ABSTRACT
Shingles is a viral skin disease caused by the Varicella Zoster virus. We report varicella zoster virus reactivation in three long-time athletes after vaccination with a COVID-19 mRNA vaccine. The three athletes had no evidence of immunosuppressive conditions or other illnesses, and all three did not suffer from COVID-19. The first patient is a 21-year-old athlete with an 8-year sports career. He developed shingles four days after being vaccinated against COVID-19. The second athlete is 20 years old and has been actively involved in fitness for ten years. He was diagnosed with herpes zoster three days after the vaccination. The third athlete is 23 years old and has been actively involved in sports and fitness since the age of 6;he was diagnosed 4 days after the vaccination against COVID-19. All three were diagnosed by a dermatologist. Discussion: The relationship between the development of herpes zoster after the administration of a vaccine against COVID-19 has been the subject of many studies worldwide, but the occurrence of herpes zoster after Covid-19 vaccination in athletes is described for the first time. Our team did not find a report of a case of an athlete with herpes zoster after vaccination for COVID-19 anywhere, which motivated us to describe the above three cases.
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The aim of this manuscript is to investigate skin diseases associated with COVID-19 under three main headings: skin problems related to personal protective equipment and personal hygiene measures, skin findings observed in SARS-CoV-2 virus infections, and skin findings due to COVID-19 treatment agents. In PubMed and Google Scholar databases, publications on skin lesions related to personal protective equipment and personal hygiene measures, skin findings observed in SARS-CoV-2 virus infections and skin findings due to COVID-19 treatment agents subjects were searched in detail. Pressure injury, contact dermatitis, pruritus, pressure urticaria, exacerbation of preexisting skin diseases, and new skin lesion occurrence/new skin disease occurrence may be due to personal protective equipment. The incidence of skin lesions due to COVID-19 was reported to be between 0.2% and 29%. Many skin lesions including maculopapular, urticarial, vesicular, chilblain-like, thrombotic/ischemic, etc., are observed in COVID-19 patients. Some authors have stated that there is an absence of SARS-CoV-2 virus infection-specific skin rashes. Many skin lesions may appear as a result of COVID-19. Even in the absence of a COVID-19 diagnosis, skin findings should be evaluated carefully in the pandemic period.
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Teledermatology is one of the most important developments of digitalisation in dermatology. It has helped to ensure continuity of care during the COVID-19 pandemic. The combination of teledermatology with artificial intelligence can significantly improve medical decision-making. Among imaging modalities, dermoscopy is the most widely used, and its effectiveness can be significantly enhanced when combined with artificial intelligence. Novel techniques that have emerged in recent years include high-frequency ultrasound, optical coherence tomography or multispectral imaging. These are currently used in dermatological research but are expected to gradually become part of daily patient care. The knowledge of digital technologies and new imaging techniques is essential for the modern dermatologist. In the future, it is expected to be an essential part of modern and optimised patient care.
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Since the outbreak of the novel coronavirus in 2019, with the relentless efforts of the country in the early stage to the "10 new measures" now, the prevention and control has been gradually released from strict regulations. The number of COVID-19 infections increased, and wide attention has been attracted by the primary skin diseases, deterioration of pre-existing skin diseases, and other skin damage that resulted from self-protection and treatment. Considering the series of skin problems caused by COVID-19 infection and prevention measures, we mainly summarize the common skin damage after the"10 new measures" and propose a strategy to guide the treatment in this article.
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Studies for vaccine development have been completed in an unprecedented time to prevent further outbreak of the dangerous and potentially fatal coronavirus disease-2019 (COVID-19) caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Some of these vaccines have been approved by various authorities and made available worldwide. While vaccine applications continue globally, the number of dermatological side effects reported after vaccination is increasing daily. Many cutaneous reactions have been reported in the literature, such as injection site reactions, pernio lesions, pityriasis rosacea, herpes zoster, and exacerbations of chronic inflammatory dermatoses such as atopic dermatitis and psoriasis. Most COVID-19 vaccines require two doses and a booster dose, and considering the new variants of the coronavirus, vaccination is estimated to continue for a while. In this context, dermatologists are more likely to encounter vaccine-related dermatological side effects in their daily practice. Dermatologists play an essential role in many issues such as diagnosis and treatment of cutaneous reactions after COVID-19 vaccination, informing patients and providing necessary counseling. This perspective will also provide helpful information for the future in terms of vaccination strategies to be developed for repeated doses. In this study, most of the cutaneous reactions reported after COVID-19 vaccination in the current literature are reviewed.
