Cutaneous reactions after SARS-CoV-2 vaccination: a cross-sectional Spanish nationwide study of 405 cases.

BACKGROUND: Cutaneous reactions after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are poorly characterized. OBJECTIVE: To describe and classify cutaneous reactions after SARS-CoV-2 vaccination. METHODS: A nationwide Spanish cross-sectional study was conducted. We included patients with cutaneous reactions within 21 days of any dose of the approved vaccines at the time of the study. After a face-to-face visit with a dermatologist, information on cutaneous reactions was collected via an online professional survey and clinical photographs were sent by email. Investigators searched for consensus on clinical patterns and classification. RESULTS: From 16 February to 15 May 2021, we collected 405 reactions after vaccination with the BNT162b2 (Pfizer-BioNTech; 40·2%), mRNA-1273 (Moderna; 36·3%) and AZD1222 (AstraZeneca; 23·5%) vaccines. Mean patient age was 50·7 years and 80·2% were female. Cutaneous reactions were classified as injection site ('COVID arm', 32·1%), urticaria (14·6%), morbilliform (8·9%), papulovesicular (6·4%), pityriasis rosea-like (4·9%) and purpuric (4%) reactions. Varicella zoster and herpes simplex virus reactivations accounted for 13·8% of reactions. The COVID arm was almost exclusive to women (95·4%). The most reported reactions in each vaccine group were COVID arm (mRNA-1273, Moderna, 61·9%), varicella zoster virus reactivation (BNT162b2, Pfizer-BioNTech, 17·2%) and urticaria (AZD1222, AstraZeneca, 21·1%). Most reactions to the mRNA-1273 (Moderna) vaccine were described in women (90·5%). Eighty reactions (21%) were classified as severe/very severe and 81% required treatment. CONCLUSIONS: Cutaneous reactions after SARS-CoV-2 vaccination are heterogeneous. Most are mild-to-moderate and self-limiting, although severe/very severe reactions are reported. Knowledge of these reactions during mass vaccination may help healthcare professionals and reassure patients.

Arthroderma benhamiae, un dermatofito causante de una tiña emergente / Arthroderma benhamiae, An Emerging Dermatophyte Cause of Tinea

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Microsporum audouinii: un dermatofito causante de una tiña reemergente / Microsporum audouinii: Re-Emergence of Ringworm Due to the Dermatophyte

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Rosettes in actinic keratosis and squamous cell carcinoma: distribution, association to other dermoscopic signs and description of the rosette pattern.

BACKGROUND: Rosettes, a dermoscopic structure characterized by four white points arranged as a 4-leaf clover, supports the dermoscopic diagnosis of actinic keratosis (AK) or squamous cell carcinoma (SCC). OBJECTIVE: The association of rosettes with other dermoscopic structures in AK or SCC and their distribution has not been analysed yet. METHODS: We conducted a prospective study of patients with histologically proven AK or SCC who presented dermoscopic rosettes at initial evaluation. RESULTS: A total of 56 tumours were collected (94.6% AK and 5.4% SCC). Thirty-seven (66.1%) lesions were non-pigmented and 19 (33.9%) pigmented. The most common dermoscopic findings were erythema (53; 94.6%) and scale (42; 75%). White circles were present in 21 lesions (37.5%); pigmented pseudonetwork in 18 (32.1%) and multiple grey to brown dots and globules in 14 (25%). Rosettes were distributed focally in 9 (16.1%) and generalized in 47 (83.9%). The rosette pattern (rosettes as the main structure) was observed only in AK (19; 35.8%). LIMITATIONS: The analysis was not blinded. The distinction between focal distribution (up to 3 rosettes) or generalized could be considered arbitrary. CONCLUSION: The rosette pattern identified in AK may be a specific pattern for AK.

Hospital admission due to respiratory viral infections in moderate preterm, late preterm and term infants during their first year of life

BACKGROUND: Respiratory viral infections are a major cause of hospitalisation in infants <1 year and might cause severe symptoms in preterm infants. Our aim was to analyse admissions due to respiratory infections in moderate, late and term infants, and to identify risk factors for hospitalisation in preterm versus term. METHODS: Prospective study in a cohort of moderate and late preterm, and term infants born between October/2011 and December/2012. Admissions due to respiratory infections during the first year of life were analysed and compared among moderate (32-33), late (34-36) and term infants. Sixteen respiratory viruses were detected by RT-PCR. Clinical data were collected. RESULTS: 30 (20.9%) out of 143 preterm infants required admission for respiratory infection, versus 129 (6.9%) of 1858 term infants born in the same period (p < 0.0001, OR: 3.6 CI 2.0 to 5.0). Hospitalised children had a higher prevalence of hyaline membrane disease (HMD) at birth (p < 0.001, OR: 7.7 CI: 2.121 to 27.954) and needed more mechanical ventilation (p < 0.001, OR: 5.7 CI: 1.813 to 18.396). Virus was identified in 25/30 (83%) preterm babies, and in 110/129 (85%) term infants. The most frequent viruses in preterm infants were RSV (76%) rhinovirus (20%). Clinical and epidemiological characteristics among term and preterm infants were similar. CONCLUSIONS: The risk of respiratory admissions during the first year of life is up to 3.6 times higher in moderate and late preterm. Once admitted, clinical features of respiratory episodes requiring hospitalisation are similar among term and preterm infants. Hyaline membrane disease and mechanical ventilation were also risk factors for respiratory admissions

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Hospital admission due to respiratory viral infections in moderate preterm, late preterm and term infants during their first year of life.

