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The presence of Demodex spp. mites on the skin is a common phenomenon in the human population. In most people, it is an asymptomatic infestation, but in some patients, it can contribute to the occurrence of diseases such as demodicosis, rosacea, or blepharitis, as well as non-specific symptoms. In this study, the results of tests assessing the presence of Demodex spp. by direct microscopic examination (DME) in 2508 patients from northern Poland with the suspicion of demodicosis were retrospectively analyzed. A total of 3684 tests were performed. Among them, only 1585 (43.02%) revealed the presence of Demodex spp., while 2099 (56.98%) were negative. It was shown that in the analyzed population of patients with clinical suspicion of demodicosis, the degree of confirmation of the presence of Demodex spp. positively correlated with the patient's age (p = 0.001) and the mite was mainly found on the edges of eyelids and on the facial skin. Additionally, in men, the presence of Demodex was more often confirmed than in women (p = 0.004). In conclusion, the proper diagnosis of demodicosis still constitutes an important clinical problem due to the non-specificity of symptoms and the low confirmation of clinical suspicions of infestation by DME, especially in lower age groups. [ABSTRACT FROM AUTHOR]

Background/Aim: Google Trends is a powerful tool for health information access and disease surveillance, including COVID-19 data forecasting. Cutaneous manifestations of COVID-19 include urticarial rash, which is multifactorial and may indicate a better prognosis. Aim of this study was to analyse the search queries for the term “urticaria” during the six years period (2017-2022) and assess the relationship between relative search volume (RSV) and a global rise in COVID-19 cases. Methods: This study examined search queries for "urticaria" from 2017 to 2022, exploring the relationship between RSV and global COVID-19 cases. Data on "urticaria" search volume in various countries were collected using Google Trends. Microsoft Excel and correlation analysis were used to analyse the data and investigate the association between search volume and monthly COVID-19 case rise. Results: During 2017-2019, the mean RSV for "urticaria" was 69.9 ± 10.1, which increased to 84.1 ± 8.6 during 2020-2022. The difference in means was statistically significant (p < 0.001). The mean RSV in 2022 (94.3) was the highest among all years studied. The increase in RSV from 2020 to 2022 moderately correlated (r = 0.56) with monthly COVID-19 case rise (p < 0.001). Nicaragua showed the highest search interest, while Africa, North America, Asia and Pacific, the Middle East and Europe had low search interest. Conclusions: This study identified a significant increase in search volume for "urticaria" during the COVID-19 pandemic. Nicaragua had the highest search interest, while English-speaking countries displayed low interest. Language variation, cultural differences and COVID-19-related health concerns may influence public interest in urticaria. These findings can aid public health officials in understanding public health concerns and tailoring effective health communication strategies. [ABSTRACT FROM AUTHOR]

BackgroundCOVID-19 presents extrapulmonary manifestations that can aid in the diagnosis. Skin manifestations have been reported but their characteristics are not yet clear. Health professionals need information about its prevalence and main characteristics.MethodsThis systematic review followed the PRISMA criteria. The protocol was registered in the PROSPERO (number CRD42020193173). Seven electronic databases and the gray literature were searched independently by two researchers. Observational analytical studies that presented data on the prevalence of skin manifestations in patients aged 19 or older with COVID-19 were included. Prevalence estimates were synthesized through a meta-analysis using random-effects models. Association meta-analysis and comparisons were performed for individual characteristics.ResultsWe included 31 studies with 10,934 patients, of which 10,121 tested positive for COVID-19. The general prevalence of skin manifestations was 29% (95% CI: 17.0–43.0; I2: 99%), the most in Africa, with a mean duration between 7 and 9 days and the most frequently affecting feet+hands (75%) and the trunk (71%). Patients with mild/moderate COVID-19 had more of chilblain-like+pernio-like lesions (97%) and inflammatory lesions (86%) than patients with severe or critical COVID-19. Manifestations of vascular origin were only in elderly patients and were significant with the severity of COVID-19 (p = 0).ConclusionThe global prevalence of skin manifestations is similar to other signs and symptoms of COVID-19. Skin assessment should be considered when investigating and diagnosing COVID-19 in adult and elderly patients.Systematic review registration: PROSPERO, identifier CRD42020193173, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020193173.

