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Background: Tranexamic acid, a synthetic derivative of the amino acid lysine, is an antifibrinolytic, procoagulant agent approved by the Food and Drug Administration for the treatment of cyclic heavy menstrual bleeding and prevention of bleeding in patients with hemophilia undergoing tooth extraction. Oral tranexamic acid has been used off-label in dermatology in the treatment of melasma and other hyperpigmentation disorders. In a recent study, oral tranexamic acid was reviewed thoroughly in treating melasma, and its effectiveness was demonstrated. Their role in treating other hyperpigmentation disorders has also been tried in several studies., Aim: To review the evidence regarding the use of tranexamic acid in treating different types of hyperpigmentation disorders other than melasma., Methodology: A comprehensive literature review was searched using the electronic online database "PubMed" and "google scholar" using key words "Postinflammatory hyperpigmentation," "lichen planus pigmentosus," "ashy dermatosis," "riehl melanosis". After that, a full-text review of the studies was performed., Result: Oral tranexamic acid has been used in different types of hyperpigmentation disorder, including postinflammatory hyperpigmentation treatment and prevention, lichen planus pigmentosus, ashy dermatosis, and Riehl melanosis in a dose range from 250 mg per day to 1500 mg per day for a period range from 2 weeks to 6 months with variable efficacy and a good safety profile., Conclusion: Oral tranexamic acid is a promising treatment option in a different type of hyperpigmentation disorders refractory to topical treatment. However, more evidence from blinded randomized controlled trials and case-control studies is needed to determine their efficacy in treating various hyperpigmentation disorders., (© 2022 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Morbilliform eruption typically implies a maculopapular rash of acute onset. Drugs are the predominant cause of this cutaneous reaction in adults, followed by infectious exanthems and some rheumatological diseases. In this article, we report on the clinical and histopathological features of generalized pruritic morbilliform eruption in a 28-year-old female following her second dose of Oxford/AstraZeneca COVID-19 vaccine. The reaction started 12 hours after receiving the vaccine with no other identifiable cause. The patient had no improvement with IV antihistamine received in the emergency department. Afterward, she showed marked improvement after receiving a short course of oral corticosteroids along with topical corticosteroid and oral antihistamine. To the best of our knowledge, we hypothesize that the basic immunological mechanism is the cause behind COVID-19-vaccine-related morbilliform eruption. Therefore, physicians should be aware of the possible adverse reactions associated with COVID-19 vaccines, such as morbilliform eruptions and other cutaneous manifestations., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Alhammad et al.)

Rheumatoid arthritis is a relatively common chronic inflammatory disorder affecting the synovial joints. Extra-articular manifestations of rheumatoid arthritis are not uncommon and include a wide range of cardiovascular, pulmonary, and neurological complications. Gastrointestinal involvement in rheumatoid arthritis is rare, but it can be impactful on the quality of life of patients. We present the case of a 45-year-old woman, with rheumatoid arthritis on methotrexate, who presented with a one-week history of abdominal pain. The patient visited the outpatient clinic earlier and was diagnosed with indigestion and was offered symptomatic treatment which failed to provide any improvement. Abdominal examination revealed a distended abdomen with generalized tenderness and rebound. However, the abdomen was soft with no palpable masses. Initial laboratory examination, including inflammatory parameters, was normal. The patient underwent a computed tomography scan of the abdomen with intravenous contrast which demonstrated inhomogeneous hyperdense mesenteric fat giving a mass-like lesion with a displacement of adjacent bowel loops. Such findings conferred the diagnosis of mesenteric panniculitis. The patient was started on corticosteroid therapy with oral prednisolone 40 mg daily with close follow-up. She developed gradual improvement in her condition and the pain resolved completely after six days. The patient was re-evaluated after six months from discharge and she had no recurrence. The case highlighted a rare association of mesenteric panniculitis and rheumatoid arthritis. Physicians should keep this mesenteric panniculitis in mind when they encounter patients with the autoimmune disorders who presented with abdominal symptoms., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Alzahrani et al.)