ABSTRACT
Leukocytoclastic vasculitis, also known as cutaneous small vessel vasculitis, embodies a challenging condition for both the physician and the patient. This condition is affecting mainly the small vessels, commonly the post-capillary venules, being characterized by presence of neutrophilic infiltration within and throughout the vessel wall with signs of leukocytoclasia, fibrinoid necrosis and local damage to the vessel wall and the surrounding tissue. Frequently, it is associated with other conditions (cryoglobulinemic vasculitis, IgA vasculitis, ANCA-associated vasculitides), infections, medication, systemic diseases (systemic lupus erythematosus, Sjogren syndrome, rheumatoid arthritis). Cutaneous leukocytoclastic vasculitis is considered a rare condition. We are presenting a 46 year old man, with history of chronic urticaria, presented in our clinic for recurrent intensely pruritic urticarian plaques, disseminated on limbs and trunk, associating bullae with serocitrin content. Petechiae and palpable purpura were observed just in a few places. Bullous lesions occurred after the patient went through COVID-19 and followed a self-treatment with paracetamol. Patch and prick tests were performed on this patient, identifying positive reactions to hydroxyisohexyl-3-cyclohexane-carboxaldehyde, fragrance mix and paracetamol. Histopathological exam evidentiated tipically aspect for leukocytoclastic vasculitis and subepidermal vesicle-bullae lesion. IgM/IgG immune complexes, C3 and fibrinogen were found positive in direct immunofluorescence exam. Through this scientific paper, we are presenting the crucial role of direct immunofluorescence exam in early diagnosis and evolution of this condition, efficacy of oral therapy with dapsone (anti-inflammatory properties, antioxidant scavenger effect, inhibitory effect on chemotaxis and function of neutrophils). Copyright © 2022
ABSTRACT
During COVID-19 era, a special attention was considered for autoimmune disorders (AD), including at thyroid, which are regarded at higher risk knowing that stress and infections might aggravate the pattern of anti-thyroid antibodies as well as thyroid dysfunction. In this study, we aim to analyse how COVID-19 infection influenced the evolution of HT parameters versus patients with HT who did not go through infection. Study design: an observational, bi-centric study in Romania during first 14 months of pandemic. By the end of April 2022, Romania registered 1,047,520 total cases of COVID19 infection (a morbidity rate calculated for entire Romanian population of 5.23%) with 27,267 total deaths (a lethality rate of 2.6%) and around 2000 new patients a day. From our database of 2210 HT patients, a number of 386 HT subjects were assessed (14 months). Among them, 33/386 patients had a different form of COVID-19 infection. The prevalence of COVID19 infection among HT patients was 9.35% which is statistically significant higher when compare with official ratio for entire Romanian population (a morbidity rate of 5.23%, z = 3.162, p = 0.00033). A feminine prevalence was identified (89.37%, N=31/33), while age was not different between subgroups (average age over 50 y). At the moment of diagnostic, thyroid function was similar between the two subgroups (?2=2.02,p=0.35). we checked ATPOs levels at every visits. Mean ATPO levels at the diagnostic time was 650 UI/mL in group 1 versus 840 UI/mL in group 2 (both groups had very high ATPO values, normal cut-offs below 34 UI/mL) with not statistical significance difference - student ttest (t?),p=0.16.Group 1: the pattern of ATPO evolution was undulatory in 74.07% of patients, decreasing - 3.7%, increasing - 11.11%, unmodified (stationary) 11.11%, similarly with group 2, meaning that ATPOs had the same profile, regardless the fact that some subjects went through COVID-19 infection. The rate of associated AD was 28.24% (N=2210), COVID-group of 42.42%, non-COVID group of 38.53% (z = 0.44, p = 0.66). In our COVID cohort of 33 patients with HT, we registered the following clinical stages of coronavirus infection: 4/33 patients who were asymptomatic;all women, average age: 65.65 years;2/33 patients with lack of smell and taste;women, over 65 years old;14/33 patients with mild form;from 31 years old to 70.5 years old (only one man);10 patients with a moderate form;all women, from 34 to 71 years old;one 87-year- old male with a severe form;one 50-year old female with a very severe form in addition to a hematologic disease and a history of severe allergic reactions;and a single patient (a 68-year-old, obese female with a severe allergic background) died of COVID-19 infection (thus generating a lethality rate of 3.03%). Conclusion. Our study showed a higher prevalence of COVID-19 infection among HT patients. These individuals do not associate increased levels of ATPO or a elevated prevalence of AD when compare with nonCOVID - HT group, and have similar age and sex ratio. Whether HT exposes the subjects to coronavirus infection is an open issue.
ABSTRACT
SARS-CoV-2, the coronavirus responsible for the ongoing pandemic, seems to have a vast spectrum of consequences, affecting almost all systems and organs. The clinical presentation may vary from asymptomatic to severe disease, both in non-pregnant and pregnant positive patients. Respiratory and cardiovascular effects are vehiculated and studied for a while now and the scientific community also started to wonder how procreation is affected by SARS-CoV-2 infection and the pandemic context. Although more research is needed, it has become apparent that the effects on reproduction are not to be neglected, whether we talk about fertility, pregnancy outcome or demographic trends.
ABSTRACT
Diagnosis, tratament and follow-up of patients with melanoma during COVID-19 pandemic is quite challenging. These patients are often immunocompromised, but, on the other hand, management of this malignant skin cancer should not be delayed. It is necessary to diagnose and stage the melanoma as soon as possible, in an attempt to provide a better prognosis. There are few data regarding the treatament of melanoma during COVID-19 pandemia. However, the general recommandations suggest testing all cancer patients prior administration of the therapy. The European Society for Medical Oncology (ESMO) provided guidelines regarding therapy of this skin cancer during COVID-19 pandemic. Every patient is different, and it is always important to evaluate the risks and benefits. © 2020 Universidade do Porto - Faculdade de Engenharia. All rights reserved.