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Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease known to affect exocrine glands, leading to symptoms such as dry eyes and mouth. However, pSS can manifest in other systems, including rare genitourinary presentations. Urinary retention, although unusual, has been associated with pSS throughout the disease, particularly when related to neurogenic bladder dysfunction. However, it is unusual for neurogenic bladder dysfunction to be the initial presentation of pSS. We present the case of a 38-year-old woman who initially presented with unexplained urinary retention, followed by the development of systemic symptoms such as hand arthritis, morning stiffness, photosensitivity, and dry eyes. As Shirmer's test was positive and anti-SSA was strongly positive, she was diagnosed with pSS. Treatment with hydroxychloroquine alleviated both her systemic symptoms and urinary retention., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sleem et al.)

SARS-CoV-2 (COVID-19) has been associated with numerous complications, including autoimmune and autoinflammatory diseases. The surge of cytokines following COVID-19 infection or vaccination has been proposed to contribute to immune dysregulation, which might subsequently give rise to an autoinflammatory syndrome. Adult-onset Still's disease (AOSD) is one of the rare autoinflammatory diseases characterized by a surge of cytokines. Although an association between COVID-19 vaccines and AOSD has been reported, an association with COVID-19 infection or nirmatrelvir/ritonavir remains very rare. In this case, we present a patient who developed AOSD after COVID-19 infection and subsequent treatment with nirmatrelvir/ritonavir. After the initial response to glucocorticoids, canakinumab was initiated, resulting in positive clinical outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, El Hasbani et al.)

Sjögren's syndrome (SS) has been widely known for its dry mouth and dry eyes presentation. Extraglandular disease manifestations may be protean and pose a challenge for clinicians, especially when the typical known manifestations are absent. Skin involvement of SS is variable, and cutaneous signs and symptoms may be the initial presentation of this syndrome. Vacuolar interface dermatitis has been linked to dermatomyositis and systemic lupus erythematosus, but rarely to SS. Herein, we present the case of an 87-year-old man who presented for widespread itchy erythematous scaly plaques that were refractory to topical corticosteroids as well as discontinuation of possible offending medications. A biopsy demonstrated vacuolar interface dermatitis in the setting of strongly positive anti-SSA. Hydroxychloroquine treatment was effective in resolving the plaques., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, El Hasbani et al.)