Abstract Background: Since the beginning of the COVID-19 pandemic, a myriad of cutaneous manifestations have been described in association with this viral infection. However, in Latin America, this kind of data is still scarce. Objective: In this sense, the goal of this study was to describe the dermatological findings observed during SARS-CoV-2 infection, in a Brazilian Hospital. Methods: This is a cross-sectional, retrospective and descriptive study of 50 cases of new-onset dermatologic symptoms in patients with COVID-19, treated at Hospital Sírio-Libanês, from February to June 2020. Results: The patients (n = 50) were classified into 6 groups, according to the elementary lesions and the statistical analysis was performed. The most common cutaneous lesions were maculopapular eruptions (44%), necrosis, purpura, and livedo (32%), urticarial lesions (12%), pseudochilblains (4%) and papular-vesicular eruption (4%). In 46% of the patients the cutaneous lesions occurred in association with other symptoms, such as pruritus (38%), pain and burning sensation (8%). Lower limbs were affected in 44% of the cases, followed by the trunk (38%), upper limbs (24%) and face (14%). Cutaneous lesions were mostly found after other COVID-19 systemic symptoms, with a mean period between the viral syndrome and cutaneous signs of 5 days (SD = 6.1 days). Study limitations: It is a small sample, in a single-center study, with patients exclusively from a private Hospitals. Conclusions: Patients in Brazil have the same proportion of lesions as revealed in other studies in Europa. The compiled data is essential for a better understanding of cutaneous manifestations deemed secondary to COVID.

Acroosteolysis (AO) is a rare condition characterized by resorption of the distal phalanges of the fingers and/or toes. It can be familial, idiopathic (IAO), occupational, or secondary. Other authors suggest a classification into primary (genetic disorders, lysosomal storage disorders) or secondary AO. Various skin and nail changes have been reported in this condition. However, the cutaneous change on the affected digit(s)/toe(s) during the natural course of AO has been poorly documented. A 5-year-old girl presented with a 3-month history of a distinct transverse boundary between normal skin proximally and affected crusted skin overlying osteolysis distally (“split” sign) on the plantar surface of the third toe. This boundary gradually elongated circumferentially to involve the dorsal surface. The mother gave a similar history of a delimitation line on the 2nd, 4th, and 5th toes of the right foot with durations of 3 months, 1 year, and 2 years, respectively, that disappeared before she noticed a shortening of those toes. X-rays revealed partial resorption of the terminal phalanx of the third toe and several lytic changes in the middle and terminal phalanx of the second, fourth, and fifth toes. The clinical features, radiology findings, and a workup that helped rule out conditions associated with AO (secondary AO) helped establish the diagnosis of IAO in our patient. This case study highlights that the natural course of IAO includes distinct skin findings, such as the “split” sign that we describe. This sign can help identify the condition early.

The skin manifestations of COVID-19 are infrequent but vary widely. Maculopapular rash, urticaria, chilblain, vesicular lesions, livedo reticularis, and petechiae are described. The manifestations are also common in adults and female gender. Authors report an uncommon skin manifestation of Covid-19 in a 15-year-old boy. [ABSTRACT FROM AUTHOR]

Joanna Rybak-d’Obyrn,1 Waldemar Placek,1 Agnieszka Owczarczyk-Saczonek,1 Maria Derkaczew,1 Ewelina Joniec,1 Robert Hofman,1 Ma&lstrok;gorzata Stompór2 1Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland; 2Department of Family Medicine and Infectious Diseases, Collegium Medicum, University of Warmia and Mazury, Olsztyn, PolandCorrespondence: Maria Derkaczew, Tel +48 607654914, Email m.derkaczew@gmail.comPurpose: The aim of this study was to assess the incidence and characteristics of COVID-19 cutaneous manifestations among geriatric patients infected with the SARS-CoV-2 virus.Patients and Methods: Sixty-four nursing home residents in Dobre Miasto, Poland (mean age: 79 years) infected with SARS-CoV-2 were monitored for skin lesions during the epidemic outbreak in 2020. Only five of them presented COVID-19 dermatological manifestation: vesicular (4 cases) and erythematous (1 case) skin lesions, which appeared after the remaining symptoms of the disease had resolved.Results: The average time between COVID-19 onset and cutaneous manifestation was 22 days. Skin lesions persisted in five cases 112, 17, 21,19 and 27 days, respectively, and were often accompanied by pruritus and neuropathic pain.Conclusion: Skin manifestations of SARS-CoV-2 infection might be misdiagnosed or overlooked, particularly among elderly patients with chronic diseases. The recognition of skin lesions due to COVID-19 might improve patients’ quality of life by reducing the intensity of symptoms such as pruritus or neuropathic pain.Keywords: geriatrics, dermatology, skin manifestation, vesicular

Background: COVID‐19 is a highly contagious respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2. COVID‐19 outbreak, which caused thousands of deaths, has been declared a pandemic by the World Health Organization in March 2020. Aim: Skin manifestations related to SARS‐CoV‐2 infection can be divided mainly into five groups: chilblainlike lesions (CBLLs), maculopapular eruptions, urticarial eruptions, vesicular eruptions, and livedo or necrosis. Other skin findings reported are erythema multiforme (EM)‐like lesions and skin findings associated with multisystem inflammatory syndrome in children (MIS‐C) and rarely with multisystem inflammatory syndrome in adults (MIS‐A). Other manifestations such as pityriasis rosea or shingles are also reported. Methods: A total of 60 articles including reviews, studies and case reports were selected for the evaluation in this review. Results: The skin manifestations associated with COVID‐19 infection are numerous and can vary widely. The major dermatological patterns of COVID‐19 can be classified as inflammatory reactions (maculopapular/morbilliform, urticarial and vesicular rashes), or lesions of vascular origin (chilblain like rashes, petechiae/purpura, and livedo acemose‐like pattern) Conclusion: We believe that the dermatologist could play an important role in the response to the SARS‐CoV‐2 pandemic through early recognition of skin lesions suggestive of COVID‐19, particularly in paucisymptomatic infections where this recognition could direct toward an early diagnosis of infection that certainly leads to a better prognosis. [ABSTRACT FROM AUTHOR]