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Pemphigus vulgaris (PV) is a rare disease that affects the skin and mucous membranes, causing blistering and erosions. Identifying and effectively managing atypical presentations of pemphigus vulgaris can be challenging due to its rarity. We describe a 32-year-old male patient with a medical history including prediabetes, moderate asthma, hyperlipidemia, coccidioidomycosis, and respiratory infections. He was evaluated via telehealth in the allergy and immunology clinic for uncontrolled asthma. Initially, he complained of a whitish film in the mouth while on treatment with fluticasone and salmeterol. He also noted new vesicular lesions on his scalp and body. When evaluated later in the clinic, he was found to have oral and periungual erosions as well as paronychia. After promptly referring to dermatology, histopathological examination and direct immunofluorescence testing were performed on the patient's lesions, revealing changes consistent with PV. Treatment with prednisone and rituximab resulted in the complete resolution of the patient's bullae and nail deformities over several months. This case highlights the importance of a thorough evaluation of complex medical histories and diagnostic testing in managing asthma and allergy symptoms. It also emphasizes the need for a multidisciplinary approach involving specialists such as immunologists, dermatologists, and infectious disease experts in the diagnosis and management of complex cases.
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BACKGROUND: An ectoparasitic disease, scabies, caused by the mite Sarcoptes scabiei var hominis. Some of the predisposing factors are overcrowding, unhygienic surroundings, immunocompromised status, dementia, homelessness, and sexual contact. In this study, we wanted to evaluate the changed distribution of lesions of scabies during pandemic. METHODS: A cross sectional study was performed on 600 patients attending the skin department of our tertiary care hospital over a period of 6 months. The sites of the scabies lesions were noted along with types of lesions. Demographic data and history of regular hand washing and sanitization were also documented. RESULTS: Our study revealed an important correlation between change in pattern of distribution of scabies lesions from being less frequent on finger webs (19%) to being more frequent on abdomen (periumbilical area) (73%) and groins (67%) due to regular hand washing and frequent sanitization, in this pandemic era. CONCLUSIONS: A significant change in distribution of skin lesions in scabies can be noticed during this COVID-19 pandemic.
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Background and Aim: Leishmaniasis is a parasitic disease transmitted by sandflies and is one of the endemic diseases of Iran. With the spread of the Covid-19 epidemic worldwide, the virus will interface with endemic infectious diseases in different regions. In this study, coronavirus disease was evaluated in patients with a history of leishmaniasis referred to the Center of Research and Training in Skin Diseases and Leprosy. Methods: A total of 91 patients with a history of leishmaniasis were studied for possible SARS-CoV-2 infection. The number of patients referred to the Center of Research and Training in Skin Diseases and Leprosy during the coronavirus epidemic was also compared with the same period before the epidemic Results: A total of 60% of patients with leishmaniasis did not report coronavirus disease. Twenty-one percent of cases had a mild corona disease, 13% had a moderate and 3% had severe corona disease. Only a single death was reported in corona patients with a history of cutaneous leishmaniasis. The number of referrals before the beginning of the corona epidemic was twice as high as during the epidemic. Conclusion: In these participants, mortality and side effects of COVID-19 were significantly less reported. However, further studies are needed to evaluate the immune system and cutaneous leishmaniasis protection against COVID-19. Various factors can be effective in reducing patients during the epidemic, including not going to medical centers, reducing the number of trips, and observance of health issues.
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Pool toes, a sport-related dermatosis, are caused by mechanical friction and water exposure, resulting in a special variant of irritant contact dermatitis. It is common in children, often misdiagnosed, and rarely reported. Here we report a case of a 7-year-old girl who developed this unusual type of frictional dermatitis;a pool toes diagnosis has been made. With topical corticosteroids, favorable results have been achieved. The recovery and healing process will be facilitated if one is aware of the underlying causes of such dermatitis and ceases the triggering factors.
