Omalizumab (OMZ) is a recombinant, humanized, and monoclonal immunoglobulin G1 (IgG1) anti-IgE antibody approved in patients 12 years of age and older with chronic spontaneous urticaria (CSU) resistant to H1 antihistamines. OMZ blocks IgE binding to its high-affinity FCεRI, resulting in a reduction in free IgE and IgE-mediated reactions. 1 The data on the use of OMZ during the coronavirus disease 19 (COVID-19) pandemic are limited, and our current knowledge is mainly based on case reports. It is recommended to continue OMZ in patients with mild-to-moderate COVID-19, and to prolong the dose intervals or interrupt the treatment according to the patient-based risk-benefit analysis in case of severe disease. 2,3 The aim of this study was to evaluate 1) the prevalence of COVID-19 infection, 2) maintenance of omalizumab treatment, 3) vaccination status, and 4) exacerbation of urticaria symptoms related to COVID-19 infection or vaccination in patients with CSU using omalizumab during the pandemic.

No abstract

The current studies focus on the association between COVID‐19 and certain comorbidities. To the best of our knowledge, the association between severe COVID‐19 and dermatologic comorbidities has not been reported yet. In this study, we aimed to describe the dermatologic comorbidities of patients with severe COVID‐19 and compare it with the control group. Patients who have died at Uşak Training and Research Hospital due to COVID‐19 and other diseases in the COVID‐19 Intensive Care Units and Internal Medicine Intensive Care Units were recruited into the study. Two groups were compared with each other regarding the most common dermatologic comorbidities. A total of 198 patients including 111 patients with COVID‐19 and 87 age and sex‐matched patients with other diseases were enrolled in the study. The most common dermatologic comorbidities were pruritus (8.1%), eczema (6.3%), skin infections (3.6%), leukocytoclastic vasculitis (1.8%), and urticaria (0.9%) in the COVID‐19 group while they were skin infections (9.2%), eczema (3.4%), pruritus (2.3%), and urticaria (1.1%) in the control group. None of patients in the control group had leukocytoclastic vasculitis. There were no significant differences between COVID‐19 and control groups in terms of pruritus, eczema, skin infections, and urticaria (P values were .117, .517, .181, .505, and 1.000, respectively). In conclusion, although it is not statistically significant, it appears that pruritus and leukocytoclastic vasculitis are more common in severe COVID‐19 patients. These cytokines‐related diseases in the immuno‐cutaneous systems may give some clues on the COVID‐19 severity. Further studies are required to elucidate the relationship between the immuno‐cutaneous system and COVID‐19 severity.

Background: Patients with acne vulgaris continue to present increasingly in dermatology outpatient clinics and seek treatment during the COVID-19 pandemic. As far as we know, the effect of isotretinoin on COVID-19 has not been studied before. Aim:We aimed to evaluate whether patients receiving oral isotretinoin are at increased risk of COVID-19 infection by comparing them with patients on topical treatment for acne vulgaris. Methods:The data were collected retrospectively from a cohort of 267 acne vulgaris patients, who were under follow-up for acne vulgaris treatment during the pandemic period.

Background: Chronic spontaneous urticaria (CSU) is a mast cell-mediated disease, which is sometimes associated with various inflammatory disorders.Omalizumab is a commonly used biological agent, which is a recombinant, humanized, monoclonal antibody against human immunoglobulin E. However, there are only few reports about the combination of omalizumab for CSU with any other biologics for accompanying inflammatory diseases in the literature. The aim of this study was to evaluate the patients whose treatment of omalizumab for CSU were combined with any other biologics for associated inflammatory disorders and to describe whether these combinations might have any safety concerns. Methods:We conducted a retrospective cohort study of adult patients with CSU treated with omalizumab concurrently using another biological agent for their other dermatological conditions.Results: Thirty-one patients, 19 women and 12 men, were evaluated. The mean age was 45.13 years. The median duration of omalizumab was 11 months.Biological agents which patients were treated other than omalizumab were as follows: adalimumab biosimilar (n = 3), ustekinumab (n = 4), secukinumab (n = 17) and ixekizumab (n = 7). The median duration of concurrent use of omalizumab and other biologics was 8 months. None of the drug combinations was stopped because of side effects. Conclusion:This observational study demonstrated that omalizumab treatment for CSU in combination with any other biological agents for dermatological disorders appeared to be well tolerated without any major safety concerns.