Acroosteolysis (AO) is a rare condition characterized by resorption of the distal phalanges of the fingers and/or toes. It can be familial, idiopathic (IAO), occupational, or secondary. Other authors suggest a classification into primary (genetic disorders, lysosomal storage disorders) or secondary AO. Various skin and nail changes have been reported in this condition. However, the cutaneous change on the affected digit(s)/toe(s) during the natural course of AO has been poorly documented. A 5-year-old girl presented with a 3-month history of a distinct transverse boundary between normal skin proximally and affected crusted skin overlying osteolysis distally ("split" sign) on the plantar surface of the third toe. This boundary gradually elongated circumferentially to involve the dorsal surface. The mother gave a similar history of a delimitation line on the 2nd, 4th, and 5th toes of the right foot with durations of 3 months, 1 year, and 2 years, respectively, that disappeared before she noticed a shortening of those toes. X-rays revealed partial resorption of the terminal phalanx of the third toe and several lytic changes in the middle and terminal phalanx of the second, fourth, and fifth toes. The clinical features, radiology findings, and a workup that helped rule out conditions associated with AO (secondary AO) helped establish the diagnosis of IAO in our patient. This case study highlights that the natural course of IAO includes distinct skin findings, such as the "split" sign that we describe. This sign can help identify the condition early. [ABSTRACT FROM AUTHOR]

Abstract Introduction Patients with chikungunya virus infection commonly present with fever, skin rash, and severe joint pain. The vesiculobullous rash is rare in adults but common in infants. In addition, septic shock and acute respiratory distress syndrome are rare complications of atypical and severe acute chikungunya infection. Case presentation We report the presence of an 18-year-old Thai female, at 31 weeks gestation, with fever, maculopapular rash, and polyarthritis. The rash later progressed to a vesiculobullous pattern, and she developed septic shock and acute respiratory distress syndrome. Skin biopsy and blood were positive for chikungunya virus RNA. The patient was intubated with a mechanical ventilator and subsequently fully recovered. Conclusion Atypical skin manifestation and severe acute disease is likely due to immune response attenuation in pregnancy. The possibility of progression to severe or atypical disease in pregnant women suffering chikungunya should always be considered.

Recently, there is an increased number of reports being published on Methotrexate (MTX) related cutaneous manifestations. We aimed to identify and critically appraise descriptive studies describing the MTX related skin manifestations, treatment approach, and their outcomes. An extensive literature search was performed in the PubMed, Embase, and Scopus databases from inception to April 2021 without any restrictions along with the bibliographic search of included studies, grey literature search, and a snowball search was performed in Google and Google Scholar to identify the relevant literature. Descriptive studies reporting MTX related cutaneous manifestations were considered for the review. The study selection, data extraction, and quality assessment were conducted by two independent reviewers and any disagreements were settled by consensus with the third reviewer. 31 out of 8,365 descriptive studies including 38 patients (22 females and 16 males) aged between 12 and 78 years prescribed for the management of rheumatoid arthritis, ankylosing spondylitis, and psoriasis were included in this review. Toxic epidermal necrolysis (TEN), papular eruption, vasculitis, erosions of psoriasis, ulcerated psoriatic plaques, local reactions, keratinocyte dystrophy, erythema multiforme, drug rash with eosinophilia and systemic symptoms, Steven Johnson syndrome and photosensitive dermatitis were the majority of MTX induced cutaneous reactions. Immediate withdrawal of MTX, providing appropriate care with anti-inflammatory, topical steroids, and supplementation with folic acid were reported to be effective for the management of the MTX related cutaneous manifestations. Clinicians and healthcare professionals should be aware of possible acute cutaneous drug reactions induced by MTX to avoid further consequences and fatal conditions. Immediate withdrawal of MTX and supportive care were reported as an efficacious therapeutic management of acute cutaneous drug reactions. CRD42020220038. [ABSTRACT FROM AUTHOR]