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Viral infections, including SARS-CoV-2, the virus that causes COVID-19 infection, have been implicated in the development of pustular dermatoses, including generalized pustular psoriasis (GPP) and acute generalized exanthematous pustulosis (AGEP). We performed a literature review of existing cases of GPP and AGEP associated with COVID-19 infection and/or treatment reported over a period of 12 months. We summarize the clinical characteristics of these cases and report an additional six new cases of GPP and AGEP. Seven patients with COVID-19 infection were diagnosed with new-onset or exacerbated GPP, and 33 patients were diagnosed with AGEP. In 55% of the cases, no concomitant potential culprit drug trigger was identified. We present this review of cases of COVID-associated acute pustular dermatoses to further contribute to the spectrum of cutaneous eruption associated with SARS-CoV-2 infection.
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In the Chinese city of Wuhan at the end of 2019, an infection by an unknown virus began, which with subsequent studies was called SARS-CoV-2, causing a pandemic that has generated the largest crisis worldwide in recent years, causing a large number of deaths, with multiple systemic manifestations but which has also had clinical pictures at the skin level;recently there have been reports of people who had COVID-19 infections and later had skin manifestations due to herpes virus as a co-infection;the most frequent were herpes simplex type 1-2, varicella zoster, herpes zoster and herpes virus 6-7, generating even more complications in patients. Although the pathogenesis of this association is not entirely clear, it is believed to be secondary to the state of immunosuppression induced by SARS-CoV-2, being important that health personnel are informed about this entity that increases mortality.
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Dengue infection has always been a major challenge to the public health and in the absence of specific treatment and availability of effective vaccine, this infection has been able to cause repeated outbreaks in different parts of the world for the past many years. This study was planned to analyse the symptoms and complications of dengue positive patients in the backdrop of Covid -19 pandemic. METHODS- A retrospective observational analysis was done on 87 patients presenting to a tertiary care center in northern India by taking into account of their presenting symptoms, haematological parameters and complications. RESULTS- Out of 87 patients 59 (67%) were males and 28 (32%) were females with maximum (36%) belonging to the age group of 18-30 years. 69% patients were from village areas. Fever, headache were the most common symptoms and thrombocytopenia (99%) was the most common haematological complication followed by liver dysfunction (88%). Respiratory symptoms were seen in 18% and skin manifestations were seen in 12% patients. CONCLUSION- Dengue infection continues to be a major cause of morbidity and mortality in many parts of the world. The early recognition of symptoms and signs is imperative to the successful management of disease. With the existence of Covid 19 infection it becomes more important to carefully observe and differentiate between the two viral illnesses as both can have overlapping symptoms.
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Background: Psoriasis is a chronic and inflammatory skin disease. Many triggering factors can cause exacerbation of psoriasis, such as infection, trauma, and drugs. Several vaccines are known to cause new lesions or exacerbation of psoriasis, including Bacillus Calmette-Guerin (BCG), influenza, tetanus-diphtheria, and pneumococcal polysaccharide. In the COVID-19 pandemic, the COVID-19 vaccine is known to cause the appearance of new lesions or exacerbation of psoriasis. Case presentation: A woman, 31 years old, came to the clinic with itchy reddish patches with white scales on her face, chest, stomach, back, arms, and both legs, and increased since 2 weeks ago. Previously, the patient got the first COVID-19 vaccine (Sinovac), and three days later, red patches appeared with white scales on the chest, stomach, and back. The patient had been diagnosed with psoriasis 3 years ago. Dermatology examination showed reddish patches with white scales on the face, chest, stomach, back, arms, and both legs. Auspitz sign and Kaarvetsvlek phenomen were positive. PASI score was 9,2. Dermoscopy examination showed red dot distribution on light pink background and white scales. She was treated with desoximetasone cream 0,05% twice a day and cetirizine tablet 10 mg once a day. After 2 months of therapy, reddish patches were decreased, and the PASI score was 6,9. Conclusion: COVID-19 vaccine can cause exacerbations in psoriasis patients, but this vaccine can still be given to psoriasis patients. It is based on the documented efficacy of the COVID-19 vaccine in the prevention of severe COVID-19 infection and fatality. Psoriasis patients should be consulted before getting vaccinated for COVID-19, and prompt clinical visits should be available if exacerbation develops.
