Erythema multiforme and COVID-19. what do we know

Background: Erythema multiforme (EM) is an acute cutaneous eruption often associated with infections and more rarely with drugs. This review aimed to evaluate the association between erythema multiforme and coronavirus disease 2019 (COVID-19). Methods: A systematic search of PubMed/MEDLINE, Scimago Scopus, and ISI/Web of Science was performed. Original articles, case series, or case reports were evaluated and selected. Results: Fourteen articles were selected, describing a total of 70 patients. EM is a cutaneous eruption rarely occurring in COVID-19 and is, in most cases, associated with a hypersensitivity reaction to the virus. In these cases, EM seems to affect patients younger than 30 years or older than 55 years. Infrequently, some drugs used in the management of COVID-19 may induce EM, especially hydroxychloroquine. The three groups of patients seem to have different clinical characteristics and courses. Conclusions: From these data, it is possible to preliminarily propose that EM or EM-like eruptions linked to COVID-19 might be divided into three types: the virus-related juvenile type (affecting patients <30-year-old), the virus-related older type (affecting patients >55 years), and the drug-induced type. The occurrence of a skin rash does not seem to be related to the severity and clinical course of COVID-19

[pt] PREVISÃO NUMÉRICA DE ESCOAMENTO BIFÁSICO EM TUBULAÇÕES UTILIZANDO O MODELO DE DESLIZAMENTO

Na produção de gás e petróleo em campos de águas profundas são comumente encontrados trechos verticais de dutos (risers) na aproximação final à plataforma. Nesta configuração, podem ocorrer escoamentos bifásicos no regime de golfadas severas (severe slug) que gera alternância na produção da fase gasosa e líquida. Esta alternância é caracterizada por períodos de produção de gás sem líquido seguido de altas taxas de produção de ambas as fases. O regime severo de golfadas é geralmente descrito em quatro fases: formação da golfada, produção da golfada, rompimento da golfada pela fase gás e fluxo reverso do que restou da fase líquida. Este regime induz o escoamento a condições mais extremas do que um outro regime, visto que resultam em um aumento de pressão no duto durante a formação da golfada e em um aumento na taxa de produção durante a expulsão da mesma. O presente trabalho consiste da simulação numérica do regime de golfadas severas para um trecho de tubulação horizontal seguido de outro vertical, assim como apresentar uma análise de um regime estatisticamente permanente. A previsão do escoamento é obtida utilizando-se uma formulação unidimensional baseada no modelo de Drift. A freqüência das golfadas é comparada com outros estudos numéricos da literatura, obtendo-se uma concordância bastante satisfatória.In the gas and oil offshore deep water production is usual to find risers in Production Unit final approach. Regarding to this configuration, two-phase flows can evolve to a severe slug regime that create gas and liquid alternate production. This cyclic behavior is characterized by periods of gas production followed by very high liquid and gas flow rates. The severe slug flow regime is normally described as occurring in four phases: slug formation, slug production, blowout, and liquid fallback. This flow regime introduces new conditions that can be found in other regimes because of the pressure increase during the slug formation and the large flow rates during the slug production. The present work consists of the numerical simulation of the severe slug flow regime into a horizontal pipeline section followed by a vertical section, as well as to present an statistically steady state analysis. The flow prediction is obtained through a one-dimensional formulation based on the Drift Flux Model. The slug frequency is compared with other numerical studies available in the literature, and a very satisfactory agreement is obtained