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Background/Aim. Diabetes mellitus (DM) can be associated with numerous skin diseases. This study aimed to determine the pattern and incidence of skin manifestations in patients with type 2 DM and their link to glycemic control. Methods. This cross-sectional study was conducted at the Skin and Venereal Diseases Clinic, University Clinical Centre of the Republic of Srpska in Banja Luka, Bosnia and Herzegovina, from January 2016 to January 2018. Adult patients of both genders suffering from type 2 DM and cutaneous manifestations participated in the study. Glycemic control was assessed according to the values of glycated hemoglobin (HbA1c) of 7%. Results. The mean age of 105 study participants (46% m ale and 5 4% female) was 6 8.4 ± 10 years, while the mean HbA1c was 8.3 ± 1.6%. Unsatisfactory glycemic control was found in 74.3% of patients with the mean HbA1c at 8.9 ± 1.4%, while satisfactory glycemic control was found in 25.7% of patients, with the mean HbA1c at 6.7 ± 0.2% (p < 0.001). Infections were the most frequent skin diseases (43.9%). Bacterial infections were most common (26.7%), followed by fungal infections (24.8%), xerosis (17.1%), psoriasis (15.2%), fibroma molle (14.3%), diabetic ulcer (7.7%), prurigo (6.7%), and stasis dermatitis (5.7%). Other skin manifestations were found at a lower rate. A significant association was found between unsatisfactory glycemic control and skin infections (p = 0.009). Conclusion. The most common skin manifestations in patients with type 2 diabetes are infections. They occurred more often in patients with unsatisfactory glycemic control.

We retrospectively analyzed the clinical and laboratory data of patients diagnosed with anti-transcriptional intermediary factor 1 (TIF-1γ) antibody-positive polymyositis (PM)/dermatomyositis (DM) to clarify the characteristics of this disease. We identified 14 patients with TIF-1γ antibody-positive DM (TIF-1γ DM), 47 with anti-aminoacyl-tRNA synthetase antibody (ARS)-positive PM/DM, and 24 with anti-melanoma differentiation-associated gene 5 antibody (MDA-5)-positive PM/DM treated at the Kurume University Hospital between 2002 and 2020. Patients with TIF-1γ DM were significantly older than the other two groups. Nine patients with TIF-1γ DM were female, thirteen patients had DM, and one had clinically amyopathic DM. Primary malignant lesions were lung (3), uterus (2), colon (2), breast (2), ovary (1), lymphoma (1), and unknown (2). Cutaneous manifestation and dysphagia were the most common symptoms in TIF-1γ DM. Erythema (9/14), the V-neck sign (8/14), heliotrope (9/14), and nailfold telangiectasia (14/14) were significantly more common in TIF-1γ DM. Furthermore, no patients with TIF-1γ DM had interstitial lung abnormality on high-resolution CT. In patients with TIF-1γ DM, the frequency of dysphagia and unusual erythema, particularly that which spreads from the trunk, and nailfold telangiectasia, were characteristic findings. In most patients with TIF-1γ DM, it is necessary to administer other immunosuppressive drugs along with glucocorticoids. [ABSTRACT FROM AUTHOR]

Objectives Myositis-specific autoantibodies (MSAs) define distinct clinical subsets of idiopathic inflammatory myopathies (IIMs). The anti-nuclear matrix protein 2 (NXP2) antibody, a MSA detected in juvenile/adult IIMs, has been reported to be associated with a high risk of subcutaneous calcinosis, subcutaneous oedema and internal malignancies. The study aimed to clarify the clinical features of anti-NXP2 antibody-positive IIMs in detail. Methods This was a multicentre retrospective observational study on 76 anti-NXP2 antibody-positive patients. The antibody was detected via a serological assay using immunoprecipitation and western blotting. The patients were selected from 162 consecutive Japanese patients with IIMs. Results The cohort of anti-NXP2 antibody-positive IIMs included 29 juvenile patients and 47 adult patients. Twenty-seven (35.5%) patients presented with polymyositis phenotype without dermatomyositis-specific skin manifestations (heliotrope rash or Gottron sign/papules); this was more common in the adults than children (48.9% vs 15.8%, P  < 0.01). Nine (11.8%) patients had subcutaneous calcinosis, and 20 (26.3%) patients had subcutaneous oedema. In addition, the proportion of patients with muscle weakness extending to the distal limbs was high (36 patients [47.4%]) in this cohort. Adult patients had a higher prevalence of malignancy than the general population (age-standardized incidence ratio of malignancies: 22.4). Conclusion Anti-NXP2 antibody-positive IIMs, which include dermatomyositis sine dermatitis, are characterized by atypical skin manifestations and extensive muscular involvement. [ABSTRACT FROM AUTHOR]

Behçet's disease (BD), a chronic multi‐systemic disorder, presents diverse clinical manifestations depending on patient ethnicity and geographic region. Use of varying diagnostic criteria augments clinical heterogeneity. We aimed to characterize heterogenous manifestations in patients with full‐blown BD fulfilling the major diagnostic criteria in use. We retrospectively analyzed 338 patients diagnosed with complete BD based on Japanese diagnostic criteria, which fulfill both International Study Group (ISG) criteria and the International Criteria for BD (ICBD). Unbiased clustering analysis was performed to elucidate the heterogeneous spectrum, followed by subgroup analysis of identified clusters. Results of unbiased clustering analysis identify dominant skin lesion type as an important factor that determines clustering among the heterogenous BD patients. Regression analysis reveals that presence of predominantly papulopustular lesions has protective effect for vascular involvement compared to other skin phenotypes. In conclusion, unbiased clustering analysis highlights that dermatologic manifestation can be a factor to understand the heterogeneity of BD and determining the dominant type of skin lesions may help clinicians predict major vascular involvement. [ABSTRACT FROM AUTHOR]