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Background and Design: Systemic retinoids are commonly used medications in dermatology and indicated in various skin disorders such as acne vulgaris and psoriasis. Data about the risk of Coronavirus disease-2019 (COVID-19) in patients using systemic retinoids are limited. Thus, this study aimed to investigate the risk of COVID-19 in patients undergoing systemic retinoid therapy. Materials and Methods: A total of 186 patients who have undergone systemic isotretinoin and acitretin therapy were recruited. Patients who presented to the dermatology clinic for various skin diseases, such as eczema, vitiligo, tinea, etc., who were not on systemic retinoid therapy, and who received topical medications comprised the control group. The development of COVID-19 in the retinoid therapy group and the control group was retrospectively reviewed using hospital database. Results: The mean age of the patients in the retinoid therapy group was 25.72+or-0.67 and that in the control group was 25.4+or-0.62. Moreover,165 patients received isotretinoin, and 21 patients received acitretin treatment. The isotretinoin dosage ranged from 0.5 to 0.8 mg/kg wheras the acitretin dosage ranged between 10 and 25 mg/day. Two patients (1.07%) in the retinoid therapy group and 8 (4.3%) patients in the control group were diagnosed with COVID-19. None of the patients receiving acitretin was diagnosed with COVID-19. COVID-19 diagnosis was established in the 2nd and 3rd months of isotretinoin treatment, and lung involvement was not observed. No significant difference regarding the number of COVID-19 cases and disease severity was found between the two groups (p=0.105;p=0.258, respectively). Conclusion: Isotretinoin and acitretin use was not associated with increased COVID-19 risk or disease severity. Systemic retinoids appear to be a safe treatment modality in the COVID-19 era.
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These proceedings contains 30 articles that covered various topics related to immunology and related fields. The conference papers presented focused on investigating the role of genetics, microbiome, and immunological pathways in disease pathogenesis and treatment. Studies presented at the conference explored the genetic factors associated with obesity in Brazilian children, the role of flavonoids in reprogramming microglia towards a neuroprotective inflammatory profile, the gut microbiome in asthmatic individuals, and the involvement of the MTOR gene and its variants in the severity of COVID-19. Other studies evaluated the immunodiagnostic potential of a protein exclusive to Corynebacterium pseudotuberculosis, genetic markers associated with alcohol dependence and asthma, and the effects of nicotine on glial cells in Parkinson's disease. The conference also presented research on the molecular mechanisms associated with the anti-glioma and immunomodulatory effects of flavonoids, the influence of Trypanosoma cruzi co-infection on the immune response and clinical outcome of patients with cutaneous leishmaniasis, and the association of metalloproteinase gene variants with periodontitis. Furthermore, the papers presented discussed the production of Zika virus singular peptide for the development of serological immunassays, and the role of genetic polymorphisms in the IL1B and IL6 genes in periodontitis. Lastly, the conference included research on the immunological response of broiler chickens fed with diet supplemented with zinc, and the modulatory effects of Agatis flavone on the glial response in an ex vivo model of brain trauma.
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Guidelines on the use of PCR for fungal (ringworm), Parvovirus, Panleukopenia, and Covid-19 detection are discussed. Advantages of using PCR was also presented and emphasized its significance in assessing the context, history, clinical presentation and consequences of action (or inaction), as well as the laboratory result from tested animal patients.
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Human skin is continually exposed to internal and external forces, dynamic as well as static. The skin is normally flexible and can resist mechanical trauma due to friction, pressure, vibration, suction and laceration to a considerable degree. However, an excess of these forces can abnormally affect the structure and function of the skin, setting the stage for the development of a skin disorder. Repetitive trauma can cause lichenification, hyperpigmentation, erythema, scaling, fissuring, blisters, ulceration and chronic alterations. Frictional dermatoses is an under-recognised entity with no clear-cut definition and encompasses a variety of terms such as frictional dermatitis, frictional melanosis, frictional pigmentary dermatoses and certain other named entities, many of which are confusing. The authors propose to define frictional dermatoses as 'a group of disorders caused by repetitive trauma to the skin as a result of friction of varied aetiology which can have a wide range of cutaneous manifestations depending on the type of insult.' The exact prevalence of frictional dermatoses as a separate entity is unknown. Authors who conducted this review include a group of dermatologists and post graduate students from various institutions. Literature was reviewed through PubMed, Medscape, Medline, ResearchGate and Google Scholar using the terms 'frictional dermatitis,' 'friction and skin,' 'dermatoses and culture,' 'clothing dermatitis,' 'friction melanosis,' 'PPE induced dermatoses in COVID-19 era,' etc. A total of 122 articles were reviewed and 100 articles among them were shortlisted and included in the study, after removing duplications. The review was followed up with further deliberation which resulted in the formulation of a new definition and classification of frictional dermatoses taking into account the morphology, histopathological characteristics, anatomical region affected and the major predisposing factors. The rising incidence of mechanical dermatoses in the COVID-19 era was also emphasised.
