Therapeutic Use of Amniotic Membrane Dressing in Toxic Epidermal Necrolysis.

A 45-year-old woman presented with painful erosions and a few dusky vesiculobullous lesions all over the body, including the face, trunk, arms and legs, and oral and genital mucous membranes, for 3 days after consuming tablet diclofenac for fever. There was hemorrhagic crusting on the lips along with conjunctival hyperemia. A clinical diagnosis of toxic epidermal necrolysis (TEN) was made. The Severity-of-Illness Score for Toxic Epidermal Necrolysis (SCORTEN) was 3 at the time of admission. All routine investigations, including liver function test (LFT), kidney function test (KFT), fasting blood sugar (FBS, 105 mg/dL), and viral serology (Hepatitis B surface antigen [HBsAg], hepatitis C virus [HCV], and Human immunodeficiency virus [HIV]-1, 2), were normal. Blood and urine cultures were sterile. A chest X-ray (posteroanterior [PA] view) and electrocardiogram (ECG) did not reveal any abnormality. The patient was treated conservatively with supportive care, including intravenous fluids, maintenance of ambient temperature, air-fluidized bedding, and appropriate pain and ophthalmic care. For skin lesions, normal saline dressing with paraffin gauge was used; however, after 5 days of treatment, coverage of skin lesions with amniotic membrane dressings was planned due to poor healing. Amniotic membranes are taken from normal delivery patients using aseptic precautions and ensuring negative viral (HBsAg, HCV, and HIV-1, 2) serology. Blood clots were removed from amniotic membranes and stored in buffered normal saline by adding gentamycin. The membranes were applied over the denuded areas (Figures 1 and 2) and wrapped with sterile bandages. The membranes were replaced after 3 days, and removed on day 4 of the second application. More than 90% improvement was observed (Figures 3 and 4) on removal of second application. Supportive treatment was continued, and the patient was discharged on day 20 of admission. (SKINmed. 2022;20:215-217).

Psoriasis Flare-Up After COVAXIN BBV152 Whole Virion Inactivated Vaccine.

Psoriasis is an inflammatory skin condition with a chronic relapsing course that can negatively impact a patient's quality of life. Various triggering factors can cause the flare-up of psoriasis, which also include vaccination. The most common vaccine associated with this is influenza. In this global pandemic of coronavirus disease 2019 (COVID-19), emergency authorization for mass vaccination has been adopted by many countries in the world. Psoriasis flare has been reported after the Pfizer COVID-19 vaccine and CoronaVac vaccine. Currently, both the virus-causing disease and the vaccines are still being studied owing to their dynamicity. We report a case of a 21-year-old gentleman with chronic plaque psoriasis of three years, who developed generalized pustular psoriasis eruption after administration of the first dose of COVAXIN. To the currently available literature, this was the first case of this complication associated with COVAXIN.

Association of Psoriasis With Thyroid Disorders: A Hospital-Based, Cross-Sectional Study.

Background Although numerous studies have been conducted to determine the relationship between psoriasis and thyroid dysfunction, contrasting results have been reported. The link between psoriasis and thyroid disease has not been elucidated well. This study aimed to determine the frequency of thyroid dysfunction and its relationship with gender, age, duration, and severity of psoriasis among patients with psoriasis. Methodology Psoriasis was diagnosed clinically, and the severity of the disease was assessed by the Psoriasis Area Severity Index (PASI) score and the body surface area (BSA) involved, as measured by Wallace's rule of nine. A total of 111 patients with psoriasis were analyzed for thyroid dysfunction, which included thyroid-stimulating hormone, free T3, free T4, and anti-thyroid peroxidase (anti-TPO) antibody levels. SPSS version 23.0 (IBM Corp., Armonk, NY, USA) was used for analysis. Results Out of the 111 analyzed psoriasis patients, deranged thyroid status was observed in 22 patients. Anti-TPO was increased in 19 patients. Patients with thyroid dysfunction had a more severe form of psoriasis (both by PASI score and BSA involvement) than those with mild psoriasis (61.9% vs. 38.1%), whereas patients with increased anti-TPO had a milder disease. Conclusions This study illustrated deranged thyroid status and thyroid autoimmunity in 19.8% and 17.1% of psoriasis patients, respectively, suggesting thyroid dysfunction and autoimmunity. However, further studies are required to expand our knowledge of psoriasis and its association with thyroid dysfunction and thyroid autoimmunity, as well as with age, gender, disease duration, and severity of psoriasis.