Serious health threat of mucormycosis during the ongoing COVID-19 pandemic: what dermatologists need to know in this regard.

BACKGROUND: Recently, a surge of mucormycosis in patients affected with or recovered from SARS-Cov-2 has been noted, especially in developing countries such as India, Pakistan, and Iran. AIM: To focus on existing data about the important aspects of COVID-associated mucormycosis. METHODS: We searched on PubMed, Google Scholar, and Scopus in this regard, and all of the relevant papers published until August 28, 2021, for which we could access their full-texts, were included. RESULTS: We found some recommendations made by ophthalmologists, anesthesiologists, and ENT surgeons and tried to summarize them to provide a practical guide for dermatologists. CONCLUSION: Careful examination and clinical suspicion are the key factors for correct diagnosis especially in patients affected by or recently recovered from COVID. Implementing some preventive measures such as using a titrated dose of corticosteroids and encouraging patients to get vaccinated should be considered to tackling this serious issue.

COVID vaccination in patients under treatment with rituximab: A presentation of two cases from Iran and a review of the current knowledge with a specific focus on pemphigus.

SARS-COV2 vaccines were approved without long-term monitoring due to emergent situations. This has raised some issues about the timing and protocol of receiving vaccines in specific situations such as patients receiving immunomodulatory agents including rituximab, which is widely used for various disorders such as multiple sclerosis, pemphigus, and many rheumatologic disorders. We described two cases of pemphigus vulgaris (a new case and one with flare-up) following vaccination with Astrazeneca in Iran and reviewed the existing data in this regard through searching on PubMed, Google Scholar, and Scopus. All of the relevant papers published until June 28, 2021, which we could access their full-texts were included. We found some recommendations made by rheumatologists, neurologists, and dermatologists in regard to vaccination timing in this group of patients and tried to summarize them to provide a practical guide for clinicians. Clinicians should perform a careful, individualized risk-benefit assessment for their patients and consider a delay in rituximab administration after completion of COVID vaccination if there is not any considerable risk of disease relapse or organ failure. Moreover, choosing vaccines with potential of providing protection after single dose, especially in countries with limited access to vaccines may be a reasonable approach.