In Patient_2, bortezomib was discontinued in October 2017 since she had reached partial response with decrease of the monoclonal component. Nine months later, biochemical progression and new bone lesions, with 18% of plasma cells in the bone marrow aspirate, prompted her hematologists to consider starting another proteasome inhibitor. Although no previous reports on tolerance to alternative proteasome inhibitor in patients with a history of severe skin reactions to bortezomib had been published, we set out to try carfilzomib (KYPROLIS ® , Amgen Inc., Thousand Oaks, CA, USA), since its molecular structure was different enough to predict a low level of cross-reactivity. SPT (2 mg/mL) and IDT (0.2 mg/mL) to carfilzomib were negative both at immediate and delayed reading. A controlled intravenous challenge with carfilzomib (20 mg/m 2 ) was performed in a hospital setting in July 2018, with good tolerance. The patient received two more cycles without any side effects.Here, we present two new cases of confirmed delayed hypersensitivity to bortezomib with positive late-reading intradermal tests that suggest an underlying T-cell mechanism. To our knowledge, this is the first report of a desensitization schedule to bortezomib and the first evidence that carfilzomib is well tolerated and can be considered as a safe alternative in patients with delayed hypersensitivity to bortezomib. CONF LICTS OF INTERESTThe authors declare that they have no conflicts of interest.In our experience, negative cases occurred mainly in users, without fingertip affectation and with more facial and leg involvement. The final predominant diagnosis was irritant hand dermatitis whichshould be always reached after ruling out sensitization to acrylates.As conclusions, our study confirms a prehensile pattern in patients who apply the substance (professionals or "do it yourself" users) and a different clinical location of lesions in negative patch tested patients. We highlight the limitation in work ability created in our patients which in many cases required a definitive change of job, and the potential sensitization to acrylates in general population, specially when these substances are self-applied by the user. CONF LICTS OF INTERESTThe authors declare that they have no conflicts of interest.

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Grover-like skin eruption: another cutaneous manifestation in a COVID-19 patient Dear Editor, Coronavirus disease 2019 (COVID-19) is caused by a new virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and can affect different organs and produce a wide variety of symptoms. Many cutaneous manifestations have

Mycosis Fungoides is the most common cutaneous T-cell lymphoma however, it is rare in children. We present the case of a Folliculotropic Mycosis Fungoides in a 13-year-old boy which initially presented as a plaque on his face and was treated with local PUVA therapy. Afterwards the lesions spread so the treatment was changed to systemic PUVA with good response. Although the experience in the treatment of Mycosis Fungoides in pediatric patients is limited, PUVA therapy seems to be an effective and safe option.

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