The distribution of PIDs was different from that reported in Western countries, with a particularly high proportion of Combined Immunodeficiencies and phagocyte defects in number and/or function. More is needed to improve PID diagnosis and treatment in our country.

Skin manifestations are frequent among patients with primary immunodeficiency diseases (PIDs). Their prevalence varies according to the type of immunodeficiency. This review provides the reader with an up-to-date summary of the common dermatologic manifestations of PIDs among Tunisian children. We conducted a prospective study on two hundred and ninety children with immune deficiency. Demographic details (including age, sex, and consanguinity) with personal and family history were recorded. Special attention was paid to cutaneous manifestations. Dermatological involvements were grouped according to the etiology of their most prominent sign. Cutaneous manifestations were found in 164 patients (56.5%). They revealed the diagnosis of PIDs in 71 patients (24.5 %). The mean age at presentation was 21 months. Overall the most prominent cutaneous alterations were infectious. They accounted for 106 cases (36.55%). The most prevalent causes of cutaneous infections were bacterial: 93 cases (32.06%). Immuno-allergic skin diseases were among the common findings in our study. These include eczematous dermatitis found in 62 cases (21.38%). Malignancy related PIDs was seen in a boy with Wiskott Aldrich syndrome. He developed Kaposi’s sarcoma at the age of 14 months. Cutaneous changes are common among children with PIDs. In pediatric patients with failure to thrive, chronic refractory systemic manifestations often present in other family members, recurrent cutaneous infections unresponsive to adequate therapy, atypical forms of eczematous dermatitis or unusual features should arouse the suspicion of PIDs and prompt specialized immunologic consultation should be made.

The pandemic coronavirus SARS-CoV-2 poses unprecedented stress on the hematopoietic cell transplantation (HSCT) centers. Immunological recovery after HSCT is habitually required for infection control [1]. However, the natural history of the SARS-CoV-2 in pediatric patients receiving HSCT is largely unknown. Furthermore, the transplantation units are facing many other challenges related to HSCT planning and the risk of SARS-CoV-2 spread among healthcare personnel. A traceable outbreak of SARS-CoV-2 among healthcare workers at an adult HSCT unit was recently reported affecting five nurses [2]. Few separated case reports of SARS-COV2 were published in children receiving HSCT [3,4]. We report on an outbreak of COVID-19 among healthcare workers and patients at a pediatric HSCT unit, measurements taken for its containment, and the outcome of pediatric HSCT recipients diagnosed with SARS-CoV-2 infection. This is, to our knowledge, the first report of the SARS-CoV-2 outbreak in a pediatric HSCT unit.

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