Background Cutaneous manifestations of COVID-19 may be useful disease markers and prognostic indicators. Recently, post-infectious telogen effluvium and trichodynia have also been reported. Objective To evaluate the presence of trichodynia and telogen effluvium in patients with COVID-19 and describe their characteristics in relation to other signs and symptoms of the disease. Methods Patients with a history of COVID-19 presenting to the clinics of a group of hair experts because of telogen effluvium and/or scalp symptoms, were questioned with regards about their hair signs and symptoms in relation to the severity of COVID-19 and associated symptoms. Results Data from 128 patients were collected. Telogen effluvium was observed in 66.3% of patients and trichodynia in 58.4%. Trichodynia was associated to telogen effluvium in 42.4% of cases and was associated to anosmia and ageusia in 66.1% and 44.1% of cases, respectively. In the majority of patients (62.5%), hair signs and symptoms started within the first month post-COVID-19 diagnosis and in 47.8% of patients after 12 weeks or more. Limitations Recruitment of patient in specialized hair clinics, lack of a control group, and lack of recording of patient comorbidities. Conclusion The severity of the post-viral telogen effluvium observed in patients with a history of COVID-19 infection is influenced by COVID-19 severity. We identified an early onset (<4 weeks) and a late onset (>12 weeks) telogen effluvium.

Biologic drugs represent a substantial progress in the treatment of chronic inflammatory immunologic diseases. However, its crescent use has revealed seldom reported or unknown adverse reactions, mainly associated with anti-tumor necrosis factor (anti-TNF). Psoriasiform cutaneous reactions and few cases of alopecia can occur in some patients while taking these drugs. Two cases of alopecia were reported after anti-TNF therapy. Both also developed psoriasiform lesions on the body. This is the second report about a new entity described as 'anti-TNF therapy-related alopecia', which combines clinical and histopathological features of both alopecia areata and psoriatic alopecia. The recognition of these effects by specialists is essential for the proper management and guidance of these patients.

A psoríase possui diversas formas de apresentações clínicas. Lesões hiperceratósicas podem ser observadas e verificam-se na literatura diversas denominações para essas lesões, como elefanthine, rupióide, ostrácea e pseudocórnea. É interessante notar que duas dessas denominações se remetem à semelhança com conchas encontradas nos estudos de conquiliologia: rupióide e ostrácea. Os autores comparam os aspectos morfológicos das variantes da psoríase hiperceratósica com as conchas de diversas espécies de moluscos.

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