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Background/Objectives: Pityriasis rosea (PR) is a self-limiting exanthematous disease associated with the endogenous reactivation of human herpesviruses (HHV)-6 and HHV-7. Classically, the lesions gradually resolve, leaving no sequelae. Therefore, the best treatment is reassuring the patient and suggesting a resting period. However, atypical PR cases characterized by extensive, persistent lesions and systemic symptoms may impact the patient's quality of life, and, therefore, a treatment can be prescribed. There is limited evidence on the comparative effectiveness of pharmacological treatments for PR; therefore, we performed a network meta-analysis to compare these interventions. Methods: Overall, 12 randomized control trials (RCTs) were identified. The outcomes were itch resolution and rash improvement. Results were expressed as risk ratio (RR) and 95% confidence interval (CI). We also calculated the relative ranking of the interventions for achieving the aforementioned outcomes as their surface under the cumulative ranking (SUCRA). Results: On network meta-analysis, only oral steroids and the combination of oral steroids+antihistamine resulted significantly superior to the placebo in terms of itch resolution (RR 0.44, CI 0.27–0.72 and RR 0.47, CI 0.22–0.99). Oral steroids resulted in the best treatment (SUCRA 0.90) for itch resolution. In terms of rash improvement, only acyclovir and erythromycin resulted significantly superior to placebo (RR 2.55, CI 1.81–3.58; and RR 1.69, CI 1.23–2.33), and acyclovir outperformed all the other tested interventions. Consequently, acyclovir ranked as the best intervention (SUCRA score 0.92). Conclusions: Acyclovir represents the best option for patients with PR that have extensive, persistent lesions or systemic symptoms. Steroids and antihistamines seemed the best treatment for itch resolution. [ABSTRACT FROM AUTHOR]

Background: Coronavirus Disease 2019 (COVID‐19) is a viral illness caused by the novel coronavirus SARS‐CoV‐2 which spreads via droplets from an infected person. There has been an unprecedented rise in the use of personal protective equipment and practice of personal hygiene measures against COVID‐19. The extended use of protective measures (PM) can lead to ill effects on the skin. Our aim was to investigate PM‐induced dermatoses amongst healthcare workers and the general population during the COVID‐19 pandemic. Methods: A cross‐sectional study was conducted over a period of 2 months. The study subjects were patients who presented to dermatology outpatient clinics or sought teleconsultation for skin problems related to the use of PMs against COVID‐19. A detailed history was obtained and cutaneous examination was documented for all the patients in a pre‐set proforma. Diagnoses of the adverse skin effects were formulated based upon history and clinical examination. Results: A total of 101 cases with cutaneous adverse effects due to the use of PMs against COVID‐19 were included in the study. The general population and healthcare workers were affected similarly, comprising of 54.5% and 45.5%, respectively. The mean age of the study participants was 36.71 ± 15.72 years. The most common culprit material was soap and water (56.4%). Contact dermatitis was found to be the most common adverse effect in the majority of our patients (72.3%). The most common symptom reported was pruritus (45.5%). The wearing of personal protective equipment for a longer duration was significantly associated with multiple symptoms (P = 0.026). Conclusion: The enhanced use of different PMs against COVID‐19 can result in a variety of adverse skin effects. In our study, the use of soap and water was the most common culprit PM, and contact dermatitis was the most common adverse effect noted. [ABSTRACT FROM AUTHOR]

Background: Auricular keloids are very frequent and often have a peculiar response to therapy. Despite a variety of treatment options, recurrence is the norm. An integrated surgical-radiotherapy approach is suggested to have the most significant effect on recurrence rate, varying from 3.5% to 27%. The aim of this study was to assess, through a retrospective review of our cases, the effectiveness and safety of postoperative radiotherapy performed over 26 years and to observe whether all localizations of auricular keloids behave in the same way. Methods: Sixty patients affected by 76 auricular keloids were included in this study. The median time interval between the surgery and the beginning of radiotherapy was 3 days. The total dose administered ranged from 10 Gy to 45 Gy, by means of weekly fractions of 5 Gy each. Results: The mean follow-up was 47.85 months. In 10 cases (13.2%) a recurrence occurred. The 5-year relapse-free rate from the end of the combined treatment was 79.84%. The cosmetic result was judged as good in all cases. No late stochastic or non-stochastic damages were observed. Conclusion: Our data significantly support the dermatologic postoperative radiotherapy role in the treatment approach of all auricular keloids. [ABSTRACT FROM AUTHOR]

A quiz concerning the diagnosis of the 29-year-old Egyptian warehouse man who was presented with a six-month history of multiple papular nodular lesions on limbs, erosions on his legs and erythematous plaque on left wrist.

A medical quiz about the diagnosis of an older patient with vegetating nodules after dental erosions is presented.

A letter to the editor related to a case study of a woman with cutaneous leishmaniasis (CL) is presented.

Background: Mucous membrane pemphigoid (MMP) is an autoimmune disease characterized by scarring lesions at mucosal sites. Although the pathogenic role of specific IgG and/or IgA has been already demonstrated and the detection of these immunoglobulins is a criterion in the diagnosis of MMP, little is known about IgE role in this disease. Therefore, the main purpose of this study was to assess the presence of circulating and tissue bound IgE in patients with MMP and their possible correlations with clinical presentation and disease course., Methods: We conducted a retrospective study on 29 patients affected by MMP, recruited from a single center. Direct and indirect immunofluorescence studies were assessed to analyze the presence of specific IgE directed against the basal membrane zone. For each patient, fluorescence data were compared to clinical features., Results: Linear deposits of C3, IgG and IgA were present in 86.2%, 62% and 37.9% of cases respectively, while IgE linear deposits were detected in 17 out of 29 patients (58.6%) including one case with isolated IgE positivity. Circulating IgE and IgA anti-BMZ were present in 7 (24.1%) and 5 (17.2%) patients, respectively. Both the presence of circulating IgA and of tissue bound IgE deposits correlated with disease activity index (P<0.014)., Conclusions: Our results demonstrated the presence of IgE autoantibodies in MMP, particularly in more severe cases. Thus, IgE detection may represent an additional useful diagnostic tool in this disease.