Introduction: Telogen effluvium (TE) is one of the causes of non-scarring hair loss that occurred commonly 2-3 months after a triggering factor. It was reported that the incidence of TE increased during the COVID-19 (coronavirus disease 2019) pandemic.However, to date, there is no study evaluating the status of COVID-19 before the onset of hair loss in patients with TE. The aim of this study is to evaluate the patients with TE whether they had COVID-19 or not before the onset of their hair loss and to compare the demographic and clinical characteristics and laboratory parameters of those with and without a history of COVID-19. Method:We conducted an observational cohort study of TE patients. The diagnosis of TE depended on anamnesis and physical examination of the patients. Also, hair pull test was performed. Demographic data and the results of COVID-19 real-time polymerase chain reaction (RT-PCR) were recorded from the electronic medical records.Results: Totally, 181 patients with TE were included in the study. Sixty-four of patients (35.4%) had been diagnosed with COVID-19 before the hair loss started. The median duration of development of hair loss was 2 months (range 1-11 months, IQR 3) after COVID-19 diagnosis. In this group, 87.5% of patients (n = 56) had acute TE and 12.5% of patients (n = 8) had chronic TE. The rate of acute TE and the use of vitamin supplements were ignificantly higher (p < 0.001 and p = 0.027, respectively) and the monocyte count in peripheral blood was lower (p = 0.041) in the group diagnosed with COVID-19. Discussion and Conclusion:It was stated that monocytes and macrophages infected by SARS-CoV-2 can produce pro-inflammatory cytokines that play a crucial role in the development of COVID-19-related complications. Also, it was suggested that the number of monocytes tends to be lower in the late recovery stage. The lower monocyte count in patients with a history of COVID-19 in our study may be related to evaluating the patients in the late period of recovery and the migration of circulating monocytes to hair follicles. The history of COVID-19 must be questioned in patients with TE. It should be kept in mind that hair loss that develops after COVID-19 may be presented as chronic TE form too. The exact mechanisms of hair loss induced by COVID-19 are not fully explained; the roles of monocytes on the hair follicles may be one of the responsible mechanisms. How to cite this article: Koç Yıldırım S, Erbağcı E, Demirel Öğüt N. Evaluation of patients with telogen effluvium during the pandemic: May the monocytes be responsible for post COVID-19 telogen effluvium?

Background Dupilumab is approved for the treatment of atopic dermatitis (AD). However, there are few studies demonstrating its efficacy and safety, particularly in the treatment of adult‐onset AD. Objective The aim of this study is to evaluate the real‐life experience regarding the efficacy and safety of dupilumab in the treatment of adult‐onset AD. Methods This study is a case series in retrospective design. Patients with the diagnosis of adult‐onset AD, using dupilumab at a standard dose for at least 3 months, were included in the study. Demographic and laboratory data of the cases, data regarding to dupilumab treatment, were recorded. The eczema area severity index (EASI) and the visual analog scale (VAS) for itch were used to evaluate treatment efficacy. Results A total of 16 patients, 6 female and 10 male, were included. The median age was 41 years, the median age of the disease onset was 37.5 years, and the median duration of the disease was 90 months. The median duration of the dupilumab treatment was 10.5 months. The mean percent reduction from baseline in EASI score was 85.8 ± 12.2 at 3 months, 90.7 ± 9.3 at 6 months, and 93.1 ± 5 at 12 months. The mean percent reduction from baseline in VAS itch score was 82.2 ± 8.6 at 3 months. Acute vestibular neuritis was developed in one patient during the dupilumab therapy and resolved with anti‐inflammatory therapy. Conclusion Dupilumab seems to be highly effective and safe in the treatment of adult‐onset AD. The present study is important as it is the first study to evaluate this patient group specifically.

have significantly different mortality rates compared to those without these conditions (Table 1).Further analysis of the populations on targeted therapies revealed no significant associations in both the COVID-19 infection rates or hospitalization rates of women with acne, PCOS, or hirsutism on spironolactone, estradiol, or metformin (P > 0.05) (Table 2).Our results suggest that there is no evidence for an increased risk of COVID-19 infection, hospitalization, or mortality in women with acne vulgaris, PCOS, or hirsutism. Additionally, management with common medications was not associated with COVID-19 infection risk. In particular, spironolactone, which was speculated early in the pandemic to increase the risk of COVID-19 infection by increasing circulating angiotensin converting enzyme (ACE), did not appear to influence infection risk in our patients. The lower COVID-19 rates of