The review is devoted to the skin manifestations of new coronovirus infection (SARS-CoV-2), information about which is constantly updated. However, this information has not been systematized yet. The purpose of this review is to analyze the dermatological manifestations of a new coronavirus infection. On average, 12.520.4% of patients with confirmed COVID-19 have developed skin manifestations. The question of whether the skin symptoms are a secondary consequence of a respiratory infection or a primary infection of the skin itself remains open at the moment. The possible mechanisms of development of skin lesions and the role of diseases of complement system and blood hypercoagulation in the pathogenesis of the disease are discussed in the article. The review also provides descriptive and clinical examples of skin manifestations in COVID-19. Since COVID-19 tends to be asymptomatic within 14 days, skin manifestations can be an indicator of infection, which leads to the timely diagnosis. In addition, doctors' awareness about skin symptoms associated with COVID-19 infection plays a big role in preventing misdiagnosis of the disease. The authors cite their own clinical сase of a patient with COVID-19 and associated skin angiitis.

Introduction: Patients with chikungunya virus infection commonly present with fever, skin rash, and severe joint pain. The vesiculobullous rash is rare in adults but common in infants. In addition, septic shock and acute respiratory distress syndrome are rare complications of atypical and severe acute chikungunya infection. Case presentation: We report the presence of an 18-year-old Thai female, at 31 weeks gestation, with fever, maculopapular rash, and polyarthritis. The rash later progressed to a vesiculobullous pattern, and she developed septic shock and acute respiratory distress syndrome. Skin biopsy and blood were positive for chikungunya virus RNA. The patient was intubated with a mechanical ventilator and subsequently fully recovered. Conclusion: Atypical skin manifestation and severe acute disease is likely due to immune response attenuation in pregnancy. The possibility of progression to severe or atypical disease in pregnant women suffering chikungunya should always be considered. [ABSTRACT FROM AUTHOR]

Copyright of Der Hautarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

As a respiratory viral infection caused by a novel coronavirus, COVID‐19 became rapidly pandemic within a few months. Despite the wide range of manifestations and organ involvement in COVID‐19 patients, the exact pathogenesis of severe and fatal types of COVID‐19 and causes involved with the individual base of the disease is not yet understood. Several studies have reported clinical, laboratory, and histopathological data in favor of vascular injury in multiple organs of critically ill patients with COVID‐19 as a result of hyperactive immune response, inflammation, and cytokine storm. Also, both clinical and histopathological evidence points to such vascular involvements in the skin. Given the ease of clinical examinations and skin biopsy and the lower risks of transmission of COVID‐19 to healthcare workers, the present review article was conducted to investigate the vascular skin manifestations of COVID‐19 patients clinically and/or histopathologically as helpful clues for better understanding the pathogenesis and predicting the prognosis of the disease, especially in severe cases. [ABSTRACT FROM AUTHOR]

Background: The outbreak of coronavirus disease 2019 (COVID-19) has become a global crisis, as the World Health Organization (WHO) declared COVID-19 as a global pandemic. Complete heart block, resulting from an abnormal heart rhythm, is a rare presentation of this infection, which can be life-threatening due to possible progression into ventricular tachycardia. Case Presentation: We report a critical case of COVID-19 in a young woman without any medical history. She was admitted to the hospital with a rare, but serious presentation of temporary complete heart block with a skin rash after three weeks of treatment with an antiviral agent and hydroxychloroquine. The result of cardiac monitoring, using a Holter monitor, was normal, and her sinus rhythm returned to normal without any interventions. Conclusion: This case emphasized the importance of regular follow-ups for patients with COVID-19 and highlighted the need for attention to unusual presentations, such as brief episodes of unconsciousness and chest pain.

Infection with the new coronavirus SARS-CoV-2, responsible for COVID-19 disease, may occur differently from person to person. The main symptoms of SARS-CoV-2 virus infection are dry cough, dyspnea, fever and fatigue. In addition, other symptoms that occur less frequently in COVID-19 disease have been described, such as: headache, diarrhea, muscle aches, conjunctivitis and skin manifestations. The cutaneous manifestations appeared in this disease are mainly represented by the morbiliform rash, urticaria, COVID fingers and less often vesicular eruptions and livedo reticularis. These skin lesions are also found in other diseases and can cause problems of differential diagnosis, especially in the case of adverse drug reactions.

