Correspondence urticarial and morbilliform eruptions. Less frequently seen reactions included chilblains, cosmetic filler reactions, herpes zoster or herpes simplex flares, and pityriasis rosea-like reactions. Only two patients had cutaneous vasculitis. Lupus-like skin lesions or lupus deterioration were not reported. 7 Strong agreement exists that all patients with autoimmune rheumatic diseases should be vaccinated against COVID-19. However, SARS-CoV-2 vaccination should be considered as a potential trigger of disease flares, especially in individuals with certain ANA constellations (e.g. anti-Ro/SSA and anti-La/SSB antibodies) predisposing for CLE.

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Dear Editor,The recent approval of highly effective prophylactic vaccines against COVID-19 is a monumental step in the global fight against the ongoing SARS-CoV-2 pandemic. Two types of SARS-CoV-2 vaccines are currently used, messenger-RNA (mRNA) vaccines and recombinant adenoviral (AdV) vector vaccines. 1 Both of them encode the production of the SARS-CoV-2 spike protein, which is the primary target for neutralizing antibodies. We report a case of subacute cutaneous lupus erythematosus (SCLE) that transitioned into systemic lupus erythematosus (SLE) following AdV-vaccination with AZD1222.A 62-year-old woman presented with a generalized morbilliform exanthema and new onset of fatigue and musculoskeletal pain (Fig. 1). Six months before the first visit to our department, the patient had experienced erythematosquamous papules and plaques symmetrically located in the sun-exposed areas (chest, upper back, lower arms, and dorsal hands). Laboratory investigations found a normal blood cell count and serum chemistry, but increased titres for antinuclear antibodies (1 : 320; normal <1 : 160) and positivity for anti-Ro/SSA(60) antibodies. All other extractable nuclear antigens were unremarkable. Further

Summary Background and objectives In recent years, considerable insight has been gained into the pathogenesis, diagnosis and treatment of cutaneous sarcomas, including atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS). Both entities have shown increasing incidence rates in the last decade. This study was initiated to evaluate how these new insights impact the number of diagnoses of AFX/PDS compared to other cutaneous sarcoma entities. Patients and methods In a retrospective study of four German skin cancer centers, all histopathological reports of cutaneous sarcomas (AFX, PDS, dermatofibrosarcoma protuberans, cutaneous leiomyosarcoma, angiosarcoma, and Kaposi sarcoma) confirmed by board‐certified dermatopathologists were analyzed during a time‐period of seven years (2013–2019). Additionally, utilization of immunohistochemical markers (including pan‐cytokeratin, S100, desmin, CD34, CD10, procollagen‐1, CD99, CD14, and CD68) as an adjunct to diagnose AFX/PDS was recorded. Results Overall, 255 cutaneous sarcomas were included in the present study. The diagnosis of a cutaneous sarcoma has consequently risen from 2013 to 2019 (from 16 to 52 annual cases). The results of AFX/PDS revealed 4.6 times more diagnoses in 2019 than in 2013. Atypical fibroxanthoma represented the most common subtype, displaying 49.3 % of all diagnosed cutaneous sarcomas. Additionally, the increase of AFX/PDS was linked to the use of immunohistochemistry, with specific immunohistochemical markers used in 57.1 % of cases in 2013 compared to 100 % in 2019. Conclusions This retrospective study of four German skin cancer centers demonstrates a substantial rise of AFX/PDS, possibly due to recently established diagnostic and terminology standards. This rise is probably linked to increased utilization of specific immunohistochemical markers. Atypical fibroxanthoma/PDS may be more common than previously thought and seems to represent the most frequent cutaneous sarcoma subtype.

We read with great interest the recently published article by Joos et al. on the successful use of baricitinib for cutaneous lupus erythematosus. The authors presented a heavily pretreated case of subacute cutaneous lupus erythematosus (SCLE) with almost complete clearance following 6 months of baricitinib therapy. We would like to add our experiences of baricitinib for SCLE in a patient with concomitant frontal fibrosing alopecia.

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CD30-positive primary cutaneous anaplastic large cell lymphoma (C-ALCL) is an indolent type of cutaneous lymphoma with favourable clinical prognosis. Pseudocarcinomatous hyperplasia (PCH) is a rare benign epithelial condition that can resemble invasive squamous cell carcinoma both clinically and histopathologically. PCH predominantly occurs in CD30-positive lymphoproliferative disorders. We report a 75-year-old woman with PCH in a multifocal C-ALCL located on the scalp and right retroauricular area, which rapidly responded to treatment with psoralen ultraviolet A photochemotherapy. Comprehensive virological analyses for potential oncogenic viruses, including Epstein-Barr virus, human herpesvirus-8, human papillomaviruses, the recently discovered cutavirus and nine different human polyomaviruses, were negative.

The mechanism of onychomadesis (nail shedding) and beau's lines following hand-foot-mouth disease.