Mycosis fungoides (MF) palmaris and plantaris is a rare form of MF. Only few cases are reported in the literature. Different forms are described: eczematous lesions, dyshidrosis lesions, verrucous lesions, dry pulpitis, ulcerated lesions, pustulosis, and hyperkeratotic lesions. Histology is typical for MF with a positive T-cell receptor gene rearrangement in majority of cases. Prognosis is good. Resistance to topical steroids is common, and classical treatment consist of chlormethine gel and radiotherapy.

International Journal of DermatologyVolume 62, Issue 7 p. e370-e371 Correspondence Paradoxical nail psoriasis induced by the IL-17A inhibitor ixekizumab in palmoplantar pustulosis Raphaël André MD, Corresponding Author Raphaël André MD [email protected] Division of Dermatology and Venereology, Geneva hospitals, University of Geneva, Geneva, SwitzerlandSearch for more papers by this authorWolf-Henning Boehncke MD, Wolf-Henning Boehncke MD Division of Dermatology and Venereology, Geneva hospitals, University of Geneva, Geneva, SwitzerlandSearch for more papers by this authorEmmanuel Laffitte MD, Emmanuel Laffitte MD Division of Dermatology and Venereology, Geneva hospitals, University of Geneva, Geneva, SwitzerlandSearch for more papers by this author Raphaël André MD, Corresponding Author Raphaël André MD [email protected] Division of Dermatology and Venereology, Geneva hospitals, University of Geneva, Geneva, SwitzerlandSearch for more papers by this authorWolf-Henning Boehncke MD, Wolf-Henning Boehncke MD Division of Dermatology and Venereology, Geneva hospitals, University of Geneva, Geneva, SwitzerlandSearch for more papers by this authorEmmanuel Laffitte MD, Emmanuel Laffitte MD Division of Dermatology and Venereology, Geneva hospitals, University of Geneva, Geneva, SwitzerlandSearch for more papers by this author First published: 14 April 2023 https://doi.org/10.1111/ijd.16686 Conflict of interest: None. Funding source: None. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. References 1Mylonas A, Conrad C. Psoriasis: classical vs. paradoxical. The Yin-Yang of TNF and type I interferon. Front Immunol. 2018; 9: 2746. 2Mrowietz U, Leonardi CL, Girolomoni G, Toth D, Morita A, Balki SA, et al. Secukinumab retreatment-as-needed versus fixed-interval maintenance regimen for moderate to severe plaque psoriasis: A randomized, double-blind, noninferiority trial (SCULPTURE). J Am Acad Dermatol. 2015; 73(1): 27–36 e1. 3Noell C, McQuade B, Gottlieb A, Rosmarin D. Anti IL-17 flared psoriasis in a patient on secukinumab. Dermatol Ther. 2017; 30(4):e12505. 4El-Komy M, Amer M, Mostafa A, ElKalioby M. Secukinumab retreatment associated psoriasis flare with pustules. J Dermatolog Treat. 2020; 33(2): 1107–10. 5Sladden MJ, Sladden CS, Gulliver WPF. Secukinumab-Induced Psoriasiform Eruption. JAMA Dermatol. 2017; 153(11): 1194–5. Volume62, Issue7July 2023Pages e370-e371 ReferencesRelatedInformation

Dear Editor, “ COVID toes ” are known to be associated with severe acute respiratory syndrome coronavirus (SARS-CoV-2) pathogene-sis. 1 Descriptions are concordant worldwide, however, follow-up is poorly described. Between February 2020 and April 2021, 4 cases lasting >3 months were followed-up in our dermatology clinic.The fi rst patient was a 19-year-old woman without medical history. Two months after the onset of COVID-19 symptoms, chilblains-like acral lesions (CLAL) appeared on her toes (Figure 1). She complained of itching. There was no worsening with cold. SARS-CoV-2 serology was positive, and antinuclear antibodies, cryoglobulin, cryo fi brinogen, cold agglutinin were negative. Chilblains-like acral lesions were still visible 4 months after onset. The second patient was an 18-year-old woman in good health. Two weeks after the onset of COVID-19, asymptomatic CLAL appeared on her toes and fi ngers. SARS-Cov-2 infection was con fi rmed by polymerase chain reaction (PCR). Moreover, she presented with a transient and painless urticarial eruption of the trunk, knees and hands exacerbated by heat and disappearing with cold. We found positive antinuclear antibodies with nucleolar fl uorescence and rheumatoid factor, but there was no clinical systemic lupus sign. CLAL were still visible at 3 months. The third patient was a 60-year-old