Rheumatoid Neutrophilic Dermatitis (RND) is rare type of skin manifestation in Rheumatoid Arthritis (RA) patients usually seen in long standing seropositive RA. It has very rarely been reported in seronegative RA patients. Here, a case of a young 24-year-old male with clinical features including skin rash over the body, non tender macular lesions on palms, forearms, legs, trunk and pain in joints has been reported. Clinical examination, skin biopsy, raised inflammatory markers and other investigations were suggestive of seronegative RA with neutrophilic dermatitis. The patient was successfully managed with steroids and conventional disease modifying drugs like hydroxychloroquine and methotrexate at three months follow-up period. Thus, RND may involve complications with progressive joint involvement in patients with seronegative RA.

Kaposiform hemangioendothelioma (KHE) is a very rare, locally aggressive vascular neoplasm. It occurs mostly in children and is rarely observed in adults. It typically originates on the skin, later affecting the deep soft tissue of the extremities, head or neck, and retroperitoneum by infiltrative growth. It is locally aggressive, does not regress spontaneously, and tends to metastasize locally as well as to the regional lymph nodes. In this article, we report a case of adult-onset KHE with neurofibromatosis type 1. The patient presented to our department with a 2-month history of a painful ulceration in her left popliteal area. Since KHE had not previously been reported in patients with neurofibromatosis, the diagnosis was difficult due to the similarity of the skin manifestation to neurofibromatosis-associated lesions. We share our experience of diagnosing and treating this rare case of adult-onset KHE.

Rosacea with severe neurological symptoms such as burning and stinging is often not treated effectively by conventional therapies. The aim of this study was to investigate the clinical characteristics of Korean rosacea patients with prominent neurological symptoms. The demographic features, medical history, clinical manifestations and treatment modalities of 17 neurogenic rosacea patients who had prominent neurological symptoms and 106 erythematotelangiectatic rosacea (ETR) patients as a control group were investigated. All 17 neurogenic rosacea patients had severe persistent erythema with burning/stinging sensation limited to both cheeks. Among these patients, 94.1% were female (16/17). Heat stimuli (58.8%, 10/17) and stress (52.9%, 9/17) were major aggravating factors. Fourteen of 17 patients (82.3%) improved after receiving anticonvulsants and antidepressants. In conclusion, rosacea patients with severe neurological symptoms show distinct clinical manifestations and should be classified separately, and a different therapeutic approach is necessary for them. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID‐19) emerged in Thailand in January 2020. Thailand was the first to report a confirmed case outside China. Cutaneous eruption in COVID‐19 has been reported since the disease became pandemic but limited in tropical countries such as Thailand. The aim of this study was to observe the incidence, characteristics and relation of cutaneous eruption with COVID‐19 at Bamrasnaradura Infectious Diseases Institute, a referral center of emerging infectious diseases in Thailand. An observational descriptive study observed the incidence and characteristics of cutaneous eruption in 204 COVID‐19‐infected patients at Bamrasnaradura Infectious Diseases Institute. We report five patients, who represented six incidences of skin eruption with four characteristics: maculopapular rash (50%), acute generalized exanthematous pustulosis (16.67%), Stevens–Johnson syndrome (16.67%) and urticarial vasculitis (16.67%). Incidences of cutaneous eruption in COVID‐19 at Bamrasnaradura Infectious Diseases Institute were low. Most of the incidents were associated with medication used to treat COVID‐19 infection, so drug allergy cannot be excluded as a cause of the rashes. Therefore, drug allergy should always be ruled out, and skin manifestation in COVID‐19‐infected patients should be further observed. [ABSTRACT FROM AUTHOR]

COVID‐19 had a great impact on medical approaches among dermatologist. This systematic review focuses on all skin problems related to COVID‐19, including primary and secondary COVID‐related cutaneous presentations and the experts recommendations about dermatological managements especially immunomodulators usage issues. Search was performed on PubMed, Scopus, Embase and ScienceDirect. Other additional resources were searched included Cochrane, WHO, Medscape and coronavirus dermatology resource of Nottingham university. The search completed on May 3, 2020. Three hundred seventy‐seven articles assigned to the inclusion and exclusion groups. Eighty‐nine articles entered the review. Primary mucocutaneous and appendageal presentations could be the initial or evolving signs of COVID‐19. It could be manifest most commonly as a maculopapular exanthamatous or morbiliform eruption, generalized urticaria or pseudo chilblains recognized as "COVID toes" (pernio‐like acral lesions or vasculopathic rashes). During pandemic, Non‐infected non‐at risk patients with immune‐medicated dermatologic disorders under treatment with immunosuppressive immunomodulators do not need to alter their regimen or discontinue their therapies. At‐risk o suspected patients may need dose reduction, interval increase or temporary drug discontinuation (at least 2 weeks). Patients with an active COVID‐19 infection should hold the biologic or non‐biologic immunosuppressives until the complete recovery occur (at least 4 weeks). [ABSTRACT FROM AUTHOR]