Cutis marmorata telangiectasica congenita: caso clinico

La cutis marmorata telangiectasica congenita (CMTC) è una rara e sporadica condizione congenita caratterizzata dalla presenza di una persistente cute marmorata, teleangectasie, flebectasie e possibile ulcerazione e atrofia cutanea. Diverse anomalie sono state frequentemente riportate in associazione a CMTC. La più comune anomalia associata è l’asimmetria di zone del corpo (comunemente iperplasia o ipoplasia degli arti), seguono altre anomalie vascolari (malformazioni capillari), glaucoma, e meno frequentemente alterazioni psicomotorie e/o ritardo mentale. L’evoluzione è caratterizzata da una rapida risoluzione delle lesioni nei primi due anni di vita. Rari i casi in cui si ha persistenza delle lesioni. Inoltre risultano essere pochi i casi di CMTC seguiti con un follow-up a lungo termine. Noi riportiamo il caso di una paziente con persistente CMTC, di 30 anni, con ipoplasia delle estremità inferiori e con le caratteristiche lesioni cutanee reticolari, a macchia, di colore blu-rosa che non scomparivano con il variare della temperatura. La paziente non presentava atrofia cutanea, ulcere, glaucoma e macrocefalia. La terapia della CMTC persistente si presenta difficoltosa e la laser terapia necessita di maggiori studi. Abbiamo trattato le lesioni con laser a luce pulsata con ottimi risultati sulla involuzione delle lesioni

Post-Stroke Asymmetric Prurigo Nodularis Responding to Dupilumab Treatment: A Case Report

Prurigo nodularis (PN) is a dermatological condition characterized by nodular hyperkeratotic lesions mainly on the legs and arms. Asymmetrical PN is a rare dermatological condition often associated with paralysis and stroke. In this paper, we present the case of a 77-year-old woman who developed post-ictal PN which responded to dupilumab, an anti-interleukin-4/13 drug approved for the management of AD, with an extreme reduction in itch sensation. Dupilumab and other therapies reducing Th2 inflammation may, in the future, become an alternative treatment for post-ictal pruritus/PN nonresponding to traditional therapies. Of course, larger studies will be necessary to confirm our case’s findings

Topical 5% Imiquimod Sequential to Surgery for HPV-Related Squamous Cell Carcinoma of the Lip

Background: Squamous cell carcinoma (SCC) is one of the most common neoplasms affecting the oral cavity and the face. Its more differentiated forms may be associated with human papilloma virus (HPV) infection. Case report: In this paper, we report the case of an 86-year-old patient with a well-differentiated SCC of the lower lip associated with HPV treated with surgery with a non-complete histological resolution. Imiquimod 5% cream was applied on the surgical scar once a day for two weeks and then once a week. Two years after SCC removal, no relapse has occurred. Conclusions: Topical imiquimod may be a safe and effective treatment after surgery in SCC of the oral area to reduce the risk of relapses

Picosecond Q-Switched 1064/532 nm Laser in Tattoo Removal: Our Single Center Experience

Background: Tattoo removal is becoming increasingly popular, and Q-switched lasers represent the gold standard in the treatment of this condition. In this study, we report our experience with a new Q-switched picosecond laser device, evaluating its effectiveness and safety. Methods: A total of 34 patients asking for tattoo removal were consecutively enrolled in this open study. The clinicians decided on operating settings based on the Fitzpatrick phototype, the type of tattoo, and the tattoo location. A maximum of seven sessions, with a minimum interval of eight weeks between each session, were performed. At the six month follow-up visit following the last treatment session, patient satisfaction was assessed using a visual analogue scale and two dermatologists evaluated the aesthetic outcome based on pictures taken before and after treatment. Results: A total of 34 patients were included and analyzed: 17 females (50%) and 17 males (50%). The mean patient age was 43.6 ± 11 years. Participants’ Fitzpatrick skin type ranged from II to IV. The mean number of treatment sessions performed was 3.3 ± 2.0 per patient. Over 40% of patients showed complete removal of the tattoo, with most of the patients indicating satisfaction with the treatment. Conclusions: The Q-switched 1064/532 nm laser may be considered the gold standard treatment for tattoo removal. Picosecond pulses seem to guarantee fewer sessions and excellent results when compared to other laser systems in tattoo removal

An Innovative Dual-Wavelength Laser Technique for Atrophic Acne Scar Management: A Pilot Study

