An Unusual Presentation of Erythema Multiforme Following the Administration of Pfizer-BioNTech COVID-19 mRNA Vaccine in a Pediatric Patient.

Coronavirus disease 2019 (COVID-19) caused a global calamity that forced emergency use authorization to Pfizer-BioNTech COVID-19 (BNT162b2) vaccine. It is efficacious in preventing symptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in seronegative recipients. The safety profile is still unclear; however, commonly reported symptoms post-vaccination are fatigue, headache, muscle pain, chills, and injection-site pain. COVID-19 disease elicits, to some extent, cutaneous side effects like urticaria, morbilliform rash, and chilblain-like eruption. Vaccination against COVID-19 was reported to induce similar dermatologic manifestations, such as urticarial rash, delayed large-local reaction, local injection-site reaction, and morbilliform eruption. Erythema multiforme (EM) is a rare manifestation post-vaccination, and only a few reports implicate it as a culprit in cutaneous eruptions following the BNT162b2 vaccine. This report delineates the presentation of a healthy 14-year-old girl to a dermatology clinic who developed EM post-vaccination with the first dose of BNT162b2. New-onset EM-eruption post-vaccination with BNT162b2 had been reported previously in 14 cases, and one case reported on the flare of preexisting-EM.

Abemaciclib-Associated Skin, Hair, and Nail Toxicities: A Case Report.

Abemaciclib is a cyclin-dependent kinase 4/6 inhibitor that is utilized to manage hormone-sensitive human epidermal growth factor receptor-2 positive metastatic breast cancer. Palbociclib and ribociclib are types of other orally administered CDK4/6i that share similar safety and tolerability compared with Abemaciclib. Reported side effects include reversible neutropenia of a lower grade, gastrointestinal toxicity, and anemia. CDK4/6i could induce dermatological side effects. Although less frequent, cutaneous adverse effects of CDK4/6i account for 25% of medication discontinuation. Frequent cutaneous adverse events are rash and pruritus; nonetheless, hair loss, nail changes, vitiligo, and photosensitivity reactions, were also reported to a lesser extent. Herein, we report a case of hair, nail, and pigmentary disorder that occurred 10 months after initiating abemaciclib treatment.

Pityriasis Rosea Eruption Following the Administration of Oxford-AstraZeneca Vaccine.

The coronavirus disease 2019 (COVID-19) infection has led to accelerated development and utilization of vaccines to prevent its implications on health. One of these vaccines is a vector-based, Oxford-AstraZeneca Vaccine (AZD1222). Frequently reported side effects are related to host-immune response. While dermatologic manifestation is peculiar in nature and denotes a serious eruption that might defer future vaccination. Herein, we present a case of a medically free 37-year-old female who developed clinical and histological evidence of pityriasis rosea (PR) after administration of a second-dose vaccination of AZD1222. The first dose of vaccination was administered as Pfizer BioNTech COVID-19 mRNA (BNT162b2) vaccine. This case is unique in nature as this patient developed AZD1222-induced PR, while some reports in the literature have linked PR to the BNT162b2 vaccine. This patient continued to receive a booster vaccination with BNT162b2 with no reportable side effects.

Folliculitis decalvans managed with adalimumab: A case report.

Folliculitis decalvans (FD) is a rare neutrophilic cicatricial alopecia of the scalp that manifest with inflammation, pruritus, pustules, and tufted hair. Most dermatologist treat FD with topical or oral antibiotics. We recommend considering treatment with biologics to preserve and stabilize the ongoing inflammatory process in moderate to severe FD.

Giant cell lichenoid dermatitis within healed varicella zoster site.

There are dermatoses that arise within healed zosteriform sites, such as granulomas annulare, acneiform eruptions, psoriasis, lichen planus, and giant cell lichenoid dermatitis "GCLD." Nonetheless, graft-versus-host disease should be considered and ruled out, especially in patients post-bone marrow transplant. Herein, we report a case of GCLD manifesting within healed zosteriform sites.

Unilateral Linear Lichen Planus Pigmentosus Responding to Isotretinoin: A Case Report.

