We have recently noticed an outbreak of chilblain-like lesions in Italy contemporarily to COVID-19 epidemic. Due to the wellknown lockdown-related difficulties to visit the patients, 1 we created a Google form aimed to collect information about patients presenting with these singular clinical findings. An easy to access and quick tool was chosen by the investigators in order to permit the other colleagues to spend the least amount of time, given the severe health emergency. The form was submitted through social media and email to hundreds of Italian dermatologists and paediatricians. In 5 days, we collected 63 patients through the form, but data are still going to be collected. Here the first preliminary results. No significant difference in gender was noticed (57.4% females vs 47.6% males). The median age was 14 years (IQR: 12-16). Feet alone were mostly affected (85.7%) followed by feet/hands together (7%) and hands alone (6%). Pictures of patients were uploaded in 54 patients, with 31/ 54 presenting with erythematous-oedematous lesions (Fig. 1) and 23/54 with blistering lesions (Fig. 2). Pain and itch were equally observed (27% vs. 27%), followed by pain/itch together shown in 20.6% of patients. Asymptomatic lesions were present in 25.4%. Median time from the onset to clinical diagnosis was 10 days (IQR: 6-15). At time of diagnosis, most patients pre-
Twice-weekly proactive application of 0.03% tacrolimus ointment over 12 months was effective for most paediatric study patients in preventing, delaying and reducing the occurrence of AD exacerbations.
Sandoz and Sanofi. A. Cristaudo has been principal investigator in clinical trials sponsored by Abbvie, Leo Pharma and Pfizer. F. Cusano received honoraria as speaker and advisory board member from Sanofi Genzyme. M. Esposito has served as a speaker for Sanofi-Genzyme.
We report a family affected to the fourth generation by uncombable hair syndrome. This syndrome is characterized by unruly, dry, blond hair with a tangled appearance. The family pedigree strongly supports the hypothesis of autosomal dominant inheritance; some members of the family had, apart from uncombable hair, minor signs of atopy and ectodermal dysplasia, such as abnormalities of the nails. The diagnosis was confirmed by means of extensive scanning electron microscopy. A trial with oral biotin 5 mg/day was started on two young patients with excellent results as regards the hair appearance, although scanning electron microscopy did not show structural changes in the hair. After a 2-year-period of follow-up, hair normality was maintained without biotin, while nail fragility still required biotin supplementation for control.
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