Contact dermatitis as an adverse reaction to some topically used European herbal medicinal products part 2: Echinacea purpurea– Lavandula angustifolia. Contact Dermatitis. 2015;72(4):193-205. 5. Farmer PW. The patch test as a means of diagnosis in contact dermatitis. Med J Aust. 1941;1:9-11. 6. Woelk H, Burkard G, Grünwald J. Benefits and risks of hypericum extract LI 160: drug monitoring study with 3250 patients. J Geriatr Psychiatry Neurol. 1994;7:S34-S38. How to cite this article: O'Hagan T, Bisconti I, Leck C, et al. Delayed-type hypersensitivity reaction to St. John's wort extract confirmed by patch testing. Contact Dermatitis. 2022; 87(4):381‐383. doi:10.1111/cod.14172

A 69 years non-atopic man presented with a 6 months history of pruriginous lesions started on his back with subsequent extension to his arms. At clinical examination, erythematosquamous plaques were present on his back, shoulder and arms (Figure 1A). The biopsy showed parakeratosis with intraepidermal oedema and spongiosis with lymphocyte exocytosis in epidermis consistent with eczematous dermatitis. Topical corticosteroids allowed improvement but the lesions relapsed whenever they were stopped. The only change in his environment was his new car with leather seats. Patch tests were performed with the European baseline series, a preservative, a textile series, a piece of his sofa's leather and a piece of his car seat's leather 'as is'. Patch test materials were supplied by Chemotechnique Diagnostics. At the readings on Day (D) 2 and D 4, the patch tests showed positive results for octylisothiazolinone (OIT) 0.1% pet. (++) and the leather car seat samples (++) (Figure 1B). They were negative for methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) 0.01% aq., MI 0.2% aq. and benzisothiazolinone (BIT) 0.1% pet. The patient has used two cream products for the treatment of his leather seats (Creams A and B). Both products lacked information about their composition. These two products as well as a small piece of car seat leather were sent for chemical analysis to the Official Food and Veterinary Control Authority of Geneva. An amount 0.5 g of crushed leather was stirred in 5 ml of methanol (MeOH) and sonicated for 15 min. After 10 min of centrifugation (3500 RCF), the sample was analysed by high-pressure liquid chromatography coupled to a diode array detector from Agilent Technologies. Separation was achieved using a Poroshell 120 EC-C18 column (100 × 4.6 mm i.d.; 2.7 μm) from Agilent technologies maintained at 40°C with a gradient mobile phase consisting of 5 mM ammonium formate (pH 4.2) (Solvent A) and MeOH (Solvent B). The gradient started with 8% B for 1 min and then was linearly increased in serial plates: first to 25% B in 1 min, then to 30% B in 5 min, to 50% B in 4 min and to 70% B in 10.5 min. It was then further increased up to 100% B in 5.5 min and held for 2 min at the final composition. Gradient was then decreased to the starting composition in 0.1 min and equilibrated for 5 min before next injection. Thiazolinone compounds were detected at 274 nm for MI and MCI, 280 nm for OIT and 318 nm for BIT. Two cream products (A and B) were also analysed in the same way. Results are reported in Table 1. OIT was identified and quantified at very high concentration (305 mg/kg) in the leather car seat and was not found in the protective creams suggesting that OIT was originally present in the leather. OIT is a preservative agent with antifungal and antibacterial properties used in different products such as paints, household detergents, cutting and cooling fluids and the leather industry. In the last few years, multiples cases of non-occupational allergic contact dermatitis to OIT in leather goods have been reported.1, 2 Since 2018, in our clinic, this case is the second reported case of leather contact dermatitis due to OIT.3 In collaboration with the Official Food and Veterinary Control Authority of Geneva, 58 random leather goods from the Swiss market (belts, shoes for kids, sofa and etc.) were analysed and surprisingly, OIT was present in 55.1% of them (Table 2) with sometimes high concentrations up to 184 mg/kg (mean concentration: 44.7 mg/kg). Furthermore, the potential harmful effects of OIT on human health are still not well elucidated. Kim et al.4 showed in their in vitro study that OIT induced blood brain barrier dysfunction. Currently, there is no European legislation regarding the maximum authorized concentration of OIT in leather goods. As their usage increases, careful monitoring of contact allergy to this preservative seems indicated. Yassaman Alipour Tehrany: Conceptualization; writing – original draft; writing – review and editing. Raphael André: Writing – review and editing. Aurélie Bugey: Conceptualization; writing – review and editing; methodology; investigation. Doriane Santimaria: Investigation. Patrick Edder: Supervision. Pierre Piletta: Conceptualization; writing – review and editing; supervision. Open access funding provided by Universite de Geneve. The authors declare no conflicts of interest.