BACKGROUND: Respiratory viral infections are a major cause of hospitalisation in infants <1 year and might cause severe symptoms in preterm infants. Our aim was to analyse admissions due to respiratory infections in moderate, late and term infants, and to identify risk factors for hospitalisation in preterm versus term. METHODS: Prospective study in a cohort of moderate and late preterm, and term infants born between October/2011 and December/2012. Admissions due to respiratory infections during the first year of life were analysed and compared among moderate (32-33), late (34-36) and term infants. Sixteen respiratory viruses were detected by RT-PCR. Clinical data were collected. RESULTS: 30 (20.9%) out of 143 preterm infants required admission for respiratory infection, versus 129 (6.9%) of 1858 term infants born in the same period (p<0.0001, OR: 3.6 CI 2.0 to 5.0). Hospitalised children had a higher prevalence of hyaline membrane disease (HMD) at birth (p<0.001, OR: 7.7 CI: 2.121 to 27.954) and needed more mechanical ventilation (p<0.001, OR: 5.7 CI: 1.813 to 18.396). Virus was identified in 25/30 (83%) preterm babies, and in 110/129 (85%) term infants. The most frequent viruses in preterm infants were RSV (76%) rhinovirus (20%). Clinical and epidemiological characteristics among term and preterm infants were similar. CONCLUSIONS: The risk of respiratory admissions during the first year of life is up to 3.6 times higher in moderate and late preterm. Once admitted, clinical features of respiratory episodes requiring hospitalisation are similar among term and preterm infants. Hyaline membrane disease and mechanical ventilation were also risk factors for respiratory admissions.

Antimicrobial assays of natural extracts and their inhibitory effect against Listeria innocua and fish spoilage bacteria, after incorporation into biopolymer edible films.

The antimicrobial activity of twelve natural extracts was tested against two fish spoilage bacteria (Pseudomonas fluorescens and Aeromonas hydrophila/caviae) and Listeria innocua, in order to assess their potential utilization in the preservation and safety of minimally processed fish products. After a screening of the active extracts by agar diffusion and vapour diffusion methods, oregano and thyme essential oils and citrus extract were selected. The minimum inhibitory concentration (MIC) of the selected extracts was determined by disc diffusion method against target bacteria and at two temperatures: bacteria's optimal growth temperature (30 °C or 37 °C) and refrigeration temperature (4 °C). Due to its better solubility, lack of odour and greater inhibitory effect obtained against L. innocua at refrigerated temperature, citrus extract was selected and incorporated at 1% (v/v) into different biopolymer film forming solutions (gelatin, methyl cellulose and their blend 50:50 w/w). The antimicrobial activity of the developed films was then evaluated, just after preparation of the films and after one month of storage at 43±3% relative humidity and 24±3 °C. Regardless of the biopolymer matrix, all the developed films showed antimicrobial activity against the target bacteria. The most sensitive bacterium towards active films was L. innocua while P. fluorescens appeared as the most resistant one, in accordance with the previously performed antimicrobial tests for pure extracts. The differences in activity of the films between the tested two temperatures were not significant except for L. innocua, for which three times higher inhibition diameters were observed at refrigerated temperature. The inhibitory effectiveness of the films against the tested strains was maintained regardless of the biopolymer matrix for at least one month. Therefore, these edible films show potential for their future use in fresh fish fillets preservation.

Lúnulas rojas en alopecia areata / Red lunulae in alopecia areata

Las lúnulas rojas pueden observarse de forma excepcional en la alopecia areata. Describimos el caso de una mujer de 23 años con alopecia areata en placas multifocal de un año de evolución que evoluciona a una alopecia areata total. Pocas semanas después, se pueden apreciar lúnulas rojas en todos los dedos de las manos y en el primer dedo de ambos pies. La patogénesis de las lúnulas rojas es incierta. Suelen desarrollarse poco después de la fase aguda y desaparecen lentamente dejando, en algunos casos, líneas de Beau (AU)

Red lunulae have been observed excepcionally in alopecia areata. We describe a 23-year-old girl with a multifocal alopecia areata of one year evolution which progress to a totalis. Few weeks later, we can observe red lunulae in all fingernails and both great to enails. Pathogenesis of red lunulae is uncertain. They usually appear shortly after the acute on set of hair loss and disappear slowly leaving, in some cases, Beau´s lines(AU)

In vitro effects of cadmium on two different animal cell models.

