7 Zou L, Ruan F, Huang M et al. SARS-CoV-2 viral load in upper respiratory specimens of infected patients.

developed such lesion. This could be explained by the fact that we did not include paediatric patients, where pernio commonly manifests. 1 Retiform purpura and skin necrosis are cutaneous manifestations that correlate strongly with severe COVID-19 infection; the Spanish Workgroup that studied 375 patients reported that individuals who developed these cutaneous manifestations have a mortality of 10%. 1,2 Results obtained from our study are similar to what is reported in literature. In the database collected by the AAD, manifestations considered to be related with a favourable-intermediate prognosis were pernio, morbilliform exanthem, urticaria, macular erythema, vesicular eruption and papulosquamous eruption.We conclude that dermatological manifestations in COVID-19 are relatively common. These could be useful as prognostic markers, especially in hospitals or primary healthcare centres with limited resources, since their relationship with the clinical severity of the disease depends on the type of dermatological manifestation.

Walsh et al., who described it as an acanthoma with features of porokeratosis, predominantly in men, on their extremeties. 1 It is clinically described as either solitary or multiple hyperkeratotic plaques (often verrucous) or a nodule with mild pruritus. Absence of a central area of epidermal atrophy is a clinically important feature in distinguishing porokeratoma from porokeratosis. 2 Porokeratoma is characterised by prominent multiple and confluent cornoid lamellae throughout the lesion in histopathological examination, whereas the cornoid lamellae is only located at the periphery in classical porokeratosis. 1 The cause of porokeratoma has not been elucidated in which no family history of porokeratoma has been reported as yet. Although dermal amyloid deposits have been observed in several cases of porokeratosis, this is the first report of it occurring in porokeratoma. The causal link between the porokeratosis and the amyloidosis remains unclear. 3 Possible treatments could include complete excision of the lesion, cryotherapy, laser or oral acitretin. 2 It has been reported that porokeratotic cases can have malignant potential, particularly in chronic large lesions. 2 Regular monitoring and follow-up is therefore recommended.

No abstract

La incidencia de complicaciones informadas luego de la cirugía bariátrica (CB) ha ido en aumento en relación con la epidemia de obesidad y el mayor número de procedimientos quirúrgicos realizados a nivel mundial. Entre las complicaciones, la hipoglucemia hiperinsulinémica postprandial (HHP) adquirió relevancia, aunque es una de las menos conocidas y comprendidas de la cirugía bariátrica (CB), frecuentemente inadvertida y por lo tanto subdiagnosticada. Se distingue de la hipoglucemia de ayuno en que su presentación es típicamente posterior a la ingesta, asociada a valores de hipoglucemia precedidos por hiperglucemia e hiperinsulinemia en sangre. Se caracteriza por el incremento de la variabilidad de la glucemia, con absorción acelerada, aumento y caída rápida de azúcar en sangre, por lo que comprende valores de hiper e hipoglucemia. Debe sospecharse cuando se detectan síntomas adrenérgicos o de neuroglucopenia postprandiales luego de la CB1.Ha sido considerada más frecuente luego del bypass gástrico en-Y-Roux (BGYR), pero también fue descripta asociada a otras técnicas quirúrgicas, como la derivación biliopancreática/switch duodenal (DBP/SD)2 y la gastrectomía vertical en manga (GVM), y de otras intervenciones que comprometen el píloro o el vaciamiento gástrico3. No se observó luego de la cirugía con banda gástrica ajustable, un procedimiento que no altera la anatomía gastrointestinal4-5.