Il est désormais admis que les « orteils COVID » sont associés à la pathogenèse du SARS-CoV-2. Les descriptions sont concordantes dans le monde entier, mais le suivi est peu décrit. Nous présentons 4 cas « d'orteils COVID » avec un suivi de plusieurs mois. Entre février 2020 et avril 2021, 4 cas de plus de 3 mois ont été suivis rétrospectivement dans notre clinique dermatologique. Le premier patient était une femme de 19 ans sans antécédent médical. Deux mois après l'apparition des symptômes de la COVID-19, des lésions acrales de type engelures apparaissaient sur les orteils. Elle se plaignait de démangeaisons. Il n'y avait pas d'aggravation avec le froid. La sérologie SARS-CoV-2 était positive, et la recherche d'anticorps antinucléaires, de cryoglobuline, de cryofibrinogène, d'agglutinines froides était négative. Les engelures étaient encore visibles à 4 mois. Le deuxième patient était une femme de 18 ans en bonne santé. Deux semaines après l'apparition des signes de la COVID-19, des engelures asymptomatiques apparaissaient sur les orteils et les doigts. L'infection par le SARS-Cov-2 était confirmée par PCR nasopharyngée. En outre, on observait une éruption urticarienne transitoire et indolore du tronc, des genoux et des mains, exacerbée par la chaleur et disparaissant avec le froid. La biologie montrait des anticorps antinucléaires positifs avec une fluorescence nucléolaire, et un facteur rhumatoïde. Les engelures étaient encore visibles à 3 mois. Le troisième patient était une femme de 60 ans en bonne santé. Peu après les signes de la COVID-19 avec des symptômes typiques légers, apparaissaient des engelures indolores des orteils. Elle notait une exacerbation par la chaleur, mais pas d'aggravation par le froid. Un épisode de nécrose digitale fut observé et les engelures disparaissaient après cinq mois. Le 4e cas était une femme de 20 ans qui souffrait de symptômes compatibles avec la COVID-19. Cependant, aucune PCR nasopharyngée n'était réalisée et la sérologie était négative. Deux mois plus tard, des engelures et une érythromélalgie apparaissaient sur les orteils. Aucune autre cause n'était trouvée. Les symptômes persistaient après 10 mois, avec à certains endroits une évolution nécrotique superficielle. Notre petite série de cas montre une durée d'évolution des engelures de 3 à 10 mois. La symptomatologie varie de l'absence de douleur à l'incapacité fonctionnelle, avec parfois une évolution nécrotique. Nos données montrent une longue durée de ces symptômes. À ce jour, les « orteils COVID » n'ont pas été intégrés dans le concept de « long COVID » représentant les complications persistantes de la COVID-19 ; et aucun syndrome acral aigu pédiatrique n'a eu cette durée d'évolution. Nous suggérons de définir les orteils chroniques de la COVID-19 comme une entité distincte des formes aiguës survenant au cours de l'infection.

Objectives/Hypothesis To compare the results of magnetic resonance imaging with magnetic resonance sialography (MRSIAL) and the clinical and laboratory characteristics in a well‐characterized cohort of patients with primary or secondary Sjögren's syndrome (SS) meeting the American–European Consensus Group criteria. Study Design: Retrospective, observational, monocentric study. Methods Thirty‐six patients (81% female, mean age = 48 ± 35 years) with primary or secondary SS who underwent MRSIAL were included in the study. Results MRSIAL revealed characteristic radiological signs in the parotid, sublingual, and submandibular salivary glands in 35/36 patients (97%). Patients presenting with anti‐Sjögren's syndrome–related antigen A (SSA) autoantibodies showed more often fatty infiltration, a “pepper‐and‐salt” appearance, ductal stenosis, and/or ductal dilation of the parotid gland (88%, 88%, and 72% respectively) than patients negative for anti‐SSA (12%, 4%, and 28% respectively). MRSIAL demonstrated signs characteristic of SS in all 11 patients with negative minor salivary gland biopsy. For 15 patients undergoing ultrasound examination only, 11 (73%) had SS findings, but all 15 had SS findings on MRSIAL. Two cases of parotid lymphoma were detected by MRSIAL (6%). Conclusions MRSIAL is a reliable technique to detect glandular anomalies in patients with SS, and seems to provide a valuable aid in the diagnosis of SS. Level of Evidence 4 Laryngoscope , 131:E83–E89, 2021