Objectives Manual systematic literature reviews are becoming increasingly challenging due to the sharp rise in publications. The primary objective of this literature review was to compare manual and computer software using artificial intelligence retrieval of publications on the cutaneous manifestations of primary SS, but we also evaluated the prevalence of cutaneous manifestations in primary SS. Methods We compared manual searching and searching with the in-house computer software BIbliography BOT (BIBOT) designed for article retrieval and analysis. Both methods were used for a systematic literature review on a complex topic, i.e. the cutaneous manifestations of primary SS. Reproducibility was estimated by computing Cohen's κ coefficients and was interpreted as follows: slight, 0–0.20; fair, 0.21–0.40; moderate, 0.41–0.60; substantial, 0.61–0.80; and almost perfect, 0.81–1. Results The manual search retrieved 855 articles and BIBOT 1042 articles. In all, 202 articles were then selected by applying exclusion criteria. Among them, 155 were retrieved by both methods, 33 by manual search only, and 14 by BIBOT only. Reliability (κ = 0.84) was almost perfect. Further selection was performed by reading the 202 articles. Cohort sizes and the nature and prevalence of cutaneous manifestations varied across publications. In all, we found 52 cutaneous manifestations reported in primary SS patients. The most described ones were cutaneous vasculitis (561 patients), xerosis (651 patients) and annular erythema (215 patients). Conclusion Among the final selection of 202 articles, 155/202 (77%) were found by the two methods but BIBOT was faster and automatically classified the articles in a chart. Combining the two methods retrieved the largest number of publications. [ABSTRACT FROM AUTHOR]

Keywords: COVID-19; cutaneous vasculitis; inclusion bodies; skin manifestation EN COVID-19 cutaneous vasculitis inclusion bodies skin manifestation 27 29 3 12/29/21 20220101 NES 220101 ACKNOWLEDGEMENTS The patient presented in this manuscript gave written informed consent to the publication. Leukocytoclastic vasculitis secondary to COVID-19 infection presenting with inclusion bodies: A histopathological correlation Various skin manifestations, such as petechiae, livedoid patch, and pseudo-chilblains, associated with vasculopathy have been reported.1-3 Herein, we present a case of leukocytoclastic vasculitis (LCV) in a patient diagnosed with COVID-19 infection. [Extracted from the article]

COVID-19 was announced pandemic by March 2020. Due to the high prevalence of the disease and its staggering spread, it is very important to identify various manifestations of this viral infection. The aim of this study is to review published articles about cutaneous involvement of COVID-19 disease. Cutaneous manifestations are rare in COVID-19 disease and it is essential to recognize these possible skin manifestations in order to detect and treat COVID-19 disease and to prevent further transmission. [ABSTRACT FROM AUTHOR]

Objective: Sjogren's syndrome (SS) is a chronic autoimmune disease characterized by dryness of mucous membranes. The most commonly affected glands are salivary and tear glands, but disease may affect all exocrine structures in the body. In this study, we aimed to determine the incidence of skin and mucosal findings in SS patients in our country. Material and Methods: Sixty one patients with primary SS diagnosed with SS American/European diagnostic criteria were included in the study. Age, sex, duration of disease, drugs used, serological tests, subjective symptoms and extraglandular findings were recorded. Complete dermatological examination was performed in addition to the history of complaints from all patients regarding skin diseases. If necessary, microscopic and pathological examinations were performed. Results: Of the 61 patients with SS, 95.1% were female and 4.9% were male. The ages of the patients were between 26-70 (mean 51.81). The duration of the disease ranged from 3-244 months (mean 53.66 months). While 83.6% of the patients had xerophthalmia, 93.4% had xerostomy. 95% of the patients had at least one skin or mucosal sign. The highest rate was xerosis cutis with 83.6%. The other common findings were pruritus (50.8%), genital pruritus and malar erythema (27.8%) and angular cheilitis (26.2%). Conclusion: It is important to know the incidence of skin findings in SS patients in our country in terms of taking precautions for preventable diseases and arranging their treatments when necessary. Detection of high skin findings suggests that the follow-up of SS patients should be performed by the dermatologists as well as romatologists. [ABSTRACT FROM AUTHOR]

In recent years, dermatologic manifestations in oncohematologic patients have become more common. The aim of our study was to determine the incidence and heterogeneity of skin manifestations in patients followed at our Hematology Department. This observational monocentrical study was conducted on 60 patients. We divided the observed conditions in exanthematous, purpuric, vesicular-bullous, papulonodular, urticarial, and eczematous manifestations. Moreover, all lesions were classified according to pathogenesis, in (a) specific skin manifestations, caused by neoplastic skin infiltration; (b) immune-mediated manifestations, based on immunological mechanisms; and (c) skin lesions due to immunodeficiency. Altogether, 73 clinical manifestations were reported. Specific manifestations (a) were detected in 15.1% of the cases, mainly with papulonodular appearance. Immune-mediated manifestations (b) were found in 37 cases (50.7%), particularly with eczematous or exanthematous appearance, and leukemia was the malignancy most frequently reported in these patients. Eventually, lesions due to immunosuppression (c) were reported in 34.2% of the cases. They were represented by infections and cutaneous malignancies, and usually manifested with papulonodular lesions. Skin lesions in oncohematologic patients are a common event. A multidisciplinary approach based on the collaboration between the hematologist and the dermatologist is crucial to achieve a proper diagnosis, and correctly manage these manifestations. [ABSTRACT FROM AUTHOR]