The aim of this study was to assess comparatively the effects of cadmium on two different in vitro cell models, a cell line derived from proximal tubule renal cells (LLC-PK1) and haemocytes or blood cells of mussels (Mytilus galloprovincialis). Cells were seeded in 96-well microplates and exposed in vitro to different concentrations of cadmium (CdCl(2)) ranging from 10 to 2000 microM for haemocytes and from 1 to 100 microM for LLC-PK1 cells, added to the culture medium. After 24 h of exposure, different assays were performed on haemocytes: neutral red uptake, phagocytosis of neutral red-stained zymosan, XTT assay, activity of lysosomal acid phosphatase and demonstration of the actin cytoskeleton using TRITC-labeled phalloidin. Cell viability expressed as LC50 was 750 microM when using the neutral red assay and 400 microM with the XTT assay. The phagocytic ability and the activity of acid phosphatase increased significantly in cells treated with Cd in a non dose-dependent manner. Doses of Cd above 100 microM caused disruption of the actin cytoskeleton. In LLC-PK1 cells, cell viability expressed as LC50 was found to be around 40 microM when using the neutral red assay and 50-60 microM with MTT and LDH assays, respectively. These results show that mussel haemocytes are in general more resistant to Cd exposure than LLC-PK1 cells. Furthermore, Cd appears to stimulate phagocytic and lysosomal activities in haemocytes in vitro.

Reacciones al color rojo de los tatuajes / Red tatoo reactions

Presentamos cinco pacientes (tres mujeres y dos varones) que consultaron por reacciones al color rojo de los tatuajes. Todos ellos referían prurito y elevación de las zonas coloreadas en rojo que había comenzado entre varios días y 4 años después de la realización de los mismos. Se tomaron biopsias de las lesiones, que mostraron un patrón liquenoide en tres de ellos, una dermatitis espongiótica en otro y una hiperplasia pseudoepiteliomatosa en el último. A tres se les realizaron pruebas epicutáneas, encontrándose únicamente una positividad a la tinta aportada por uno de ellos, sin otras positividades en la batería estándar y de colorantes textiles. Venticinco controles con dicha tinta fueron negativos. Nuestros casos concuerdan con la literatura, en la que se describen distintas reacciones al color rojo de los tatuajes, todas ellas con una clínica muy similar, siendo el patrón histológico variable, en la mayoría de los casos de tipo liquenoide. Las pruebas epicutáneas tienen muy baja sensibilidad y no se ha podido establecer una relación causal con ningún elemento químico (AU)

Dermatofibroma aneurismático o hemorrágico / Aneurysmal or hemorrhagic dermatofibroma

El Dermatofibroma aneurismático es una rara variante de dermatofibroma pero con características histopatológicas distintivas. En el seno de la lesión se advierten hendiduras y espacios vasculares (sin revestimiento endotelial), llenos de material hemático y acompañados de abundantes depósitos de hemosiderina, que resultan de la extravasación de sangre dentro del estroma tumoral. Este aspecto histopatológico hace discutible el término aneurismático como adjetivo más correcto o no para definir este tipo de dermatofibroma.Presentamos el caso de una lesión en una joven de 14 años cuyo diagnóstico inicial fue de lesión angiomatosa, y describimos las características clinicopatológicas del tumor, así como el diagnóstico diferencial, fundamentalmente con lesiones de estirpe vascular. asimismo discutimos los diferentes términos propuestos por los autores para definir este cuadro (AU)

In vitro activities in mussel hemocytes as biomarkers of environmental quality: a case study in the Abra Estuary (Biscay Bay).

Mussels, Mytilus galloprovincialis, were collected from six coastal sites of dissimilar water quality (Zierbena, Santurtzi, Arrigunaga, Galea, Meñakoz, and Plentzia) at Biscay Bay in September 1991, January 1992, June 1992, and September 1992. The extent of hemocyte infiltration in connective tissue of the digestive gland was quantified by stereology on histological sections in terms of volume density of hemocytes (HVD). HVD was elevated in mussels collected from Plentzia (the less polluted site) in January 1992 and September 1992, while such increases occurred in January 1992 in Santurtzi and Arrigunaga and in September 1991 and September 1992 in Galea. Conversely, HVD was reduced in Arrigunaga in September 1991 and in Galea in January 1992. Moreover, HVD was kept unchanged through the year in mussels collected from Meñakoz and Zierbena. On the basis of this preliminary in vivo study, hemocytic activities of mussels collected in September 1994 from Arrigunaga and Plentzia were further investigated by means of four in vitro immunotoxicity assays: (a) the trypan blue exclusion assay, indicative of cell viability; (b) the zymosan phagocytosis assay, indicative of phagocytic activity; (c) the diaminobenzidine-manganese (DAB-Mn2+) oxidation assay for estimating reactive oxygen intermediate (ROI) production; and (d) the neutral red (NR) uptake assay, indicative of endocytic ability. These in vitro tests indicated some significant differences between Plentzia and Arrigunaga. Hemocytes from mussels collected in Plentzia exhibited a higher capability to phagocytose zymosan while, conversely, hemocytes from mussels collected in Arrigunaga endocytosed more NR and produced more ROI under nonstimulated conditions. These differences in the in vitro hemocytic activities of mussels from Plentzia (nonpolluted) and Arrigunaga (moderately polluted) suggest that in vitro assays may be used as biomarkers of environmental quality in coastal and estuarine areas.