Abstract Background: Topical corticosteroids (TCS) are the mainstay of treatment in atopic dermatitis (AD) flares. The fears and worries concerning TCS are known as corticophobia. Corticophobia is common in patients with AD and can lead to suboptimal TCS application and treatment failure. Health literacy (HL) may influence corticophobia. TOPICOP© and HLS-EU-PT questionnaires have been developed to evaluate corticophobia and HL, respectively. Objective: Evaluate the relationship between corticophobia and the degree of HL in patients with AD. Methods: Prospective cross-sectional study with AD patients followed at a Dermatology Department, between September 2019 and February 2020. Patients, or their parents (if patients had ≤ 15 years), were invited to answer TOPICOP© questionnaire, HLS-EU-PT questionnaire, and a disease characterization and demographic questionnaire. Results: We included 61 patients (57.4% females, mean age 20 ± 13.8 years, mean disease duration of 12.5 ± 11.4 years). TOPICOP© mean score was 44.8 ± 20.0 (8.3 to 88.9) and HLS-EU-PT mean score was 30.5 ± 8.5 (1.1 to 47.9). TOPICOP© score was negatively correlated with HLS-EU-PT score (p = 0.002, r = -0.382, r2 = 0.146). There was no statistical difference between TOPICOP© score and disease characteristics (disease severity, family history of AD or personal history of other atopic diseases). Study limitations: Small and heterogenous cohort composed of patients and patients’ parents. Conclusions: The degree of corticophobia is similar to the values reported in other studies. HL had an inverse correlation with corticophobia. Lower HL was shown to be a predictor of higher corticophobia. The promotion of health literacy is essential for the correct use of TCS and good control of AD.

Abstract: Solar urticaria is a rare form of physical urticaria mediated by immunoglobulin E. The lesions appear immediately after the sun exposure, interfering with the patient's normal daily life. Omalizumab, a monoclonal anti-IgE antibody, has been recently approved for the treatment of chronic spontaneous urticaria, and the latest reports support its role also in the treatment of solar urticaria. Hereby, we report a case of solar urticaria refractory to conventional treatment strategies, with an excellent response to treatment with omalizumab and phototesting normalization.

Abstract: Reticulohistiocytomas represent a group of benign histiocytic dermal proliferations, which occur either sporadically as solitary cutaneous nodules or, when multiple, in association with systemic disease. Due to its nonspecific clinical presentation, reticulohistiocytoma may mimic other benign or malignant skin neoplasms; therefore, in most cases, a biopsy is needed in order to establish the correct diagnosis. The histology is typically characterized by the presence of large histiocytes with abundant eosinophilic cytoplasm with immunohistochemical profile positive for CD68, CD163, and vimentin. The authors report the case of a patient with solitary reticulohistiocytoma with illustrative clinical, dermoscopic, and histologic features.

Introdução: A úlcera de Lipschütz é caracterizada pelo aparecimento súbito de úlceras vulvares dolorosas em mulheres jovens sexualmente não ativas, sendo rara em crianças. A etiologia é desconhecida, mas existem estudos que a relacionam com a primo-infeção pelo vírus Epstein-Barr. O diagnóstico é equacionado após exclusão de outras causas de ulceração genital, nomeadamente autoimune, traumática e de infeções sexualmente transmissíveis. Caso Clínico: Criança de doze meses, que surge com ulceração vulvar, associada a febre e otite média aguda. Dos exames complementares realizados, de salientar a serologia para vírus Epstein-Barr positiva e restante estudo analítico negativo. A evolução foi favorável, com resolução das lesões após seis semanas e sem recorrência durante os 10 meses de seguimento. Discussão: Quando as causas mais comuns de úlcera genital são excluídas e não há história de contato sexual, a úlcera de Lipschütz deve ser incluída no diagnóstico diferencial.

Introduction: Lipschütz ulcer is characterized by the rapid onset of painful vulvar ulcerations that typically occurs in sexually inactive adolescent girls, being rare in young children. Although the etiology is unknown, several reports suggest that this entity may be a clinical manifestation of primary infection with Epstein-Barr virus. The diagnosis is made after excluded autoimmune causes, sexually transmitted infections and genital trauma. Case Report: A twelve-month-old girl, admitted with a history of high fever, vulvar ulceration and acute otitis media. Laboratory investigation, demonstrated an acute Epstein-Barr virus infection and ruled out other causes of acute genital ulceration, including autoimmune diseases. Clinical improvement was observed, with resolution of the genital lesions after six weeks, and no recurrence during the ten-month follow-up. Comments: In conclusion if the most common causes of genital ulcer are excluded and there is no sexual contact, Lipschütz ulcer should be included in the differential diagnosis.