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Objectives Rapid identification of infected subjects is a corner stone for control of a pandemic like the current one with the SARS-CoV-2. Easy to handle antigen tests can provide timely results which is of specific importance in a primary care setting. However, concerns exist regarding their sensitivity, which let us evaluate four commercially available tests in patients hospitalized for COVID-19. Methods We analyzed in parallel nasopharyngeal/oropharyngeal swabs from 87 consecutive patients admitted to our department with moderate to severe COVID-19 by means of quantitative RT-PCR (Cobas, Roche) and up to four antigen tests from different distributors. Antigen test results were linked to Ct (cycle threshold) values as a marker for infectivity of patients. Results We found that two out of four antigen tests correctly identified subjects with high viral loads (Ct ≤25) and three out of four tests detected more than 80% of subjects with a Ct ≤30 which is considered as a threshold for infectivity. However, one test investigated had a poor clinical performance. When investigating subjects with Ct values >30 we found that in up to 45% of the cases the antigen test was still positive. Conclusion Most antigen tests had a sufficient sensitivity to identify symptomatic subjects infected with SARS-CoV-2 and with transmissible infection. On the other hand, antigen testing may not be suitable to identify loss of infectivity in COVID-19 subjects during follow-up. Newly introduced antigen tests need to be validated in a clinical or primary care setting to define their clinical usefulness.

SummaryThe objective ofthe study was to assess the impact of psychological/psychiatric assessment in patients with chronic or intractable dermatological conditions. A diagnostic interview was undertaken in order to pin-point any temporal connection between an adverse life-event and the first appearance of the skin disorder. Following this, the dermatologist's assessment of subsequent changes in the skin disorder were noted. The three main dermatological diagnoses were atopic eczema (10), prurigo (10), and psoriasis (nine). Follow-up was for up to 5 years.A favourable response was noted in 40 out of the 64 patients who participated in the study; this was usually evident within a few weeks and maintained thereafter. Remission was achieved in 12, while 28 showed some improvement. We conclude that this liaison between dermatology and psychiatry proved a valuable adjunct to normal dermatological treatment and was followed by improvement in the majority of patients.

Background Calcipotriol ointmetit is an effective treatment for psoriasis vuigaris. Although cream formu[ations have a less emollient effect they are often more acceptable to patients.Objective To compare calcipotriol 50 ^ag/g in two different cream formulations with vehicle in patients with psoriasis vulgaris.Method A randomised, double-blind, parallel group, multi-centre, comparison of cream A in which calcipotriol 50jLig/g is dissolved, eream B in which ealcipotriol 50 ^lg/g is suspended as fine particles and vehicle. A 2-week wash-out period was followed by 8 weeks double-blind treatment. 153 Assessment The primary efficacy criterion was the change in Psoriasis Area and Severity Index (PASI). Patient and investigator overall assessment of response were secondary response criteria.Results Four hundred-and-thirteen patients received double-blind treatment. Mean reduction in PASI between baseline and end of treatment for cream A was 4.4 (95% CI 3.5-5.3), for cream B 4.2 (95% CI 3.4-4.9) and for placebo 0.8 (95% CI -0.5-2.0), mean reduction in PASI of 49.7% (95% CI 44.2%-55.2%) 48.7% (95% CI 42.7%-54.6%) and 7.1%^ (95% CI -6.2%-20.4%), respectively. 79% of patients treated with cream A, 77% with cream B and 44% with placebo were assessed as clinical success or Improrement (/;< 0.001). Patient assessment showed marked improrement or clearing of 53% with cream A, 49% with cream B and 18% with placebo. All efficacy parameters showed no difference between the two active creams but both were statistically significantly different from placebo.Clinical adverse events and laboratory parameters: The overall incidence of adverse events was 25.9% and similar in the three treatment groups; 84% of these being judged as possibly or probably related to treatment. The most common was lesional or perilesional skin irritation which occurred in 15.2%' with cream A, 10.6% with eream B and 17.2%' with placebo ip = 0.27). Twelve patients were withdrawn due to adverse events, with no statistically significant difference between the 3 groups (p = 0.25). No statistically significant change in serum calcium was recorded.Conclusion Both calcipotriol creams were equally and statistically significantly more effective than vehicle in the treatment of psoriasis vulgaris. There was no statistically significant difference between the three treatment groups in the overall incidence of clinical adverse events.

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