ObjectivesFirst, establishment and validation of a novel questionnaire documenting the burden of xerostomia and sialadenitis symptoms, including quality of life. Second, to compare two versions regarding the answering scale (proposed developed answers Q3 vs. 0–10 visual analogue scale Q10) of our newly developed questionnaire, in order to evaluate their comprehension by patients and their reproducibility in time.Study DesignThe study is a systematic review regarding the evaluation of the existing questionnaire and a cohort study regarding the validation of our new MSGS questionnaire.Materials and MethodsA Multidisciplinary Salivary Gland Society (MSGS) questionnaire consisting of 20 questions and two scoring systems was developed to quantify symptoms of dry mouth and sialadenitis. Validation of the questionnaire was carried out on 199 patients with salivary pathologies (digestive, nasal, or age‐related xerostomia, post radiation therapy, post radioiodine therapy, Sjögren's syndrome, IgG4 disease, recurrent juvenile parotitis, stones, and strictures) and a control group of 66 healthy volunteers. The coherence of the questionnaire's items, its reliability to distinguish patients from healthy volunteers, its comparison with unstimulated sialometry, and the time to fill both versions were assessed.ResultsThe novel MSGS questionnaire showed good internal coherence of the items, indicating its pertinence: the scale reliability coefficients amounted to a Cronbach's alpha of 0.92 for Q10 and 0.90 for Q3. The time to complete Q3 and Q10 amounted, respectively, to 5.23 min (±2.3 min) and 5.65 min (±2.64 min) for patients and to 3.94 min (±3.94 min) and 3.75 min (±2.11 min) for healthy volunteers. The difference between Q3 and Q10 was not significant.ConclusionWe present a novel self‐administered questionnaire quantifying xerostomia and non‐tumoral salivary gland pathologies. We recommend the use of the Q10 version, as its scale type is well known in the literature and it translation for international use will be more accurate. Laryngoscope, 132:322–331, 2022

Background Cutaneous reactions, mostly on injection site after mRNA-based COVID-19 vaccines, have been reported but not with detailed histopathological characterization. Objectives Characterization and classification of these reactions in a clinical and pathological point of view. Methods Monocentric case series of 11 patients with cutaneous manifestations, clinically and histologically characterized after COVID-19 vaccination. Results From January to June 2021, we recorded 11 cutaneous reactions to mRNA COVID-19 vaccines from BNT162b2 (n = 8) and mRNA-1273 (n = 3). Generalized reactions showing erythematous rash or purpura were the most common clinical presentation, and drug-reaction-like pattern was the most common histological finding. Conclusions A proper clinicopathological classification will be helpful in the early diagnosis and management of the cutaneous reactions to mRNA COVID-19 vaccines.

Introduction Ochroconis mirabilis, également appelé O. musae, espèce du genre mélanisé Ochroconis (Sympoventuriaceae, Venturiales) est un pathogène opportuniste chez l’homme immunocompétent. Son rôle dans la survenu d’une affection cutanée n’est que très peu connu. Matériel et méthodes Nous rapportons ici le premier cas de mycose superficielle par O. mirabilis en Suisse. Résultats Un homme de 26 ans en bonne santé s’est présenté à notre clinique dermatologique pour un prurit facial évoluant depuis 10jours. Une desquamation diffuse du visage sans érythème sous-jacent était présente. Il n’y avait pas d’hyperkératose folliculaire et aucune autre lésion cutanée. Le patient n’avait aucun contact direct avec des animaux et n’avait réalisé aucun voyage récent, ni aucune activité aquatique. Il n’avait appliqué aucun traitement topique sur son visage. L’analyse des squames de la peau a montré des spores sans filaments. La culture a montré un champignon dématié et du Candida parapsilosis se développant à partir de presque toutes les squames. L’examen microscopique du mycélium a montré des hyphes bruns avec quelques conidies bicellulaires, ce qui était évocateur d’O. mirabilis. L’identification a été confirmée par le séquençage de l’ADNr. La sensibilité aux antifongiques de la souche isolée a été déterminée montrant : itraconazole : 0,06mg/mL ; amphotericine B : 1mg/mL ; kétoconazole : 2mg/mL ; terbinafine : 2mg/mL ; griséofulvine>16mg/mL et fluconazole : >256mg/mL. Ces résultats concordaient avec les études in vitro et cliniques jusque-là décrites dans la littérature. Une guérison a été obtenue après un régime combiné de 15jours de crème et shampooing au kétoconazole. Discussion C. parapsilosis est un saprophyte connu de la peau qui, lorsqu’il est présent en grande quantité, peut induire des intertrigos, des pustules ou des lésions muqueuses. À ce jour, la présentation clinique superficielle que nous rapportons ici, n’a jamais été décrite pour Candida, ce qui nous a conduits à le considérer comme un contaminant. Notre observation indique que chez l’homme, O. mirabilis peut soit induire une mycose superficielle sous forme d’une desquamation prurigineuse diffuse sans inflammation, soit induire une mycose profonde sous forme de papules et nodules comme ceci a été décrit dans la littérature.

