COVID-19 is inflicted by SARS-CoV-2 and resulted in a global health crisis that necessitated the urgency of vaccine development to prevent its spreading among the public. Pfizer-BioNTech COVID-19 is one of the emergency use authorized (EUA) vaccines. This vaccine is efficacious against the SARS-CoV-2 virus; nonetheless, recipients have frequently reported side effects. Recipients of this vaccine experienced miscellaneous side effects like fatigue and headache. However, cutaneous eruptions of varying degrees of severity and involvements have been manifesting post-vaccination. Dermatological eruptions following vaccination against COVID-19 disease are poorly recognized. Dermatological manifestations triggered postvaccination differ in the clinical context and patient's demographic features. The only constant factor is various clinical and histopathological relations to establish the diagnosis of cutaneous eruption postvaccination.Herein, we report a case of an 18-year-old male with T-cell acute lymphocytic lymphoma (ALL) in remission since August 2018 and other comorbidities. After the administration of the first dose of the Pfizer-BioNTech COVID-19 vaccine, the patient developed pruritic eczematous eruption presenting as grouped erythematous-violaceous papulovesicular lesions with fine scales over his upper and lower extremities. These eruptions started two days after the administration of the vaccine. This eruption became generalized 21 days after receiving the second dose of the Pfizer-BioNTech COVID-19 vaccine. Clinical suspicion of the drug-induced vesicular eruption was suspected; thus, a biopsy was obtained and showed erosions and mixed inflammatory cell infiltrate. From a clinical and histopathological correlation, vesicular eruption following vaccination with Pfizer-BioNTech COVID-19 was confirmed. Nevertheless, other diagnoses cannot be ruled out, but from the clinical-histopathological association, the vaccine-inflicted eruption is the likely culprit. Reports are crucial to understanding the nature of such dermatological manifestation after emerging diseases and counteractions like vaccinations. The dermatological manifestations are vaguely recognized; thus, by reporting on the cases similar to the case in this report, more data will be available to understand the nature and underlying cause of such eruptions.
Leptomeningeal carcinomatosis (LC) is a rare complication of primary malignancy that spreads to leptomeninges and cerebrospinal fluid (CSF). Due to its rarity, it is often diagnosed as a late complication of an advanced tumor. This report presents a case study of a 72-year-old nonsmoking female with multiple comorbidities with two-week rapidly progressive cognitive decline and extrapyramidal symptoms (EPS). She presented with speech difficulties, tension headaches, and episodes of inattention. On examination, she had a masked face, mild bradykinesia, mild rigidity more apparent in the limbs than axially, and slight hyperreflexia in the lower limbs with a normal plantar reflex (down-going). Magnetic resonance imaging (MRI) of the brain with gadolinium showed diffuse leptomeningeal dissemination. CT of the right lower lobe showed lobe apical segment mass lesion with air bronchogram extension to the hilum, which raised the suspicion that the patient had lung cancer. The microscopic analysis of cerebrospinal fluid (CSF) cytology showed poorly differentiated malignant cells favoring adenocarcinoma. Based on these investigations, leptomeningeal dissemination on the MRI led to a wide differential diagnosis; however, given the findings in the CT scan and CSF, the patient was diagnosed with leptomeningeal carcinomatosis secondary to metastatic lung cancer. Although LC is a rare terminal complication that presents with a wide range of symptoms, typically including headache, altered mental status, diplopia, back pain, cerebral signs, and leg weakness, our patient presented with an uncommon presentation, which was EPS. Therefore, this case report highlights the importance of early detection of LC in any patient presenting with unspecific neurological manifestations.
Background: Hypotrichosis with Recurrent Skin Vesicles (HYPTSV) is an extremely rare condition, having autosomal recessive inheritance. Here in we report a 4-years- old Saudi boy who presented with a history of recurrent skin blisters that are localized to the extremities and hypotrichosis since birth.Methods: The present study describes a consanguineous Saudi family segregating HYPTSV in an autosomal recessive fashion. A single proband (II-1) exhibited features such as diffused non-scarring alopecia on the scalp, intraepidermal blister, post-inflammatory hyperpigmented macules, and follicular hyperkeratosis. DNA of the index was subjected to whole-genome sequencing (WGS). Furthermore, 3D protein modeling was performed for the mutated and normal protein.Results: WGS revealed a novel bi-allelic missense variant (c.154G>C; p. Val52Leu) in the DSC3 gene, which segregated perfectly using Sanger sequencing. In addition, 3D protein modeling revealed a substantial change in the mutated DSC3 protein as compared to the normal DSC3 protein.Conclusion: This is the 3rd novel variant reported in the DSC3 gene associated with the HYPTSV phenotype. This report further strengthens the evidence that bi-allelic variants in the DSC3 cause severe HYPTSV in humans.
Acne vulgaris is a widespread health issue affecting teenagers, young adults, and adults. The prevalence of this unpleasant condition varies between populations. A thorough literature review was carried out to discuss this underestimated issue through multiple perspectives. The search found that acne vulgaris has a substantial negative psychological impact on individuals leading to low quality of life and less productivity, yet it is usually neglected. Various factors, modifiable and non-modifiable) were associated with the progression of acne, such as family history, genetics, and diet, yet others were controversial. Lifestyle modifications are of high importance since they may contribute to the development of acne. Numerous anti-acne drugs are available in the form of topical and systemic, however, topical treatment options in general are preferred thanks to their effectiveness and less severe side effects.
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