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The article describes the onset of pemphigus foliaceus against the background of vaccination with the combined vector vaccine "Gam-COVID-Vac" ("Sputnik V"). A feature of this clinical case is the duration of the period from the moment of development of the first symptoms of the disease to clinical and immunohistochemical confirmation of the diagnosis, which, in fact, indicates a low availability of specialized medical care for rare dermatoses. In particular, the waiting period for taking material for histological examination lasted for several months, which, in fact, is not an isolated case. At the same time, against the background of an increase in clinical symptoms, this became an additional factor in the patient's self-referral to a specialized federal state medical institution, where, within two weeks, the diagnosis was confirmed by immunohistochemical analysis methods and inpatient treatment was carried out with a pronounced positive effect. In addition, the analysis of the medical care provided to the patient showed insufficient alertness and the level of training of dermatovenereologists in diagnosing rare dermatoses accompanied by blistering rashes. In particular, the patient initially underwent several courses of antifungal therapy in combination with intravenous infusion of systemic glucocorticosteroids. The article also presents an analysis of the frequency of occurrence of this disease in different countries for more than 100 years. © 2022 Vestnik Dermatologii i Venerologii. All rights reserved.
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The advent of vaccines has drastically reduced the incidence, morbidity, and mortality related to COVID-19, and with the increase in the number of vaccinated subjects, there have been reports of some adverse events, including skin reactions. In this paper, we report a clinical case of Purpura Annularis Telangiectodes of Majocchi following a third-dose administration of the Pfizer-BioNTech COVID-19 vaccine. Almost 30 days after the third dose, the patient presented erythematous annular patches on the lower limbs with purpuric peripheral areas and a central clearing with no other symptoms. A dermoscopic examination showed capillaritis, reddish-brown dot-clods on a coppery-red background caused by leaky capillaries. To date, the causes of Majocchi's disease are not well-defined; in the literature, three vaccination-related cases have been reported: one after a flu vaccination and two after an anti-SARS-CoV-2 one. Dermatologists should be trained to promptly recognize these clinical manifestations after vaccination, which will likely become a common finding in daily clinical practice, especially given the large diffusion of SARS-CoV-2 vaccinations.
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Background and Aim: There have been concerns regarding the potential exacerbation of autoimmune bullous diseases (AIBDs) following vaccination against COVID-19 during the pandemic. In the current study, vaccine safety was evaluated in patients with AIBDs. Methods: In this study, patients with AIBDs were contacted via face-to-face visits or phone calls. Patient demographics, vaccine-related information, pre- and post-vaccine disease status, and complications were recorded. The exacerbation was considered either relapse in the remission/controlled phase of the disease or disease worsening in the active phase. The univariate and multivariate logistic regression tests were employed to determine the potential risk factors of disease exacerbation. Results: Of the patients contacted, 446 (74.3%) reported receiving at least one dose of vaccine injection (54.7% female). Post-vaccine exacerbation occurred in 66 (14.8%) patients. Besides, there were 5 (1.1%) patients with AIBD diagnosis after vaccination. According to the analysis, for every three patients who received vaccines during the active phase of the disease one experienced disease exacerbation. The rate of disease exacerbation increased by three percent with every passing month from the last rituximab infusion. Active disease in the past year was another risk factor with a number needed to harm of 10. Conclusion: Risk of AIBD exacerbation after the COVID-19 vaccine is not high enough to prevent vaccination. This unwanted side effect, can be reduced if the disease is controlled at the time of vaccination.