Erythematous Linear Lesion on the Course of Superficial Fibular Nerve After the Topical Application of Black Henna: A Case Report.

Henna is commonly used in body arts, where it produces orange-brown color. It is often mixed with chemicals such as para-phenylenediamine (PPD) to fasten the dyeing process and produce a black color. However, PPD has many allergic and toxic effects. We present a case of henna-induced cutaneous neuritis, which is not reported before. A 27-year-old female presented to our hospital, complaining of pain in her left great toe after applying black henna. Upon examination, the proximal nail fold was inflamed, and an erythematous non-palpable tender lesion was noticed on the dorsum of the foot. The lesion had an inverted-Y shape that was confined to the course of the superficial fibular nerve. Cutaneous nerve inflammation was favored after excluding all the anatomical structures in the region. Black henna should be avoided since it contains PPD, which can be absorbed through the skin and affect the underlying cutaneous nerves.

Using Absorbable Sutures for Traumatic Wound Closure to Avoid Additional Hospital Visits for Suture Removal During the COVID-19 Pandemic: A Randomized Controlled Trial.

Introduction The COVID-19 pandemic worldwide forced governments to undertake intervention measures to encourage social distancing. Meanwhile, traumatic skin lacerations require multiple hospital visits for dressing changing and suture removal since they are usually repaired with non-absorbable sutures. These visits can be avoided by using absorbable sutures instead. However, absorbable sutures carry the "potential" risk of wound infection. In the current study, our first objective was to determine the non-inferiority of absorbable sutures regarding infection rate after repairing traumatic wound lacerations in comparison to the conventional non-absorbable ones. Our second objective was to evaluate the superiority of absorbable sutures in regard to postoperative clinic visits for suture removal and wound dressing compared to the non-absorbable ones. Methods A sample of 471 patients with traumatic skin lacerations was analyzed during the COVID-19 pandemic in April 2020. In the control group, wounds were repaired using non-absorbable sutures, while rapid-onset absorbable sutures were used in the treatment group. By conducting a phone/video call follow-up after 21 days, several parameters regarding infection signs and clinic visits were compared between both groups. Results A significant decrease in total trauma patients (45.4%) and those who required suturing (51.2%) was observed in April 2020 compared to the same month of the previous four years (p = 0.001 (2016), p = 0.027 (2017), p = 0.027 (2018), and p = 0.001 (2019)). Regarding wound infection, no statistically significant difference (p = 0.623) was observed between the absorbable (3.2%) and non-absorbable (4.9%) groups. Using absorbable sutures resulted in significantly (p < 0.001) fewer postoperative hospital visits compared to using non-absorbable sutures (mean: one versus three visits). Conclusion Using absorbable sutures to repair traumatic wound lacerations is safe regarding wound healing and infection rates. They also reduce postoperative hospital visits since they are not intended to be removed. Therefore, they should be considered during a pandemic to reduce hospital visits for suture removal, which will subsequently enhance social distancing and relieve hospital load.