Primary immunodeficiency diseases (PIDs) are characterized by an increased risk of infections, autoimmunity, autoinflammation, malignancy, and allergic disorders. Skin disorders are also common clinical features in PIDs and may be among the presenting manifestations. Recognition of specific PID‐associated skin conditions in combination with other clinical features as described in the currently used warning signs could raise suspicion of an underlying PID. We aimed to provide a systematically obtained overview of skin disorders and their prevalence in PIDs. Secondary, the prevalence of Staphylococcus (S.) aureus–associated skin disorders and atopy was reviewed, as these are the most prominent skin features in PIDs. A systematic search was performed in EMBASE, MEDLINE, Web of Science, Cochrane, and Google Scholar (up to May 9, 2018). All original observational and experimental human studies that address the presence of skin disorders in PIDs were selected. We rated study quality using the Institute of Health Economics Quality Appraisal Checklist for Case Series Studies. Sixty‐seven articles (5030 patients) were included. Study quality ranged from 18.2% to 88.5%. A broad spectrum of skin disorders was reported in 30 PIDs, mostly in single studies with a low number of included patients. An overview of associated PIDs per skin disorder was generated. Data on S. aureus‐associated skin disorders and atopy in PIDs were limited. In conclusion, skin disorders are prominent features in PIDs. Through clustering of PIDs per skin disorder, we provide a support tool to use in clinical practice that should raise awareness of PIDs based on presenting skin manifestations. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 infection has spread all over the world in the last year, causing millions of COVID-19 cases among humans with a large variability of symptoms and signs, including those on the skin. Among these, a contemporary cluster of chilblain-like lesions with no certain relationship with the infection has been reported. The aim of this paper is to delineate a profile of chilblain-like lesions and to establish the state-of-the-art knowledge about this new phenomenon.

A case study of a 49-year-old Japanese male with COVID-19 who developed EAC after receiving remdesivir intravenously, and his skin lesion resolved with topical steroids and oral antihistamine after discontinuation of the drug, and underlying immunopathogenic similarity between COVID-19 infection.

Background: A substantial number of research studies on metronidazole-related cutaneous symptoms have recently been published. Our objective was to identify and evaluate descriptive studies that described metronidazole-related skin manifestations, therapeutic interventions, and consequences., Methods: A comprehensive literature search was carried out in the PubMed, Scopus, and grey literature databases from inception to April 2022 without any constraints, as well as a snowball search in Google and a search in Google Scholar. Descriptive articles describing metronidazole-related cutaneous manifestations were considered for the review. Two distinct reviewers carried out the research selection, data extraction, and quality assessment; any discrepancies were resolved by consensus with the third reviewer., Results: About 24 out of 4648 descriptive studies, including 26 patients (20 Female patients and 6 male patients), were included in this review. The included studies comprised a range of ages from 16 to 78 years old. Metronidazole was indicated for the treatment of bacterial vaginosis, trichomoniasis, sepsis, anti-infection therapy, perforated appendicitis, rosacea, vaginal discharge, dysentery, acne rosacea, trichomonal vaginitis, lichen planus, liver abscess, facial rosacea, intestinal amoebiasis, and gingivitis. Fixed drug eruption was the most common skin manifestation which was reported in 7 cases included in this review. Cutaneous manifestations were ameliorated by cessation of the offending drug and by apportioning antihistamines, topical steroids, parenteral corticosteroids, emollients, and topical moisturizers., Conclusion: Clinicians and healthcare professionals should be cognizant of the potential cutaneous adverse drug reactions (CADRs) induced by metronidazole to mitigate fatal circumstances. The management of the CADRs appears to respond effectively with immediate drug discontinuation and supportive therapy., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: The outbreak of coronavirus disease 2019 (COVID-19) has become a global crisis, as the World Health Organization (WHO) declared COVID-19 as a global pandemic. Complete heart block, resulting from an abnormal heart rhythm, is a rare presentation of this infection, which can be life-threatening due to possible progression into ventricular tachycardia. Case Presentation: We report a critical case of COVID-19 in a young woman without any medical history. She was admitted to the hospital with a rare, but serious presentation of temporary complete heart block with a skin rash after three weeks of treatment with an antiviral agent and hydroxychloroquine. The result of cardiac monitoring, using a Holter monitor, was normal, and her sinus rhythm returned to normal without any interventions. Conclusion: This case emphasized the importance of regular follow-ups for patients with COVID-19 and highlighted the need for attention to unusual presentations, such as brief episodes of unconsciousness and chest pain. [ABSTRACT FROM AUTHOR]