1] s[sup -1]. Comparison with previous studies conducted with human serum albumin-bound quercetin suggests that quercetin analogues tailored to be carded preferentially by lipoproteins might be more powerful plasma antioxidants than natural quercetin carded by serum albumin. [ABSTRACT FROM AUTHOR]

Neutral tryptophan (•Trp) and tyrosine (TyrO•) radicals are repaired by certain flavonoids in buffer, in micelles and in human serum albumin (HSA) with corresponding formation of semioxidized flavonoid radicals. In deaerated buffer, •Trp but not TyrO• radicals react with catechin. In micelles, quercetin and rutin repair both •Trp and TyrO• radicals. In addition to amino acid reactivity, microenvironmental factors and nature of the flavonoids govern this repair. Electron transfer efficiencies from quercetin to negatively charged •Trp radicals are 100% in the micellar pseudophases of positively charged cetyltrimethylammonium bromide, (CTAB), and neutral Triton X100 (TX100), but 55% in negatively charged sodium dodecyl sulfate (SDS). In oxygen-saturated CTAB micelles, quercetin also reacts with the superoxide radical anion. When bound to domain IIA of HSA, quercetin repairs, by intra- or intermolecular encounter, less than 20% of oxidative damage to HSA. Quercetin can also repair freely circulating oxidized molecules with repair efficiencies falling to 7% for oxidized Trp, Tyr and α-MSH and to less than 2% for urate radical. This limited effectiveness is attributed both to the inaccessibility of bound quercetin and rutin toward radicals of circulating molecules and to the diffusion-controlled recombination of these radicals. [Copyright &y& Elsevier]

Neutral tryptophan (•Trp) and tyrosine (TyrO•) radicals are repaired by certain flavonoids in buffer, in micelles and in human serum albumin (HSA) with corresponding formation of semioxidized flavonoid radicals. In deaerated buffer, •Trp but not TyrO• radicals react with catechin. In micelles, quercetin and rutin repair both •Trp and TyrO• radicals. In addition to amino acid reactivity, microenvironmental factors and nature of the flavonoids govern this repair. Electron transfer efficiencies from quercetin to negatively charged •Trp radicals are 100% in the micellar pseudophases of positively charged cetyltrimethylammonium bromide, (CTAB), and neutral Triton X100 (TX100), but 55% in negatively charged sodium dodecyl sulfate (SDS). In oxygen-saturated CTAB micelles, quercetin also reacts with the superoxide radical anion. When bound to domain IIA of HSA, quercetin repairs, by intra- or intermolecular encounter, less than 20% of oxidative damage to HSA. Quercetin can also repair freely circulating oxidized molecules with repair efficiencies falling to 7% for oxidized •Trp, Tyr and α-MSH and to less than 2% for urate radical. This limited effectiveness is attributed both to the inaccessibility of bound quercetin and rutin toward radicals of circulating molecules and to the diffusion-controlled recombination of these radicals. [Copyright &y& Elsevier]

This article explores the intricacies of laser surgery, acknowledging inherent risks and complications. Patients with higher Fitzpatrick phototypes, characterized by unique biological traits, face heightened vulnerability during laser treatments. Limited experience with darker skin tones necessitates a higher level of laser expertise and a conservative approach. The study aims to comprehensively review laser therapy's side effects and complications, with a specific focus on Fitzpatrick phototypes IV through VI. We searched the MEDLINE database from 1972 to 2023 to consolidate knowledge. Results illuminate nuanced challenges associated with laser surgery in higher phototypes. In conclusion, this research emphasizes the need for enhanced expertise and caution in laser procedures for individuals with darker skin, offering valuable insights to optimize patient safety and outcomes. [ABSTRACT FROM AUTHOR]

Basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) are high-incidence, non-melanoma skin cancers (NMSCs). The success of immune-targeted therapies in advanced NMSCs led us to anticipate that NMSCs harbored significant populations of tumor-infiltrating lymphocytes with potential anti-tumor activity. The main aim of this study was to characterize T cells infiltrating NMSCs. Flow cytometry and immunohistochemistry were used to assess, respectively, the proportions and densities of T cell subpopulations in BCCs (n = 118), SCCs (n = 33), and normal skin (NS, n = 30). CD8+ T cells, CD4+ T cell subsets, namely, Th1, Th2, Th17, Th9, and regulatory T cells (Tregs), CD8+ and CD4+ memory T cells, and γδ T cells were compared between NMSCs and NS samples. Remarkably, both BCCs and SCCs featured a significantly higher Th1/Th2 ratio (~four-fold) and an enrichment for Th17 cells. NMSCs also showed a significant enrichment for IFN-γ-producing CD8+T cells, and a depletion of γδ T cells. Using immunohistochemistry, NMSCs featured denser T cell infiltrates (CD4+, CD8+, and Tregs) than NS. Overall, these data favor a Th1-predominant response in BCCs and SCCs, providing support for immune-based treatments in NMSCs. Th17-mediated inflammation may play a role in the progression of NMSCs and thus become a potential therapeutic target in NMSCs. [ABSTRACT FROM AUTHOR]

Vitiligo is a chronic pigmentary skin disorder that results in white, hypopigmented macules and patches. It causes a considerable psychological and emotional burden on the affected individuals and their families. Several therapeutic options have been employed in vitiligo including topical and oral drugs, surgical techniques, and phototherapy which is considered the cornerstone treatment. Different wavelengths and modalities are available, but narrowband UVB (NB‐UVB) is considered the safest and the most effective phototherapy alternative. NB‐UVB acts on multiple steps in vitiligo pathogenesis, and it is capable of inducing stabilization and repigmentation of vitiligo lesions. Technological advances have led to the development of both new phototherapy devices and new medical and surgical therapeutic options that can be combined with phototherapy to achieve optimal results. There is no standard treatment, and individual patient and disease characteristics should be considered. We review the current evidence in what concerns UVB phototherapy for vitiligo treatment, including novel combination treatments that may help to provide the best care for these patients. [ABSTRACT FROM AUTHOR]

This article discusses the treatment of localized granuloma annulare (GA) with the 595-nm pulsed dye laser (PDL). GA is a benign skin disease that can affect individuals of all ages, with a higher prevalence in women. Despite various treatment methods, finding a consistent and long-term solution for GA remains challenging. The article presents a case study of a 60-year-old woman with GA on her back that was resistant to previous treatments. After two sessions of PDL treatment, the granuloma completely resolved with no recurrence during the one-year follow-up period. The authors suggest that PDL therapy should be considered as a first-line treatment for localized GA, particularly in cases with significant erythema. Further studies are needed to explore the long-term outcomes of PDL treatment and compare its efficacy with alternative therapies. [Extracted from the article]

A retrospective study was conducted on pediatric patients examined via dermatology emergency consultation over 1 year. A total of 1352 diagnoses, including 100 distinct disorders, were recorded. Regardless of the diversity of skin conditions observed, a relatively small number of disorders were found repeatedly. We encourage education aimed at ED providers to focus on the diagnosis and management of the more commonly encountered disorders, including atopic dermatitis and infectious skin disorders. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article on persistent herpes gestationis treated with high-dose intravenous immunoglobulin, published in the previous issue.

Inpatient care for dermatological patients during SARS-CoV-2 - a case report from Portugal Dear Editor, The recent SARS-CoV-2 pandemic has put a significant strain on dermatological practice. The change in facilities allows dermatological patients to be diverted to parallel circuits away from the epicenter of SARS-CoV-2. [Extracted from the article]

