Methotrexate as a safe immunosuppressive agent during the COVID-19 pandemic

Background: During the ongoing COVID-19 pandemic, immunocompromised patients are at a higher risk of severe infection, since the immune system has an important role in defeating this disease. This study compares the severity of COVID-19 in patients taking methotrexate with the severity of their family members' illness as patients with normal immune system function. Methods: A total of 35 participants, including 14 patients taking methotrexate and 21 patients with normal immune function, entered this study, and the indicators of COVID-19 severity were compared between these two groups. Results: The case group, who were on methotrexate therapy, had significantly less severe COVID-19 based on their symptoms, including fever (p = 0.000) and cough and dyspnea (p = 0.01) as well as in terms of COVID-19 severity indicators such as pulmonary involvement (p = 0.001), ferritin level (p = 0.001), white blood cell count (p = 0.008) and CRP level (p = 0.006), compared to the control group. There was a significant correlation between taking methotrexate and lower severity in COVID-19 disease. Conclusion: The present findings demonstrated that methotrexate does not predispose patients to severe COVID19; on the contrary, patients taking methotrexate may experience a milder disease, possibly due to their reduced severe inflammatory reactions as a result of inhibited TNF alpha, lowered IL6, and increased T regulatory cells. According to these findings, methotrexate appears to be a suitable treatment option for patients who need immunosuppressive medications during the COVID-19 pandemic

Inverse correlation between vitamin D and CRP levels in alopecia areata: A pilot study

Introduction: Alopecia areata (AA) is an autoimmune non-scarring hair loss. The role of micronutrients such as iron, zinc, and vitamins, especially vitamin D, on the natural hair cycle is well defined in literature. This study aims to evaluate the correlation between vitamin D and CRP levels in patients with alopecia areata. Methods: This cross-sectional study was performed from beginning of October 2020 until end of December 2021. Alopecia areata patients over 18 years of age gave their written consent to participate in the study. The severity of the patients' disease was assessed using the Severity of Alopecia Tool. Serum vitamin D and CRP levels were measured and CBC and LFT were also performed. Results: There were significant differences between the patients with the localized form of AA and its universal form in the following variables: Vitamin D levels, SALT score, WBC, ALKP, and CRP. There was also a significant inverse correlation between CRP and vitamin D levels (p < 0.0001). Conclusion: Vitamin D deficiency is associated with higher CRP levels, and patients with low serum vitamin D and high CRP levels are at a higher risk of developing the universalis form of AA; therefore, these patients should undergo more aggressive treatment

Ant‐induced alopecia: A new differential diagnosis for nonscarring alopecia

Ant-induced alopecia is a rare condition caused by Pheidole pallidula species. This particular cause of nonscaring alopecia should be considered a new differential diagnosis. Keywords: Pheidole pallidula; alopecia; ants; arthropods; hair

COVID ‐19 vaccination and alopecia areata: a case report and literature review

Coronavirus disease 2019 (COVID-19) is a major concern worldwide and various vaccines have been developed and approved for it, however some immune-related issues of COVID-19 vaccines should be considered and individualized for patients. In this study we report two cases of rapidly progressive hair loss following COVID-19 vaccination