Pityriasis Rosea-like eruptions following COVID-19 mRNA-1273 vaccination: A case report and literature review.

Pityriasis rosea (PR) is a self-limited disease with exanthematous papulosquamous rashes mostly associated with reactivation of human herpesvirus (HHV)-6 or HHV-7. PR-like eruptions, which occur along with peripheral eosinophilia, interface dermatitis, and eosinophils on histopathology, may result from medications or vaccinations. Previously, PR-like eruptions had been noted following vaccination for influenza or other vaccines. During this pandemic, acute COVID-19 infection has been related to PR or PR-like eruptions in several cases. Various COVID-19 vaccines associated with PR-like eruptions were rarely reported. Herein, we report a case of cutaneous PR-like eruptions following COVID-19 mRNA-1273 vaccination.

Evaluation of a new-formula shampoo containing 6% glycyrrhetinic acid complex for scalp seborrheic dermatitis: A pilot study.

BACKGROUND: Scalp seborrheic dermatitis (SD) is a chronic inflammatory dermatosis associated with sebum imbalance and proliferation of Malassezia species. Various antifungal shampoos are commonly used for scalp SD. AIMS: Glycyrrhetinic acid is known to have antioxidative, anti-inflammatory, and anti-allergic effects. This study was designed to evaluate the effectiveness of a new-formula shampoo that contains glycyrrhetinic acid for the treatment of scalp SD. PATIENTS/METHODS: Thirty-four patients were enrolled and treated with the 6% glycyrrhetinic acid complex shampoo. Efficacy was assessed clinically with Dermatology Life Quality Index (DLQI) and Adherent Scalp Flaking Score (ASFS) by the same dermatologist at baseline, week 2, and week 5. Among the 24 subjects with the most significant clinical improvement, four common microorganisms from scalp samples were analyzed by quantitative polymerase chain reaction (qPCR) at baseline, and week 5. RESULTS: The DLQI and ASFS at week 2 and week 5 improved significantly relative to baseline. The bacteria profiles showed a significant increase of Cutibacterium acnes and a decrease of Staphylococcus epidermidis at week 5. The fungi profiles showed significant decreases of both Malassezia restricta and Malassezia globosa. The ratio of C. acne to S. epidermidis increased significantly from 0.93 at baseline to 1.55 at week 5. The ratio of M. restricta to M. globosa decreased from 5.02 at baseline to 1.00 at week 5. CONCLUSIONS: The effectiveness of this new regimen was objectively demonstrated at the clinical and microbiological levels. This new formula may alleviate the bacterial and fungal dysbiosis in scalp SD.

Paraneoplastic Pemphigus and Bronchiolitis Obliterans in a Patient with Splenic B-cell Lymphoma.

Paraneoplastic pemphigus (PNP), also called paraneoplastic autoimmune multiorgan syndrome, is a rare disorder associated with underlying neoplasia. The common underlying neoplasms include non-Hodgkins lymphoma, chronic lymphocytic leukemia, and Castlemans disease. Though B-cell lymphoma is the most common underlying malignancy, only one case associated with splenic B-cell lymphoma has been recognized. The prognosis of PNP is very poor, and PNP-associated bronchiolitis obliterans (BO) is not uncommon. Herein, we report a 44-year-old woman who initially presented with multiple oral ulcers, conjunctivitis, and numerous cutaneous blisters. Serial workup established the diagnosis of PNP and revealed an underlying splenic B-cell lymphoma. Although the mucocutaneous lesions gradually healed after splenectomy and chemotherapy, deteriorating respiratory function developed 7 months later with pathologically proven BO. She finally succumbed to respiratory failure 12 months after presentation despite intensive respiratory care.

Type IV hypersensitivity from rubber chemicals: a 15-year experience in Taiwan.

BACKGROUND: Allergic contact dermatitis from rubber chemicals is frequent but has not been reported form Asia. OBJECTIVE: To study the pattern of type IV allergy to rubber chemicals in a Chinese-based population. METHODS: A retrospective study was conducted by reviewing the patch test results of 2,235 (604 men, 1,631 women) patients from January 1986 to December 2000. RESULTS: Ninety-nine patients (4.4%) had one or more positive reactions, 42 (6.9%) men and 57 (3.5%) women. The incidence did not increase throughout the study period. Among thiuram, mercapto, carba and black-rubber mix, thiuram is the most potent sensitizer, mostly for the hand and mercapto mix for the foot. Thiuram allergy is considered occupation related, while mercapto allergy, mostly from rubber slippers, is not typically related to an occupation. A negative correlation between thiuram and carba was found despite the frequent association between these two mixes. A high risk of rubber sensitization was noted in construction, health service, transportation, agriculture and hairdressing workers. A high frequency of concomitant sensitivity to cobalt was found. CONCLUSION: This is the first statistically analyzed study of rubber chemical allergy in Asia, which supports major trends concerning rubber chemical allergy from European studies. However, wearing rubber slippers in Taiwan contributes to the high percentage of foot dermatitis. Carba should still be retained in the European standard series because of the coexistence of thiuram and carba in rubber products. The concomitant sensitization to cobalt in rubber-allergic patients needs further evaluations.

A patch test study of 27 crude drugs commonly used in Chinese topical medicaments.

Chinese topical medicaments (CTMs) are commonly used in Taiwan and in Southeast Asia. However, a systematic evaluation of contact sensitization potential from CTM has not been carried out to our knowledge. This study was undertaken to investigate the incidence of contact sensitivity to the components of CTM in patients with contact dermatitis from CTM. A screening series of 27 crude drugs most commonly used in CTM as well as a modified European standard series was patch tested in 30 patients. The herbs with the most frequent positive reactions were Flos Caryophylli (see text), Radix Angelicae Pubescentis (see text), Cortex Cinnamomi (see text), Cortex Radix Acanthopanacis (see text), Caulis Impatientis (see text), Resina Draconis/Sanguis Draconis (see text), Fructus Cnidii (see text), Radix Gentiana Macrophyllae (see text), and Rhizoma Ligustici Chuanxiong (see text). Concomitant allergy to colophonium was found in most of these positive reactions. Reducing the concentration and simplifying the compositions of these components, as well as replacement with those of low allergenicity in CTM, such as Rhizoma Arisaematis (see text), Herba Lycopodii (see text), Radix Cyathulae Officinalis (see text), Rhizoma Pinelliae (see text), Radix Angelicae Dahuricae (see text), Herba Dendrobii (see text), Secretio Moschus (see text), and Stigmata Croci (see text), may be advocated. A precise labelling of the dosage of each component and the exact chemical compounds in CTM products could further improve the safety and therapeutic effects of CTM in the future.