Mimicking Rosacea? Jessner's Lymphocytic Infiltration of the Skin: A Case Report.

We report a case of rash in a 35-year-old female presenting with erythematous papules and infiltrative plaques on the nose and upper jaw resembling rosacea. The patient had been experiencing these symptoms for one year. A pathological biopsy revealed an inflammatory infiltrate consisting of dense perivascular lymphocytes surrounding hair follicles and sweat glands in the dermis. Immunohistochemistry demonstrated a predominance of CD4+ T cells compared to CD8+ T cells. Based on the clinical manifestations, histopathology, and immunohistochemistry, the patient was diagnosed with Jessner's Lymphocytic infiltration of the skin (JLIS). The patient was treated with oral Minocycline, 100mg twice daily. After 4 weeks, the dosage was reduced by half and the treatment continued for 2 months, resulting in complete resolution of the rash. The clinical presentation resembled rosacea, and this particular manifestation of JLIS has not been previously reported. Treatment with minocycline yielded satisfactory efficacy, and no recurrence has been observed for 5 year.

Relationship between ultra-short heart rate variability and short-term mortality in hospitalized COVID-19 patients.

OBJECTIVE: To assess the association between ultra-short heart rate variability (US-HRV) and short-term mortality in patients with COVID-19 and develop prognostic prediction models to identify high-risk patients as early as possible. METHODS: A retrospective cohort study was performed on 488 patients diagnosed with COVID-19 and hospitalized in the First Affiliated Hospital of Fujian Medical University from December 2022 to January 2023. 10-s electrocardiogram (ECG) data were available for these patients. The US-HRV parameters including standard deviation of all normal-to-normal R-R intervals (SDNN) and root mean square of successive differences between normal-to-normal R-R intervals (rMSSD) were calculated using Nalong ECG software. The endpoint was short-term mortality, including in-hospital mortality or mortality within 1 week after discharge. RESULTS: Of the 488 patients, 76 (15.6%) died. The SDNN and rMSSD in the death group were significantly lower than those in the survival group (P < 0.001). The area under the receiver operating characteristic (ROC) curve (AUC) for SDNN and rMSSD to predict mortality was 0.761 and 0.715, respectively. The combined use of SDNN and rMSSD had an AUC of 0.774. The mortality rate in the group with SDNN ≤7.5 ms was higher than that of SDNN >7.5 ms group (P < 0.05). With the decrease of SDNN, the mortality of patients showed an upward trend, and the mortality of patients with SDNN ≤2 ms was the highest (66.7%). Multivariate logistic regression analysis identified SDNN as an independent predictor of prognosis (odds ratio (OR) = 5.791, 95% confidential interval (CI) 1.615-20.765, P = 0.007). The AUC of Model 1 (simple model) was 0.866 (95% CI 0.826-0.905). The AUC of Model 2 (comprehensive model) was 0.914 (95% CI 0.881-0.947). CONCLUSION: SDNN was associated with short-term mortality and provided the additional discriminatory power of the risk stratification model for hospitalized COVID-19 patients.

Impact of blue light on skin pigmentation in patients with melasma.

BACKGROUND: The difference in skin pigmentation induced by blue light between melasma patients and healthy people has not been reported. This study aimed to explore the impact of different doses of blue light irradiation on the pigmentation of the skin of non-exposed areas in female melasma patients with III-IV-type skin and healthy women. MATERIALS AND METHODS: This observational study enrolled patients with melasma and healthy people at the First Affiliated Hospital of Kunming Medical University between January and April 2021. The outcomes were the degree of pigmentation, ΔL*, and ΔITA* values. RESULTS: Forty-two (21/group) participants were enrolled. After irradiation with different doses of blue light, different degrees of pigmentation could be observed in the irradiated area of the skin of female melasma patients and healthy women. The △L* and △ITA* values in the irradiated area of the skin of healthy women were higher than in female melasma patients after blue light irradiation at 20 J/cm2 (p < 0.05). There were no significant differences in the pigmentation scores, △L* values, and △ITA* values in the irradiated areas of skin at different time points after irradiation with the other doses of blue light (p > 0.05). CONCLUSION: Blue light at 20 J/cm2 induced a smaller change in pigmentation in melasma patients than in healthy women, but the effect of blue light at 40-80 J/cm2 was similar.