trates in leukocytes, where it interferes with the kinetics of the cytoskeletal microtubules by inhibiting mitosis, and so inhibiting leukocyte motility, impairing inflammation mediated by these cells.Results regarding the benefits of low-dose colchicine in patients with coronary artery disease (CAD) are contentious. 3 Therefore, the aim of this study was to systematically review randomized controlled trials (RCTs) evaluating the prognostic effects of low-dose colchicine in patients with CAD. MethodsThis systematic review followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 6 and was registered in PROSPERO C ardiovascular diseases are a major cause of morbidity and mortality worldwide. 1 An important share of the burden of cardiovascular diseases relates to atherosclerosis, which is a process that involves inflammatory cells. Inflammation can accelerate and trigger complications of the atherosclerotic process. 2 Therefore, it is not unexpected that old drugs targeting inflammation, such as colchicine, could be investigated for this cardiovascular indication.Colchicine has anti-inflammatory properties 3 and is widely used in the treatment of acute gout, as well as in Behçet's disease, pericarditis, primary biliary cirrhosis, and familiar Mediterranean fever. 4 Orally administered colchicine has an estimated bioavailability of 44%, reaches peak plasma concentration in 1 h, and has a predominantly hepatic elimination. 5 While in the circulation, colchicine concen-

COVID-19 is the clinical expression of the highly contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection. Most patients have mild symptoms, but a significant proportion have severe or critical disease, which can include cardiac injury, sepsis, acute kidney failure and respiratory failure. It is also worth highlighting the increasing number of reported COVID-19 cases with dermatological disease/manifestations. The cutaneous clinical spectrum is wide and includes maculopapular, urticarial, varicelliform and petechial rashes, pseudo perniosis, livedo reticularis, and pityriasis rosea-like, violaceous and pustular lesions. Until the physiological mechanism is fully understood, it is important to describe these manifestations, which could help identify a typical pattern. This report describes a cutaneous manifestation in a COVID-19 patient.

Acquired hemophilia A (AHA) is a rare bleeding disorder occurring mostly in elderly persons, caused by inhibition of factor VIII (FVIII). It is generally detected prior to surgery by an isolated prolonged activated partial thromboplastin time (aPTT) not correcting on mixing studies, with subsequent identification of reduced FVIII levels and presence of FVIII inhibitor. It is treated with hemostatics and immunosuppressants, which may increase the risk for life-threatening opportunistic infections.A 79-year-old woman with idiopathic acquired FVIII inhibition and severe bleeding presented with anemia, isolated and prolonged aPTT, low FVIII activity (<1%), and elevated FVIII inhibitor titer (471 Bethesda units per milliliter [BU/mL]). Initially, she was treated with recombinant activated factor VII and steroids. However, several hematomas appeared, one of which caused airway compression that required orotracheal intubation. Cyclophosphamide, rituximab (RTX), and activated prothrombin complex concentrate were initiated, resulting in clinical and laboratory resolution after five weeks. Cyclophosphamide and RTX were maintained for six and four weeks more, respectively. After 12 weeks of oral immunosuppression, the patient was readmitted due to antibiotic-resistant Pseudomonas aeruginosa sepsis, which resulted in death.Infection secondary to immunosuppression is the leading cause of death of patients with AHA. In AHA, combination therapy was shown to be more effective than monotherapy, but it was also identified to increase the risk of infection. Age, FVIII activity <1%, and FVIII inhibitor titers >20 BU are predictors of adverse events and poor prognosis in AHA patients. Additional studies are needed to clarify the ideal drug regimens and the need for prophylactic antibiotics in this population.

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