The resurgence of Mpox, predominantly among men who have sex with men (MSM), has prompted an analysis of its clinical manifestations and epidemiological patterns, particularly in individuals living with human immunodeficiency virus (HIV). This retrospective study aims to delineate and compare the clinical presentations and epidemiological characteristics of Mpox among HIV-positive and HIV-negative individuals. A total of 58 confirmed Mpox cases from a dermatology department in Lisbon were analyzed, focusing on mucocutaneous manifestations, systemic symptoms, and laboratory parameters. Our findings indicate no significant difference in disease severity and presentation between HIV-positive and HIV-negative groups, suggesting that HIV status may not be a determinant of Mpox severity, but rather an indicator of increased sexual risk behaviors, a recognized risk factor for Mpox transmission. [ABSTRACT FROM AUTHOR]

This article discusses the case of a 44-year-old man who presented with recurrent crops of tender subcutaneous nodules. The patient had a history of fever, night sweats, weight loss, and other symptoms. After examination and testing, the diagnosis was determined to be erythema nodosum leprosum (ENL) complicating borderline lepromatous leprosy. The article provides information on leprosy, its classification, and the treatment options for ENL. The authors emphasize the importance of raising awareness about leprosy to avoid misdiagnosis and delayed treatment. [Extracted from the article]

In addition, all studies demonstrating clinical benefit of these drugs in patients with COVID-19 patients were conducted in unvaccinated individuals and most in unimmunized individuals with no previous infection. Cutaneous adverse reactions to the new oral antiviral drugs against SARS-CoV-2 Currently, there are two oral antivirals directed to SARS-CoV-2: molnupiravir (Lagevrio SP ® sp ), which induces an antiviral effect via viral error catastrophe, and nirmatrelvir-ritonavir (Paxlovid™) (nirmatrelvir inhibits an enzyme needed for coronavirus replication and ritonavir decreases metabolism of nirmatrelvir, maintaining its antiviral activity at higher levels). [Extracted from the article]

Patient 3 - A 25-year-old African woman who developed inflammatory skin lesions on buttocks and thighs (e,f) 2 months after DMPA injections. Dear Editor, In Africa, very large buttocks and very full lateral thighs are considered very attractive and a sign of fertility. [Extracted from the article]

This document is a letter published in the journal Clinical Drug Investigation. It discusses the real-world effectiveness and safety of a drug called baricitinib in patients with atopic dermatitis (AD). AD is a chronic inflammatory skin disease that affects both children and adults. Baricitinib is a medication that inhibits certain cytokines involved in AD pathophysiology. The letter describes a retrospective multicenter study conducted in Portugal, which evaluated the effectiveness and safety of baricitinib over a 24-week period in patients with moderate-to-severe AD. The study found that baricitinib showed positive outcomes in terms of reducing AD severity and improving quality of life for patients. No serious adverse events were reported, and the drug was generally well-tolerated. This document discusses the effectiveness and safety of baricitinib, a medication used to treat moderate-to-severe atopic dermatitis (AD). The study found that baricitinib showed similar effectiveness to clinical trials in reducing itch and skin inflammation in patients with AD. Patients who had not received prior treatment with dupilumab, another medication for AD, showed better effectiveness with baricitinib. The study also indicated a favorable tolerability and safety profile for baricitinib. However, further real-world studies with larger patient populations are needed to gather more comprehensive evidence. [Extracted from the article]

An outbreak of monkeypox (MPX) has emerged across the globe.[[1]] In 2022, World Health Organization (WHO) reported more than 50,000 laboratory-confirmed cases until September.[1] Since early May 2022, many of these cases have been reported from countries without direct or immediate epidemiological links to West or Central Africa. A swab was performed at the base of the nipple lesion, which revealed the presence of MPX virus via real-time polymerase chain reaction (PCR). Human-to-human transmission of MPX can occur through large respiratory droplets, direct contact with the cutaneous or mucosal viral lesions/body fluids, and indirect contact with infected materials through clothing or infected linens.[[3], [5]] During the MPX outbreak of 2022, sexual activity was the most frequent transmission route, primarily among homosexual or bisexual men.[[5], [7]] Regarding the epidemiological history, the transmission route to the patient's partner remains to be elucidated. [Extracted from the article]