BackgroundErdheim-Chester disease (ECD) is a rare non-Langerhans histiocytosis with slow progression over the years that is particularly difficult to diagnose.CasesHere we report three cases of ECD without BRAF mutation presenting with a renal mass, hairy kidney appearance, and a rather benign course, for which the diagnosis of ECD was delayed, characterized by multiple investigations and unsuccessful treatments attempts. In two cases the distinction from IgG4-related disease required multiple investigations and reevaluation of the clinical, radiological, histological, and immunological characteristics.ConclusionA correct diagnosis of ECD may take several years and often requires revisiting previous hypotheses. Reassessment of histological slides and more modern complementary exams such as PET-CT or BRAF and MAPK-ERK mutation analysis can help to confirm the diagnosis of ECD and to select effective therapy.

Granuloma annulare is an idiopathic granulomatous condition. Clinical variants of granuloma annulare include classical and localized, large erythematous patch, generalized, perforating, and subcutaneous/deep forms. Rarely, granuloma annulare shows a prominent lymphoid infiltration. This form is called pseudolymphomatous granuloma annulare. Here, we describe a new case of pseudolymphomatous granuloma annulare.

Les effets secondaires cutanés des immunothérapies sont de plus en plus rencontrés en pratique courante. Bien que les réactions lichénoïdes aux anti-programmed cell-death-1 (PD1) soient connues, seuls quelques cas de lichen plan bulleux sont rapportés dans la littérature. Nous décrivons ici un cas de lichen plan secondairement bulleux survenu sous nivolumab et faisons une revue de la littérature des cas induits par anti-PD1. Une revue de la littérature des cas de lichen plan bulleux induits par anti-PD1 a été effectuée dans Medline via Pubmed. Un homme de 68 ans, suivi pour un carcinome rénal à cellules claire métastatique traité par nivolumab, développait 3 mois après le début du traitement des papules violines prurigineuses sur les membres inférieurs, d’évolution bulleuse. Après corrélation anatomoclinique, nous concluions à un lichen plan secondairement bulleux induit par le nivolumab. Une corticothérapie systémique et l’arrêt de l’immunothérapie étaient nécessaires à l’amélioration clinique. Nous avons colligé dans la littérature 20 cas de lichen plan induits par anti-PD1 (nivolumab ou pembrolizumab), dont 6 de forme bulleuse, publiés entre 2016 et 2018. Ces cas ont parfois nécessité une corticothérapie systémique voire l’arrêt de l’immunothérapie. La dermatose lichénoïde touche environ 17 % des patients sous traitement anti-PD1/PD-L1. Histologiquement, on observe des signes de dermatose lichénoïde commune. Il est difficile de faire la distinction entre le lichen plan primaire et les formes médicamenteuses, en particulier celles résultant d’un traitement anti-PD1. Il est également difficile d’apporter des réponses sur le rôle déclencheur de l’immunothérapie, car la physiopathologie du lichen plan reste mal connue. À l’inverse, l’apparition de ce phénomène avec cette classe de médicaments renforce la notion de réponse immunitaire contre un antigène kératinocytaire associé à une surexpression de la PD-L1 dans les kératinocytes. Le délai d’apparition des effets secondaires cutanés sous immunothérapie anti-PD1 peut être de plusieurs semaines à mois. L’arrêt de l’immunothérapie n’est discuté qu’en cas d’évolution défavorable sous corticothérapie systémique.