Lichen planus pigmentosus (LPP) is a rare variant of lichen planus. Due to the scarce number of patients diagnosed with LPP, there are no treatment guidelines. Multiple topical and oral agents are utilized in LPP with varying degrees of response. Isotretinoin has only been investigated in a case report and a single prospective pilot study for managing LPP. Herein, we report the efficacy, safety, and moderate improvement of LPP patients on isotretinoin 20 mg (0.25 mg/kg), topical adapalene gel, 4% hydroquinone cream, and topical sunscreen.

Migraine Prevalence and Analysis of Dietary Habits in Relation to Headache in the Female Population: A Single-Center Study From Jeddah, Saudi Arabia.

Introduction Lifestyle-related factors including dietary intake can significantly increase the chances of developing migraine. Some components of food items are thought to induce the release of vasoactive substances leading to the dilation of blood vessels, which in turn results in migraine episodes. This research aimed to assess the prevalence of migraine and examine the relation of the headache to the dietary patterns of female students and employees of King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) - Jeddah experiencing migraine attacks as well as to assess the relationship between the migraine attacks and the available dietary items served at the food outlets within the campus. Methods Two questionnaires were developed for this study. The first questionnaire was a short survey asking about the characteristics of headaches. This survey aimed to estimate the prevalence of migraine among female students and employees in KSAU-HS. Of the participants who filled the first questionnaire, those who met the International Classification of Headache Disorders (ICDH-III) criteria for migraine were given a second questionnaire to further understand the characteristics of their migraine headaches and to assess lifestyle and diet-related aggravating factors. Results The final sample size for the calculated prevalence was 410; 352 were students and 58 were faculty members. It has been found that 165 (40.24%) participants of the KSAU-HS female population met the criteria for migraine. Two (2.2%) reported an association between chocolate consumption and headaches and seven (7.8%) reported a significant association between caffeine and headaches. No specific association was perceived by the respondents between migraine attacks and the following food items: citrus fruits, pickles, cheese, and dairy products. Conclusion Our study revealed that the widespread trends for excessive consumption of coffee and caffeinated beverages at food outlets within the educational institution are occult triggers for headache attacks in a significant portion of students with migraine. The recent shift in dietary habits in our community for excessive consumption of coffee and other tyramine-rich food items has negative consequences on productivity and the economy. Our results can be conceivably extrapolated to reflect the effect of dietary habits on other streams of society, including companies, firms, schools, and workplaces that are driven by the new dietary trends.

Onychomadesis and Beau's Line Following Hand-Foot-and-Mouth Disease in a Seven-Year-Old Male.

Hand-foot-and-mouth disease (HFMD) is a viral infection frequently encountered in the pediatric age group. Common culprits in such manifestations are coxsackievirus A16 and human enterovirus 71. The patient presents febrile with erythematous papulovesicular exanthems in the mouth, palms, and soles. HFMD is self-limiting in nature with a rare-complication rate. Onychomadesis is proximal nail separation while Beau's lines are whitish transverse lines and considered a rare complication of HFMD. Both allude to halted nail-matrix proliferation, and the pathophysiology behind such manifestations is still not yet understood. It is hypothesized that the virus elicits an inflammatory process, inhibiting nail-matrix proliferation or immune-complexes depositing on nails creating an embolism. Onychomadesis and Beau's lines appear after four to eight weeks of HFMD disease resolution and persist for approximately 35 days. There are no serious sequelae of those manifestations, as the nail basement is still intact. We present a case of a seven-year-old Saudi male presenting with nail changes, mainly onychomadesis and Beau's lines, after 35 days of HFMD disease resolution. All causes of nail changes have been ruled out and diagnosis of onychomycosis and Beau's lines secondary to HFDM has been established.

Generalized Papulovesicular Eruption as a Side Effect of the Pfizer-BioNTech COVID-19 Vaccine.

