Background Coronavirus disease (COVID‐19) is related to several extrapulmonary disorders; however, little is known about the clinical, laboratory, and histopathological characteristics of pernio‐like skin lesions associated with COVID‐19 infection. Objective To evaluate and summarize the clinical, laboratory, and histopathological characteristics of pernio‐like lesions reported in the literature. Methods We conducted a search of the PubMed, SciELO, and ScienceDirect databases for articles published between January 1, 2020 and November 30, 2020, following the PRISMA recommendations (PROSPERO registration ID: CRD42020225055). The target population was individuals with suspected or laboratory‐confirmed COVID‐19 with pernio‐like lesions. Observational studies, research letters, and case/series reports were all eligible for inclusion. Observational studies were evaluated using a random‐effects model to calculate the weighted mean prevalence, overall mean, and 95% confidence interval. We evaluated case studies using the chi‐square test for dichotomous variables and the Mann‐Whitney test for continuous variables. Results A total of 187 patients from case reports and 715 patients from 18 observational studies were included. The mean age of patients was 16.6 years (range 14.5‐18.8). Feet were affected in 91.4% (87.0‐94.4%) of patients in observational studies. The proportion of patients with a positive RT‐PCR test was less than 15%. Lesion topography and morphology were associated with age. Conclusion Lesions mostly occurred in pediatric patients, and the morphological characteristics tended to differ between pediatric and non‐pediatric populations. There is a possible multifactorial component in lesion pathophysiology. The non‐positivity of laboratory tests does not exclude an association with COVID‐19. Pernio‐like lesions may be a late manifestation of COVID‐19.

Pyoderma gangrenosum is an uncommon and recurrent neutrophilic dermatosis of unknown cause. The lesions usually start as tender sterile papulopustules or erythematous nodules that undergo necrosis followed by ulceration. The lower limbs are most commonly affected and around half of the cases are associated with systemic disorders. Although rare, cases of pyoderma gangrenosum with extramucocutaneous sterile neutrophilic infiltrate have been reported, with the lungs being the most commonly affected organ. We report a case of pyoderma gangrenosum with splenic and renal impairment. Pyoderma gangrenosum should be considered a multisystemic disease with classic cutaneous manifestations and potential involvement of internal organs.

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A B S T R A C T ObjectiveTo investigate the association of the neck circumference with cardiometabolic risk factors and the Framingham risk score. MethodsThe study was a cross-sectional population-based one with 948 adults (522 women) aged 20-59 years. Sociodemographic, anthropometric, body composition, behavioral, biochemical, and hemodynamic factors were evaluated. The association between neck circumference, anthropometric variables, body composition and cardiometabolic risk factors was evaluated by multiple linear regression, adjusted for sociodemographic and behavioral factors. ResultsAre presented as β coefficients, standard errors, and 95% confidence intervals with a 0.05 significance level. The neck circumference was positively associated with triglycerides, insulin resistance index, uric acid, systolic and diastolic blood pressure, C-reactive protein, waist circumference, body mass index and total body fat estimated by dual energy X-ray absorptiometry. The neck circumference and high-density lipoprotein cholesterol were negatively associated, even after adjustment for sociodemographic and behavioral factors. Individuals with a neck circumference below the cut-off point to predicting cardiometabolic risks, 39.5cm for men and 33.3cm for women, had lower probability of having a coronary event in 10 years compared to those with a neck circumference above the cut-off point. ConclusionNeck circumference is an alternative measure to estimate body fat and as an additional marker to screen for cardiovascular risk diseases.Keywords: Anthropometry. Insulin resistance. Neck. Obesity. Risks. R E S U M O I N T R O D U C T I O NObesity is a public health problem associated with cardiovascular diseases, the prevalence of which is increasing worldwide [3][4][5]. Excess fat, especially in the upper body, is associated with lipid profile changes, increased blood pressure and hyperinsulinemia, factors that increase the Cardiovascular Disease (CVD) risks [6][7][8].The accumulation of body fat can be quantified by standard gold methods such as computed tomography and nuclear magnetic resonance, allowing an assessment of the Revista de Nutrição Rev. Nutri., Campinas, 30(6):771-781, nov./dez

Natural substances are used in folk medicines to treat injuries. Strychnos pseudoquina has scarring, antipyretic, and antimalarial actions. The present study aimed to analyze the effect of S. pseudoquina on cutaneous wound healing in rats. The S. pseudoquina extract was submitted to phytochemical prospection. The levels of flavonoids and total phenolic compounds in the extract were 50.7 mg/g and 2.59 mg/g, respectively. Thirty Wistar rats were individualized in cages with food and water ad libitum (registration no. 730/2014). After anesthesia, three circular wounds (12mm diameter) were made in the animals, which were randomly separated into five treatments: Sal, saline; VO, ointment vehicles (lanolin and Vaseline); SS, positive control (silver sulfadiazine 1%); LE 5, freeze-dried extract 5%; and LE 10, lyophilized extract 10%. The animals were treated with the ointment daily for 21 days. Every seven days, the area and the rate of wound contraction were evaluated. Tissue samples were removed for histopathological analysis of the number of mast cells, elastic and collagen fibers, and biochemical analyses, quantification of malondialdehyde (MDA), carbonylated proteins (PCN), superoxide dismutase (SOD), catalase (CAT), transforming growth factor β (TGF-β), Interleukin 10 (IL-10) and tumor necrosis factor (TNF). The number of mast cells, collagen and elastic fibers in the rat wounds were higher in the treatments with the plant. The extract also stimulated the activity of antioxidant enzymes, particularly SOD, presenting high levels, and maintained low levels of PCN. The TGF-β and IL-10 concentration was higher in the LE5 and LE10 treatment of the extract than in the Sal, OV and SS treatments on day 7. The ointment based on S. pseudoquina closed the wound faster and accelerated wound healing in animals.