Erythema Pernio-Like in Four Adolescents in the Era of the Coronavirus-2 Infection.

BACKGROUND: Although epidemic, novel coronavirus (SARS-CoV-2) infection rarely affects the pediatric population. However, in the last months, an increasing number of Italian pediatricians have reported the occurrence of erythema pernio-like in children following a flu-like syndrome, after the outbreak of SARS-CoV-2 infection. OBJECTIVE: The study aims to report cutaneous manifestation of SARS-CoV-2 infection in 4 adolescents. METHODS: Observational study reporting 4 adolescents with skin lesions, 2 weeks after the occurrence of a flu-like syndrome. RESULTS: Fourteen days after a flu-like syndrome, adolescents exhibited skin lesions to toes and feet. These lesions were rounded, with blurred limits, with a 5-15 mm diameter, red-violaceous- bluish colored, sometimes resulting in bullous lesions in correspondence of the central or apical portion, which tended to be covered with blackish crusts after evolution. Lesions were also accompanied by pain of variable intensity and evolved within two or three weeks to self-resolution without particular sequelae. In two patients, pharyngeal and nasal swabs were negative for SARSCoV- 2 infection, at the presentation of skin lesions. After 2 months from clinical manifestations, patients were tested positive for SARS-CoV-2 antibodies. CONCLUSIONS: In the pediatric and adolescent population, the occurrence of an erythema pernio-like after a flu-like syndrome could be associated with SARS-CoV-2 infection.

Treatment of facial actinic keratoses with a cream containing octatrienoic acid: a multicenter clinical experience.

BACKGROUND: Actinic keratosis (AKs) are premalignant skin lesions characterized by high rate of transformation in squamous cell carcinoma if not treated. Preclinical published data on parrodiene-derivative 2,4,6-octatrienoic acid, encourages us to study and to evaluate the effect of a topical product containing it in patients affected by mild to moderate actinic keratosis. METHODS: Seventy subjects with at least 1-3 clinically diagnosed actinic keratosis lesions, non-hyperkeratotic, non-hypertrophic, localized on the face (I-II degree actinic keratosis) were enrolled in the study. The product was applied twice/day for 60 consecutive days. RESULTS: After 60 days of treatment, a significant improvement in lesions occurred as shown by the decrease in the AKESA Score (P<0.05). Moreover, octatrienoic acid containing cream induced a 90% response rate (63/70 patients P<0.5; 95% confidence interval) with 20% complete remission (14/70 patients, P<0.05). Compared to baseline, a significant number of patients reported improvement of each AKESA sub-score after 60 days of treatment: skin thickness improved in 46 patients (P<0.0001), erythema in 21 patients (P<0.0001) and atrophy in 57 patients (P<0.0348). The average pigmentation score significantly decreased from 1.50 to 0.79 (P<0.05). CONCLUSIONS: The results of the study, confirmed also by self-assessment, allow us not only to state that the use of topical octatrienoic acid was effective and well tolerated for topical treatment of AKs leading to overall clinical improvement in approximately 90% of subjects treated for 60 days.