eczematous eruptions, predominantly on the patient's trunk (Fig. 1a,b).Laboratory assessment of a peripheral blood sample showed a normal leucocyte count of 6.7 9 10 9 /L (normal range 3.3-8.8 9 10 9 /L) with raised eosinophils (10%, 0.70 9 10 9 /L; normal ranges 0-8%, 0.07-0.45 9 10 9 /L, respectively). The serum level of thymus and activation-regulated chemokine (TARC) was elevated at 2818 pg/mL (normal level 450 pg/mL) and soluble interleukin-2 receptor levels were within normal limits.Histological examination of a skin biopsy specimen revealed epidermal spongiosis, basal vacuolar change, and infiltration of lymphocytes and eosinophils in the papillary dermis (Fig. 1c). In addition, there were no atypical lymphocytes exhibiting cerebriform or convoluted nuclei, no haloed lymphocytes or true epidermotropism in the epidermis, and no papillary dermal fibrosis.These findings did not favour a diagnosis of mycosis fungoides (MF), thus, based on the results, eczematous drug eruption due to clonazepam or azilsartan was most strongly suspected.Consequently, 3 weeks after the eruptions appeared, clonazepam and azilsartan were discontinued, and the patient was treated with prednisolone 40 mg (0.74 mg/ kg) daily and prednisolone 10 mg every 4 days, tapered over time. The eruptions disappeared within 3 weeks from initiation of prednisolone.Nine days later, to confirm the causative agent, clonazepam was restarted after obtaining the patient's informed consent. Two weeks after restarting clonazepam administration, infiltrative erythema appeared on the head, trunk and bilateral thighs (Fig. 1d,e). The serum TARC level was increased at 11 300 pg/mL. A biopsy specimen demonstrated histopathological features similar to those of the previous biopsy specimen, consisting of vacuolar changes, spongiosis, oedema, and infiltration of lymphocytes and eosinophils in the superficial perivascular region (Fig. 1f). The drug-induced lymphocyte stimulation test was positive for clonazepam.Consequently, we made a final diagnosis of eczematous drug eruption due to clonazepam, and clonazepam was discontinued. Ten weeks after discontinuing clonazepam, the eruptions disappeared and azilsartan was restarted. At follow-up 4 months after restarting azilsaltan administration, there was no recurrence of eruptions, serum TARC level had decreased to 729 pg/mL, and blood eosinophil level was within the normal range at 306/lL.Clonazepam, one of the drugs in the benzodiazepine class, is used as an antianxiety medication. To our knowledge, this is the first case of an eczematous drug eruption due to clonazepam that was correlated with serum TARC levels. TARC is a T-helper 2-type

Background Line‐field confocal optical coherence tomography (LC‐OCT) is a new in vivo emerging technique that provides cellular resolution, allows deep imaging (400 μm) and produces real‐time images in both the horizontal and vertical plane and in three dimensions. No previous description of different subtypes of melanocytic lesions and their correlation with histopathology and reflectance confocal microscopy has been reported. Aim To describe the features of melanocytic lesions by LC‐OCT and their correlation with histopathology and reflectance confocal microscopy (RCM) findings. Methods Selected melanocytic benign lesions and melanomas were imaged in vivo with RCM and LC‐OCT at the Fundación Hospital Clinic (Barcelona, Spain). A minimum area of 4 × 4 mm (block image) at four depths (stratum granulosum, suprabasal, layer dermoepidermal junction and upper dermis) were acquired with RCM and a minimum of three cubes with LC‐OCT. Horizontal, vertical sections and three‐dimensional (3D) cubes of LC‐OCT were matched with RCM (Vivablock two‐dimensional composite mosaic) and histopathology, with ~5 μm lateral resolution accuracy (the same cell nuclei were measured in X, Y and Z) and evaluated by three observers experienced in using RCM and histopathology. Results In total, 12 melanocytic tumours (2 in situ melanomas, 2 invasive melanomas, 4 atypical naevi, 2 intradermal naevi, 1 compound naevus and 1 junctional naevus) were included. High correlation with 5 μm accuracy between RCM and LC‐OCT was observed for each tumour. The 3D images of melanocytic lesions were obtained with cellular resolution and correlated with both RCM and histopathology, allowing an understanding of the architecture and precise correlation at the cellular level with RCM. Similarities between LC‐OCT and RCM for the described diagnostic features and architecture (nests of melanocytic cells, ringed and meshwork pattern, and cellular details of tumour cells as dendritic and pagetoid cells) were confirmed. The main advantage of diagnosis by RCM fixed probe was the ability to produce larger scans of the lesion using mosaicing compared with an LC‐OCT handheld probe. Conclusion LC‐OCT allows the architectural and cellular description of different types of melanocytic lesions. LC‐OCT showed high correlation with histopathology (vertical sections) and RCM (horizontal sections) in melanocytic lesions. Diagnostic criteria for RCM were similar to those for LC‐OCT.

Background To describe the cutaneous acral findings in a pediatric population noticed during this pandemic. Methods A retrospective descriptive study was performed collecting data on 36 patients under 14 years old, presenting suspicious acral skin manifestations for coronavirus disease 2019 (COVID-19). Results Patients were mostly male (63.8%). The mean age was 11.11 years. 66.67% of patients showed erythematous papules, and 44.44% purpuric macules. Feet were affected in 97.22% of patients and hands in 5.55%. Lesions were asymptomatic in 50% of patients. 30.55% of patients showed extracutaneous findings, preceding skin lesions in 12.62 days. Seven patients underwent specific severe acute coronavirus 2 (SARS-CoV-2) testing; all of these patients tested negative. Conclusions The association between these symptoms and SARS-CoV-2 remains unclear. We recommend using these manifestations as a sign of SARS-CoV-2 infection in children. This could lead to the examination of asymptomatic and mildly symptomatic children so that contagions may be avoided.