No abstract

BackgroundDespite being variable and poorly characterized, the reported cutaneous manifestations of coronavirus disease 2019 are of increasing concern. MethodologyThis study aimed to determine the prevalence and possible association between COVID-19 and herpes simplex virus (HSV) infection. A nine-item questionnaire was sent to 120 polymerase chain reactionconfirmed COVID-19 patients with a response rate of 66.67%. This cross-sectional observational study included 80 patients with mild-to-moderate COVID-19 infection who did not require hospitalization or steroid therapy. ResultsOne or more HSV infections were observed in 28 patients (35%) with COVID-19 infection, including 10 (35.7%) males and 18 (64.29%) females. Of the 28 patients, fever was reported in 17 (75%) during COVID-19. Most of the respondents (78%) described a single HSV reactivation, 14.29% had two attacks, and 7.14% experienced three attacks. Compared to previous non-COVID-19-related HSV reactivation, the COVID-19related attacks were more severe in 12 (42.85%) patients, equally severe in five (17.85%) patients, and less severe in one (3.57%) patient. Interestingly, 10 (35.71%) patients developed an initial symptomatic HSV attack during COVID-19 infection. ConclusionsThis study demonstrated a possible association between COVID-19 infection and primary HSV infection or reactivation. COVID-19 direct neuronal effect in addition to COVID-19-related psychological stress, fever, and immunological dysregulation could play a potential role in HSV reactivation or primary infection during COVID-19.

BackgroundDespite being variable and poorly characterized, the reported cutaneous manifestations of COVID-19 are of increasing concern.Aim of the StudyThis study aimed to assess the prevalence and possible association between COVID-19 and herpes simplex virus (HSV) infection.Patients and methodsA 9-item questionnaire was sent to 120 PCR-confirmed COVID-19 patients with a response rate of 66.67%. This cross-sectional observational study included 80 patients with mild to moderate COVID-19 infection who did not require hospitalization or steroid therapy.ResultsOne or more HSV infections were observed in 28 patients (35%) with COVID-19 infection, including 10 males (35.7%) and 18 females (64.29%). Of the 28 patients, fever was reported in 17 patients (75%) during COVID-19. Most of the respondents (78%) described a single HSV reactivation, 14.29% had 2 attacks, and 7.14% experienced 3 attacks. Compared to previous non-COVID-19 related HSV reactivation, the COVID-19 related attacks were more severe in 12 patients (42.85%), equally severe in 5 patients (17.85%) and less severe in 1 patient (3.57%). Interestingly, 10 patients (35.71%) developed an initial symptomatic HSV attack during COVID-19 infection.ConclusionsThis study demonstrated a possible association between COVID-19 infection and primary HSV infection and/or reactivation. The COVID-19 direct neuronal effect in addition to COVID-19 related psychological stress, fever and immunological dysregulation could play a potential role.

Sir, Urticaria is an immunologically mediated hypersensitivity reaction developing in both sexes. Although it may occur at any age, young females are more frequently affected [1]. Acute urticaria, shorter than six weeks, is generally self-limited. In contrast, a patient with urticaria lasting more than six weeks is classified as having chronic urticaria. Patients with chronic urticaria may be classified into either chronic inducible urticaria or chronic spontaneous urticaria (CSU). Urticaria may be either a true IgE mediated allergic reaction or a non-IgE mediated pseudo-allergic reaction by releasing prostaglandins and leukotrienes [2]. A routine test usually includes CBC, ESR, and infection screening. Provocation tests for physical urticaria and immunological tests are performed to identify autoimmune urticaria. Skin prick tests and oral provocation tests are employed to differentiate allergic and pseudo-allergic reactions [3]. In contrast to physical urticaria, in which the triggering physical stimuli is usually easy to identify, it is often cumbersome to determine the trigger of chronic spontaneous urticaria. The following case represents an example of such a hidden trigger of CSU.

Background: Vitiligo is an acquired depigmentary disorder of the skin, mucous membrane and hair follicle resulting from selective destruction of melanocytes. Aims of Study: Identify the clinico-epidemiological characteristics of childhood vitiligo. Patients and Methods: A retrospective study carried out at the dermato-venereology clinic of Salah Al-Din Hospital. A total of 120 vitiligo patients, all younger than 17 years old, were enrolled. Results: Among included patients, (40%) were male and (60%) were female (M:F=2:3). The mean age of onset was (11.5 SD 6.4 years) with (60.8%) of patients were (11-17) years old, (25%) were (6-11) years and (14.2%) were (0-5) years old. Majority of patients were from urban area (87.5%). Generalized types of vitiligo account for (56.7%) besides (22.5%), (17.5%) and (3.3%) represented focal, acrafacial and segmental vitiligo, respectively. Only (8.3%) have nail changes, presented as longitudinal ridging followed by leukonychia. Family history was positive in (37.5%) of vitiligo patients. Treatment used for vitiligo were topical corticosteroids (92.5%), topical calcineurin inhibitors (55%), NB-UVB (84.2%), and systemic steroids (30.8%). Conclusions: Majority of childhood vitiligo develops after puberty and predominantly affects female. Generalized vitiligo is the most frequent type. Atopic dermatitis is the most common associated disease.