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Background: The microbiological diagnosis of skin lesions related to COVID‐19 is not well known. Objective: Perform a microbiological diagnosis in COVID19‐related cutaneous manifestations. Methods: A cross‐sectional study was performed with 64 patients with cutaneous manifestations associated with COVID‐19 who underwent serological and nasopharyngeal reverse transcription polymerase chain reaction (RT‐PCR) for SARS‐CoV‐2. Results: Out of the 64 patients, 6 patients had positive RT‐PCR, with all of them developing SARS‐CoV‐2 IgG and 4 of them had positive IgM + IgA. Of the 58 patients with negative RT‐PCR, 8 cases had positive IgM + IgA and only one of them had IgG seroconversion. Therefore, the infection was demonstrated in 7 cases (10.9%) and was doubtful in 7 other cases (10.9%) who presented negative RT‐PCR and presence of IgA + IgM without subsequent seroconversion of IgG. Fifty patients (78.1%) had negative serological tests. The most frequent cutaneous pattern was pseudo‐chilblain (48.4%) followed by maculo‐papular pattern (26.6%), urticarial lesions (10.9%), vesicular eruptions (6.3%) and livedoid pattern (4.7%). The maculo‐papular pattern showed the highest positivity in RT‐PCR (3 cases; 17.6%) and serologies (4 cases; 23.5%). Skin lesions developed after the systemic symptoms in most patients (19 cases; 61.3%). Conclusions: Microbiological confirmation tests may not be an effective diagnostic technique for COVID‐related cutaneous manifestations or that attributed lesions are not related to COVID‐19. Confounding factors such as adverse drug reaction, serological cross‐reactions with other viruses, the low production of antibodies in asymptomatic or mild forms of COVID‐19 or its rapid disappearance, increase diagnostic uncertainty.

Pemetrexed is a multi-targeted folate antagonist drug approved for the treatment of advanced and metastatic non-small cell lung carcinoma (NSCLC), and malignant pleural mesothelioma, and is known to induce cutaneous adverse reactions in approximately 20% of patients. We report a case of an uncommon toxicity induced by pemetrexed: scleroderma-like condition of the lower extremities. This cutaneous adverse effect is often unrecognized, resulting in delayed diagnosis, which often leads to a worsening in the condition and increasing the risk of further fibrosing sequelae.

Since the beginning of the COVID‐19 pandemic, different types of cutaneous manifestations have been reported. In Spain, there were reports in the first weeks of April 2020 of an increase in purpuric acral lesions similar to perniosis on the hands and especially the feet of children and young adults. These patients do not normally present with clinical manifestations linked to COVID‐19, and their PCR and serological tests are usually negative for specific IgM and IgG.

Molluscum contagiosum (MC), a frequent viral infection, is generally easy to diagnose because of its characteristic clinical features. However, atypical presentations can be a diagnostic challenge for clinicians. Dermoscopy has helped in this cases by showing a characteristic dermoscopic pattern composed of a central pore or umbilication in conjunction with polylobular white to yellow amorphous structures, surrounded by linear or branched vessels (‘red crown”). However, additional dermoscopic patterns can be found. Herein we present two MC cases where rosettes were seen on dermoscopy

Acral purpura is generally a hallmark for severe internal disease. However, exogenous pigmentation related to contact with invertebrates, can induce acral purpura-like lesions. Data regarding the beetle's ability to cause skin hyperpigmentation or purpura-like lesions are scarce. We report a case of exogenous pigmentation caused by accidental contact with a darkling beetle, clinically simulating acral purpuric lesions. The history of recent drug inhalation and abnormal autoimmunity tests made this diagnosis difficult.

Exercise-induced vasculitis (EIV) is a benign cutaneous vasculitis that affects healthy individuals. We report a case of EIV in a 15-year-old male patient with a striking clinical appearance triggered by a combination of prolonged standing and disco dancing in a warm environment. Pediatric dermatologists should be aware of this activity as a possible trigger of EIV, especially in teenagers.

The association between neurofibromatosis type 1 (NF-1) and vasculopathy has been reported frequently, especially cerebral, intestinal, and peripheral vasculopathy. However, cutaneous vasculopathy is infrequent.The authors present the case of a 32-year-old man with a painful ulcer on his left thigh of 3 weeks' duration in the same location as a long-time capillary malformation associated with alopecia. The skin biopsy showed signs of perivascular fibromuscular dysplasia with proliferating myofibroblastic cells. The patient had been treated with various therapeutic options, such as topical antibiotics, oral and intralesional corticosteroids, and oral cyclosporine and intravenous prostanoids.Cutaneous vasculopathy related to the skin, such as livedo reticularis and ulcers of torpid evolution due to cutaneous vasculopathy are extremely rare. Thus, it is necessary to include skin ulcers as one of the phenotypic manifestations of NF-1.

Niño de seis años de edad que presenta una lesión cutánea en mejilla izquierda de crecimiento progresivo de cuatro meses de evolución. Sus padres refieren el antecedente de una picadura de insecto en dicha localización durante un viaje a Marrakech (Marruecos) que realizaron hace cinco meses. A la exploración se aprecia una placa eritematosa de 1, 5 cm de diámetro con costra amarillenta central (fig. 1). La dermatoscopia de luz polarizada (DLP) reveló hallazgos compatibles con una infección cutánea por Leishmania spp. (fig. 2)...