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Background A previous study has defined the maculopapular subtype of manifestations of COVID‐19. Objectives To describe and classify maculopapular eruptions associated with COVI‐19. Methods We carried out a subanalysis of the maculopapular cases found in the previous cross‐sectional study. Using a consensus, we defined 7 clinical patterns. We described patient demographics, the therapy received by the patient and the characteristics of each pattern. Results Consensus lead to the description of 7 major maculopapular patterns: Morbilliform (45.5%), Other maculopapular (20.0%), Purpuric (14.2%), Erythema multiforme‐like (9.7%), Pytiriasis rosea‐like (5.7%), Erythema elevatum diutinum‐like (2.3%) and Perifollicular (2.3%). In most cases, maculopapular eruptions were coincident (61.9%) or subsequent (34.1%) to the onset of other COVID‐19 manifestations. The most frequent were cough (76%), dyspnea (72%), fever (88%), and astenia (62%). Hospital admission due to pneumonia was frequent (61%). Drug intake was frequent (78%). Laboratory alterations associated with maculo‐papular eruptions were high C‐reactive protein, high D‐Dimer, lymphopenia, high ferritin, high LDH, and high IL‐6. Limitations The impossibility to define the cause–effect relationship of each pattern. Conclusion We provide a description of the cutaneous maculopapular manifestations associated with COVID‐19. The cutaneous manifestations of COVID‐19 are wide‐ranging and can mimic other dermatoses. This article is protected by copyright. All rights reserved.

Methotrexate (MTX), a traditional antipsoriatic drug, is very frequently used either as monotherapy or in combination with other systemic drugs.To assess the effectiveness and safety of MTX in psoriasis in usual clinical practice.We conducted a retrospective study. We performed an electronic and manual chart review of patients treated with MTX in the Psoriasis Unit of our Hospital from January 2007 to December 2014. Demographic and clinical data, PASI/DLQI scores and reasons for suspension of all patients treated with MTX in usual clinical practice were recorded.Two hundred and eighteen patients were included. MTX was administered in 67% of cases as the first systemic treatment. The average treatment duration was 17.2 ± 13.6 months. All patients were subjected to clinical and laboratory monitoring. About 33.5% of them achieved a reduction of 75% or more of the initial PASI at week 12, 34.9% at week16, 44.7% at week 24, and 52.8% at week 48. A 3.3% had to discontinue the therapy due to analytical hepatic (2.8%) or renal (0.5%) abnormalities. Only one patient experienced severe interstitial pneumonitis and none required liver biopsy.MTX is an effective and safe option for the treatment of psoriasis in the real-world clinical practice.

Folliculitis decalvans is an embarrassing and challenging disease with no established treatment guidelines. In this paper, we described four patients with this disease treated successfully with Tacrolimus ointment. All of them showed significant control of the condition, stopping inflammatory lesions and progression of the disease, although weak transitory outbreaks of inflammatory lesions were observed in some cases. Alopecia and tufted hairs remained unchanged. The discontinuation of the therapy produced rapid relapses in all cases. Close monitoring of these patients is recommended due to the potential risk of malignant transformation of the disease.

Summary Background Alpha-melanocyte-stimulating hormone receptor 1 (MC1R) has an important role in skin pigmentation and variants of the gene have been established as independent risk factors for susceptibility to cutaneous malignant melanoma. Objective To explore whether variants of the gene also influence the onset of the disease. Methods We analyzed 285 melanoma patients of European ancestry for common variation in codon 84 (D84E) of the α-MSH receptor 1 gene, which is known to have functional consequences in MC1R protein activity. Results The mean age difference at diagnosis between MC1R 84E carriers and non-carriers was 9 years (95% confidence interval [CI]: 2–17; p =0.012), with 84E non-carrier patients being older. After adjusting for gender, Clark's level, phototype, eyes and hair colour, the risk for cutaneous malignant melanoma at any age was 2.07 times higher (95% CI: 1.21–3.52; p =0.008) among MC1R 84E carriers. Enrolment criteria, geographical origin, Clark's levels and Breslow's indexes were similar between MC1R 84E carriers and non-carriers. Further analyses based on the Clark level and Breslow's index, both indicative for cancer invasion, reasonably supported an unbiased selection of patients during the study enrolment. Additional exon re-sequencing of the cyclin-dependent kinase inhibitor 2A ( CDKN2A ) gene in MC1R 84E carriers ruled out the presence of high penetrance mutations that have previously been associated with early onset of the disease. Conclusion Although our findings need to be confirmed by independent and larger studies we have described for the first time the association of D84E variant of the α-MSH receptor 1 gene as an independent risk factor for an earlier onset of cutaneous malignant melanoma.

Resumen .—Antecedentes: los signos menores de dermatitis atopica pueden ser la unica manifestacion del proceso o formar parte del cuadro florido. Su importancia para el diagnostico ha sido objeto de multiples trabajos. Objetivo : relacionar las manifestaciones cutaneas menores de dermatitis atopica con la constitucion atopica, historia personal y familiar y la interrelacion con los factores medioambientales. Metodos : se investigo a 50 ninos con manifestaciones atopicas menores, mediante exploracion clinica, analitica y pruebas epidermicas e intradermicas (true test, acaros, alimentos). Conclusiones : los criterios menores parecen ser indicadores de la constitucion atopica mas que del eccema atopico; en este, el medio ambiente y la herencia influyen de forma importante. Los eosinofilos y la IgE no se relacionaron con la intensidad del proceso cutaneo, sino con la intensidad del proceso respiratorio y la reactividad a los acaros. Los alimentos no tuvieron relacion con las manifestaciones cutaneas.