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This article discusses a series of 10 cases where patients with psoriasis developed paradoxical eczema (PE) exclusively on their ears after being treated with biologic drugs. The patients experienced the onset of PE at different times after starting biologic therapy, with a median time of 12 months. The implicated biologics included tumor necrosis factor (TNF) inhibitors, anti-interleukin (IL)-17 drugs, and anti-IL-23p19 drugs. Treatment with topical steroids and systemic therapy was successful for some patients, while others had to discontinue their current biologic treatment or switch to a different class of biologic. The duration of eczema before resolution varied depending on the treatment approach. The article suggests that the pathogenesis of PE may be related to the mechanism of action of the involved drugs and alterations in the skin microbiome. Further research is needed to better understand this phenomenon. [Extracted from the article]

A 33-year-old man presented with a two-week history of an asymptomatic ulcer of the oropharynx and submandibular lymph nodes swelling. Laboratory examinations were normal, but serological tests revealed positivity for rapid plasma reagin, Treponema pallidum haemagglutination assay and anti-T. pallidum IgM antibodies. Since the patient denied any homosexual relationship, a biopsy of the lesion was performed, which confirmed primary syphilis. The patient received an intramuscular injection of Benzathine Penicillin G (2.4 MU) with complete resolution of the lesion. Extragenital chancres occur in at least 5% of patients with primary syphilis, and the oral mucosa is the most frequent location as a consequence of orogenital/oroanal contact with an infectious lesion. Because of their transient nature, these oral ulcerations are often underestimated by the patient or by any unsuspecting clinician. Health professionals should consider the recent sexual history of their patients and should be prepared to recognise oral and systemic manifestations of sexually transmitted infections. [ABSTRACT FROM AUTHOR]