This was a study of monkeypox-infected patients in a tertiary care center in Spain describing the epidemiologic, clinical, and microbiologic features of 49 patients.

Background/Objectives: Several studies havereported that non-alcoholic fatty liver disease (NAFLD) is more frequent in patients with psoriasis, but few have reviewed the presence of liver fibrosis in those patients. Conclusions:Elastography may be a useful tool along with ultrasound to evaluate liver disease in patients with psoriasis.

Data on the effectiveness and safety of a drug in real‐world clinical practice complement the evidence from clinical trials, which are carried out in a different setting. Little has been published on the effectiveness and safety of guselkumab in the treatment of psoriasis in clinical practice. The ojective of this study was to assess the effectiveness and safety of guselkumab at 24 weeks in patients with moderate to severe plaque psoriasis in routine clinical practice. A retrospective, multicentre study of adult patients with moderate to severe plaque psoriasis treated with guselkumab for at least 24 weeks was carried out in Spain. We studied 343 patients, 249 of whom were followed for 24 weeks. By week 24, the mean (SD) psoriasis area severity index (PASI) had decreased from 11.1 (7.3) to 1.7 (2.8) (−9.3; [−10.2;‐8.4]), 85.9% of the patients had achieved PASI score of 4 or less and 77.9% a PASI score of 2 or less. In terms of relative PASI response, 59.4% of the patients achieved a PASI‐90 response and 49.0% a PASI‐100 response. On multivariate analysis, two factors reduced the probability of a PASI of 2 or less at 24 weeks: a BMI ≥30 (OR, 0.44; 95% CI, 0.22–0.88) and a greater previous exposure to biologic therapy (OR, 0.69; 95% CI, [0.56–0.84]). Adverse events were rare (9.9%) and led to withdrawal from treatment in only nine patients (2.6%) by the end of the follow‐up period. The results of this study confirm the high efficacy and safety of guselkumab indicated by the clinical trial data. In clinical practice, the absolute PASI score appears to be a better marker of response to treatment than the relative value.

Background Since 2009, an increasing number of published cases of allergic contact dermatitis (ACD) from isothiazolinones in Europe was observed, amounting to an epidemic. However, only few studies have assessed the current situation after changes in European regulation. Objectives To analyze the incidence of isothiazolinone‐related ACD in our area in the last decade. Methods A retrospective study analyzed all patients patch tested in the allergy unit in a tertiary hospital in Spain between January 2010 and June 2019. Positive patch‐test reactions to methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) and/or MI alone were recorded. Results A total of 243 patients (9.55%) with positive patch‐test reactions to MCI/MI and/or MI alone among 2544 consecutively patch‐tested patients were recorded. An initial increase in the prevalence of MCI/MI allergy was observed, from 4.5% in 2010 reaching a peak in 2015, which was followed by a significant decrease until July 2019 with 3.1% prevalence in 2019. Conclusions As shown in our data, regulatory interventions have resulted in a dramatic decrease in the prevalence of MCI and MI ACD, reaching a pre‐epidemic level of 3.1% in 2019.

Chlorhexidine is one of the most widely used antiseptics in our environment. Allergic contact dermatitis to chlorhexidine is common in adults, but is quite rare in the pediatric population. Its diagnosis is important because it can mimic other dermatoses common during childhood, and it can also lead to acute immediate hypersensitivity | 541 Pediatric Dermatology BRIEF REPORT undiagnosed. 1 Only 4 cases have been reported of ACD to chlorhexidine in pediatric patients without underlying AD. 3-5 Darrigade et al reported the largest case series of pediatric patients with ACD to chlorhexidine. Epicutaneous patch testing for chlorhexidine digluconate was positive in 7 of 14 patients tested, whereas 8 of them exhibited positivity to benzyl alcohol and positivity to both allergens in 4 cases. 1Our work showcases the role of chlorhexidine as a cause for ACD in the pediatric population, especially, but not exclusively, among patients with AD. It is worth noting that a history of surgery at an early age was identified in one patient suggesting the possibility that sensitization had occurred then. We emphasize the clinical utility of ROAT as a simple initial diagnostic approach during the initial evaluation of a patient presenting with symptoms suggestive of ACD to chlorhexidine. The different commercial formulations of this antiseptic must be taken into account, as some regularly used excipients, such as benzyl alcohol, which can also cause ACD. 1 Furthermore, we must inform parents that chlorhexidine is not only present in antiseptic products but also as a component of cosmetics. 2 Last but not least, it is imperative to rule out immediate hypersensitivity reactions, as even mild cases of ACD can indicate a potential risk of acute hypersensitivity reactions following successive exposures to chlorhexidine. 6

Coronavirus disease 2019 (COVID‐19), caused by severe acute respiratory syndrome‐related coronavirus 2 (SARS‐CoV‐2), was first reported in China on December 2019. Almost 5 months into the pandemic, little is still known about cutaneous manifestations in COVID‐19. In fact, the prevalence of cutaneous signs varies greatly in the literature, ranging from 0.2% to 20.4%. Given their potential association with COVID‐19, acral lesions have received special attention worldwide, both in the medical literature and the media. Our aim is to share our experience regarding acral manifestations during this pandemic.

No abstract

Dupilumab, a biologic drug approved for the treatment of moderate-to-severe atopic dermatitis, has been associated with resolution or improvement in pre-existing alopecia areata. We report a case of significant improvement of AA after Dupilumab-onset treatment for atopic dermatitis and review the literature.