The article discusses a case of generalized hyperpigmented and hypopigmented macules and papules in a 49-year-old woman. The patient had these skin lesions since her twenties and mentioned that her family members also had similar lesions. The physical examination revealed oval hyperpigmented macules and papules, some with a hyperkeratotic surface, along with hypopigmented macules. Histopathological examination showed characteristic features of Dowling-Degos disease (DDD), a rare genodermatosis. The article provides information on the clinical presentation, histological findings, genetic analysis, and differential diagnosis of DDD. Treatment options for DDD are also discussed. [Extracted from the article]

Melanocytic lesions and other skin tumors represent one of the most frequent reasons for pediatric dermatology consultation. Although often benign, some of them may simulate melanoma, which can be a source of anxiety for parents and clinicians. Dermoscopy is a non-invasive and painless technique that increases the diagnostic accuracy for skin tumours, while avoiding unnecessary skin biopsies. In part I of this article, we highlight the importance of dermoscopy for the diagnosis of skin tumors in pediatric patients. [ABSTRACT FROM AUTHOR]

Cutaneous leishmaniasis may mimic other infections in overlapping endemic areas and timely treatment prevents dissemination of the parasite. The required histopathological and microbiological examinations are not always available, and can only give a deferred confirmation of the diagnosis. In contrast, reflectance confocal microscopy (RCM) allows real-time visualization till the level of papillary dermis. A 59-year-old Brazilian male presented with ulcerated plaques and tumors on the extremities. The clinical differential diagnosis included leishmaniasis and other infections with lymphocutaneous pattern of dissemination. RCM showed the characteristic picture of «eggs in a bird’s nest» which has been described in cutaneous leishmaniasis. The diagnosis of leishmaniasis was later confirmed by skin biopsy, in which Leishmania guyanensis was identified by parasitological examination. After treatment with liposomal amphotericin B, reassessment with RCM corroborated the clinical cure, showing an «empty nest» picture. In conclusion, RCM noninvasively provides useful information for diagnosis and follow-up of cutaneous leishmaniasis. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 25 year old female patient who presented to physicians with a ten year history of bluish-red discoloration of his upper and lower limbs. A discussion of diagnostic testing which was conducted on the patient and resulted in him receiving a diagnosis of livedoid vasculopathy associated with plasminogen activator inhibitor-1 promoter homozygosity (4G/4G) and prothrombin G20210A heterozygosity, is presented.

Cancer patients may experience several dermatological symptoms during treatment. We describe a case of synchronous presentation of hand, foot, and mouth disease (HFMD) and palmoplantar erythrodysesthesia (PPE) in a breast cancer patient. A 36-year-old female breast cancer patient under chemotherapy presented to our consult with a 1-week history of painful palmoplantar lesions associated with the recent onset of fever and dry cough. Her daughter had been diagnosed with HFMD. There was a positive immunoglobulin M (IgM) and IgG serology for coxsackievirus. We performed two skin biopsies; one specimen was consistent with HFMD, and the other one was with PPE. To the best of our knowledge, the synchronous presentation of HFMD and PPE has not yet been reported in the literature to date. PPE and immunosuppression might have been responsible for the atypical presentation and clinical severity of HFMD. [ABSTRACT FROM AUTHOR]

Dear Editor, Janus kinase (JAK) inhibitors are emerging as a promising new treatment modality for many inflammatory conditions. All patients had mild-to-moderate acne (comedonal acne ( I n i = 3), mild papulopustular acne ( I n i = 2), and moderate papulopustular acne ( I n i = 1)), predominantly on the face. [Extracted from the article]

Trichomonas vaginalis and Mycoplasma genitalium: age-specific prevalence and disease burden in men attending a sexually transmitted infections clinic in Amsterdam, the Netherlands. Comparative prevalence of infection with Trichomonas vaginalis among men attending a sexually transmitted diseases clinic. From our clinic, TV infection in men seems to be less frequent than in the published literature.2,5 This is not related to diagnostic methods, as we routinely conduct multiplex PCR for STI diagnosis and screening. [Extracted from the article]