Search

This case highlights the relationship between the chilblain manifestation and SARS-CoV-2 infection, confirmed by nasopharyngeal swab RT-PCR and serology test. A chilblain relapse was observed after 3 months and negative nasopharyngeal swab RT-PCR ruled out virus re-infection. During the COVID-19 pandemic, an outbreak of chilblain lesions has been described worldwide. [Extracted from the article]

2 Poddighe D, Bruni P. Mycoplasma pneumoniae -induced rash and mucositis (MIRM): an unusual mild skin rash associated with severe mucosal involvement. I Mycoplasma pneumoniae i -induced rash and mucositis (MIRM), proposed as a unique entity apart from erythema multiforme (EM), Steven-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) by Canavan I et al i . in 2015, follows a less severe course and is associated with less morbidity and mortality.1,2 In SJS and TEN, widespread, confluent skin lesions, positive Nikolsky sign and significant epidermal detachment are present.3 In MIRM, mucositis, especially oral, is nearly universal (94%) and predominant over a less marked or absent cutaneous involvement.1,4 It is a major cause of morbidity, may lead to multiple confluent erosions, haemorrhagic crusting and sparse vesiculobullous perilabial eruptions and, rarely, to sequelae such as mucosal synechiae and pigmentary changes. Differently from EM-spectrum disease, lip enlargement in MIRM is persistent and can lead to a swelling of the vermilion borders with a "duck-like lips" appearance, which may be a clue to suspect MIRM in children and to timely begin appropriate treatment strategies. [Extracted from the article]

Aim: Italian national guidelines on pain management were published in 2010, but there is little information on how effective pain management is in paediatric emergency care, with other countries reporting poor levels. Using headache as an indicator, we described pain assessment in Italian emergency departments and identified predictors of algometric scale use.Methods: All Italian paediatric and maternal and child hospitals participated, plus four general hospitals. Data on all children aged 4-14 years admitted during a one-month period with headache as their chief complaint were abstracted from clinical records. Multivariable analyses identified predictors of algometric assessment, taking into account the cluster study design.Results: We studied 470 admissions. During triage, pain was assessed using a standardised scale (41.5%), informally (15.5%) or was not recorded (42.9%). Only 32.1% of the children received analgesia in the emergency department. The odds ratios for predictors of algometric assessment were non-Italian nationality (3.6), prehospital medication (1.8), admission to a research hospital (7.3) and a more favourable nurses-to-admissions ratio of 10.8 for the highest versus lowest tertile.Conclusion: Despite national guidelines, paediatric pain assessment in Italian emergency care was suboptimal. Hospital variables appeared to be stronger predictors of adequate assessment than patient characteristics. [ABSTRACT FROM AUTHOR]