The ongoing COVID‐19 pandemic has raised concerns regarding the outcome of this infection in patients with autoimmune bullous dermatoses (AIBDs) due to effect of drugs used to treat these disorders. This investigation was performed from the onset of the pandemic to June 1, 2021. Patients with AIBDs who contracted COVID‐19 were evaluated. A generalized linear model was employed to find the predictors of severe COVID‐19 among patients with AIBDs. Ninety‐three patients with AIBDs with a mean age of 50.3 years were evaluated. The most COVID‐19 related symptoms were tiredness (76.3%) myalgia (69%), and cough (63.4%). During follow‐up, the rate of hospitalization and death were 45.2% and 4.3%, respectively. Previous comorbidities (β = 0.61) and mean prednisolone dosage above 10 mg/day in the last 3 months (
β
= 1.10) significantly increased COVID‐19 severity. Also, vaccination against SARS‐CoV‐2 (
β
= −1.50) and each passing month from the last rituximab dose decreased severity (
β
= −0.02). Notably, 19.3% of the patients developed AIBD flare‐ups following COVID‐19 infection. Higher prednisone dose and the shorter interval from the last rituximab infusion were determinants of severe COVID‐19. Physicians should assess the risk versus the benefits when prescribing the medications. Moreover, vaccination could successfully attenuate COVID‐19 severity.
Generalized pustular psoriasis is a rare variant of pustular psoriasis. During the pandemic of COVID-19, every patient referred to medical centers with fever or other flu-like symptoms would be first evaluated for COVID-19. Here, we report a case of pustular psoriasis who were under biologic immunosuppressive treatment (Infliximab) and was admitted to take her every eight weeks injection of infliximab. During evaluations before the injection, persistent fever and high CRP was detected. Due to these findings, she was suspected of having COVID-19, and this suspicion delayed routine medical care and infliximab infusion for her main disease, pustular psoriasis. After two negative results of the COVID-19 PCR test, Infliximab infusion was done, and surprisingly the fever disappeared, and CRP level decreased.
prolonged treatment more than 3-5 years unless they have risk factors for major fractures, including (1) BMD À2.5 or lower (2) history of recent hip or lumbar fracture (3) continued high dose of systemic corticosteroids (4) high bone turnover indicators. 6 Treatment options for BRONJ are divided into surgical and non-surgical options which include topical or intralesional antimicrobial agents and surgical sequestrectomy, respectively. Surgical approaches are usually reserved for intractable cases with higher stages. 7
CONFLICT OF INTERESTThe authors declare no conflict of interest.
AUTHOR CONTRIBUTIONSKamran Balighi conceived the study and participated in its design and coordination. Arghavan Azizpour participated in study design as well as validation and editing. Raana Samiei carried out literature review and writing the original draft. Fateme Shirzad Moghadam cooperated with data collection. All Authors read and approved the final manuscript.
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