COVID-19 is inflicted by SARS-CoV-2 and resulted in a global health crisis that necessitated the urgency of vaccine development to prevent its spreading among the public. Pfizer-BioNTech COVID-19 is one of the emergency use authorized (EUA) vaccines. This vaccine is efficacious against the SARS-CoV-2 virus; nonetheless, recipients have frequently reported side effects. Recipients of this vaccine experienced miscellaneous side effects like fatigue and headache. However, cutaneous eruptions of varying degrees of severity and involvements have been manifesting post-vaccination. Dermatological eruptions following vaccination against COVID-19 disease are poorly recognized. Dermatological manifestations triggered post-vaccination differ in the clinical context and patient's demographic features. The only constant factor is various clinical and histopathological relations to establish the diagnosis of cutaneous eruption post-vaccination. Herein, we report a case of an 18-year-old male with T-cell acute lymphocytic lymphoma (ALL) in remission since August 2018 and other comorbidities. After the administration of the first dose of the Pfizer-BioNTech COVID-19 vaccine, the patient developed pruritic eczematous eruption presenting as grouped erythematous-violaceous papulovesicular lesions with fine scales over his upper and lower extremities. These eruptions started two days after the administration of the vaccine. This eruption became generalized 21 days after receiving the second dose of the Pfizer-BioNTech COVID-19 vaccine. Clinical suspicion of the drug-induced vesicular eruption was suspected; thus, a biopsy was obtained and showed erosions and mixed inflammatory cell infiltrate. From a clinical and histopathological correlation, vesicular eruption following vaccination with Pfizer-BioNTech COVID-19 was confirmed. Nevertheless, other diagnoses cannot be ruled out, but from the clinical-histopathological association, the vaccine-inflicted eruption is the likely culprit. Reports are crucial to understanding the nature of such dermatological manifestation after emerging diseases and counteractions like vaccinations. The dermatological manifestations are vaguely recognized; thus, by reporting on the cases similar to the case in this report, more data will be available to understand the nature and underlying cause of such eruptions.

Ibrutinib-Induced Paronychia and Periungual Pyogenic Granuloma.

Nail changes elicited by Ibrutinib are relatively infrequent but are reported in the literature. Herein, we report on two cases that developed Ibrutinib-induced nail toxicities. A 63-year-old female, with relapsing mantle cell lymphoma on Ibrutinib 560mg/day for seven months developed paronychia, onychomadesis, Beau's lines, nail fragility, and brittleness over fingernails and toenails. On the other hand, an 80-year-old male with chronic lymphoid leukemia developed a bloody papule with hemorrhagic crust and nail-plate abnormalities. Skin toxicities manifested eight months after initiating Ibrutinib therapy. From a clinical perspective, Ibrutinib-induced chronic paronychia and PG have been established. All other PG triggers have been ruled out. After the cessation of Ibrutinib, the PG improved for both cases. The exact pathogenesis of PG induced by Ibrutinib is not yet understood but it had been compared to retinoid-related changes. Thus, further research and reporting of similar cases should be done to further understand the pathophysiology of such manifestations.

Progressive Familial Intrahepatic Cholestasis Type 1 Associated with Cherry-Red Spots in an Infant: A First Case Report.

Progressive familial intrahepatic cholestasis type 1 (PFIC1) associated with a cherry-red spot, to our knowledge, has never been reported in the literature. We report the case of a 10­month­old girl with prolonged cholestasis. A diagnosis of PFIC1 was made by whole­exome sequencing. Fundus examination showed a cherry-red spot. Our case provides a new insight toward the first case of ocular manifestation of PFIC1. Further studies are required to elucidate FIC1 gene expression in the macula.

Heterogeneous Cubic Multidimensional Integrated Circuit for Water and Food Security in Fish Farming Ponds.

Among major food production sectors, world aquaculture shows the highest growth rate, providing more than 50% of the global seafood market. However, water pollution in fish farming ponds is regarded as the leading cause of fish death and financial losses in the market. Here, an Internet of Things system based on a cubic multidimensional integration of circuit (MD-IC) is demonstrated for water and food security applications in fish farming ponds. Both faces of the silicon substrate are used for thin-film-based device fabrication. The devices are interconnected via through-silicon-vias, resulting in a bifacial complementary metal-oxide-semiconductor-compatible electronics system. The demonstrated cubic MD-IC is a complete, small, and lightweight system that can be easily deployed by farmers with no need for specialists. The system integrates on its outer sides simultaneous air and water quality monitoring devices (temperature, electrical conductivity, ammonia, and pH sensors), solar cells for energy-harvesting, and antenna for real-time data-transfer, while data-management circuitry and a solid-state battery are integrated on its internal faces. Microfluidic cooling technology is used for thermal management in the MD-IC. Finally, a biofriendly polymeric encapsulation is used to waterproof the embedded electronics, improve the mechanical robustness, and allow the system to float on the surface of the water.