Background and Objectives: Acne scars are one of the most disturbing and long-term symptoms of acne vulgaris, having a negative impact on a person’s physical, emotional, and social well-being. Aim: the purpose of the study was to evaluate the efficacy and post-treatment outcomes of a dual-wavelength system combining the irradiation of two wavelengths at 10,600 nm and 1540 nm in the management of facial atrophic acne scars. Materials and Methods: Four healthy adult volunteers aged 24–53 years were enrolled. The areas treated were the full face (two patients), cheeks (one patient), and forehead (one patient). A dual-wavelength system (1540 nm and 10,600 nm) was used for this study. Patients underwent 2–4 treatment sessions, and the treatments were performed once every 45–90 days. All possible side effects such as burning sensation, dyschromia, mild to moderate post-treatment erythema, bleeding, itching, edema, and crusting were checked. The index to assess edema and erythema was based on a four-point scale (none, mild, moderate, and severe) and was applied before and at 3-month follow-up (3 MFU) after the last treatment session. In addition, a patient assessment was conducted before treatment and at 3 MFU after the last treatment session. Results: For all patients examined, the edema index was mild, while for the erythema index, 3/4 patients experienced moderate and 1/4 patients experienced mild symptoms. The mean patient downtime was 5.8 ± 0.5 days. Concerning the patient assessment, 2/4 subjects showed excellent improvement, 1/4 patients showed good improvement, and 1/4 patients showed slight improvement. As shown by the photographic assessment, a noticeable improvement in skin texture and a substantial reduction in acne scars were observed at the end of treatment. Conclusions: This dual-wavelength laser technology has the potential to be an interesting and safe approach for acne scar treatment, with a low risk of scarring/hypopigmentation and a shorter healing time

Erythema Migrans-like COVID Vaccine Arm: A Literature Review

COVID Vaccine Arm (CVA) is an adverse drug reaction from mRNA vaccine for SARS-CoV-2. CVA is characterized by erythema and edema on the vaccination site (usually deltoid area) that appears from 5 to 10 days after vaccination and is sometimes associated with itching or pain. The exact etiology of CVA is still unclear, but delayed hypersensitivity against an excipient seems to play an essential role in the pathogenesis of the disease. This work performs a systematic literature review on CVA using three different databases containing articles published until 10 November 2021. The literature review includes eight papers reporting single cases or case series of CVA. Moreover, it also addresses, other cutaneous reactions following COVID 19 vaccinations as well as possible differential diagnosis. CVA migrans-like erythema is characterized by a ring-shaped rash in the injection area, which appears some days after the injection and disappears in about 10 days. This reaction may appear more rapidly in subsequent doses

Nanosecond Q-switched 1064/532 nm laser to treat hyperpigmentations. a double center retrospective study

(1) Benign hyperpigmentations are a common problem in cosmetic dermatology. Melasma, solar lentigo, and other acquired hyperpigmentations represent an aesthetic issue for an increasing number of patients. The gold standard in managing this condition is currently 1064/532 nanometers (nm) Q-Switched lasers. This study reports our experience on the use of a Q-switched laser with a nanosecond pulse to treat these conditions. (2) Methods: A total of 96 patients asking for benign hyperpigmentation removal were consecutively enrolled at the Magna Graecia University of Catanzaro and Tor Vergata University of Rome. Treating parameters were the following: 1064 nm with a pulse duration of 6 nanoseconds (ns) for dermic lesions and 532 nm with 6 ns for epidermal ones. Up to five treatments with a minimum interval between laser treatments of thirty days were performed. A follow-up visit three months after the last session assessed patient satisfaction with a Visual Analogue Scale (VAS). Two blinded dermatologists assessed the cosmetic result using a five-point scale comparing pictures before treatment and at follow-up. (3) Results: 96 patients were included; 47 participants were women (49.0%) and 49 men (51.0%). The mean reported age was 50.0 ± 17.3 years. All patients reached a good to complete hyperpigmentation removal at the dermatological evaluation with a mean VAS score of 8.91 ± 1.07. (4) Conclusions: Q Switched 1064/532 nm laser may be considered the gold standard treatment for benign hyperpigmentations. Our results confirm the literature findings on the effectiveness of these devices