"The itching hand"- important differential diagnoses and treatment

Palms and soles itchiness as a side effect of COVID-19 vaccination

Background

COVID-19 is a pandemic disease that has no definite treatment or preventive medication until late 2020 when vaccines were developed. Vaccines are a very useful new tool against COVID-19 that stimulate the immune system after recognition of viruses or their parts. Complications post vaccination could happen and they depend on the types, vaccine mechanism of action as well as some other patients' factors.

Case report

We are reporting a 39 years old lady who is known as allergic to a strawberry and kiwi, otherwise medically free. She presented to the outpatient unit with a ten-days history of palms of the hands and soles of the feet itchiness that is associated with occasional redness after receiving the first dose of COVID-19 vaccination. There were no skin rashes or pruritis at any other sites. The patient was treated conservatively by antihistamine and the symptoms gradually resolved within five days.

Conclusion

Allergic reaction is one of the expected complications post any COVID-19 or non-COVID-19 vaccination. Although the type, distributions and severity of allergic reactions are variable from person to another, yet isolated itching to palms and soles could be a rare side effect post first dose of COVID-19 vaccination (Pfizer-BioNTech) which is worth reporting. This presentation could be a type of allergic reaction which may require holding further doses, debate is there for further case reporting, research or evaluation.

Learning points:

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Isolated itching to palms and soles could be one of the side effects of COVID-19 vaccination (Pfizer-BioNTech) which is worth reporting.

Monitoring of the oxidation of the oil from sacha inchi (

This work focuses on the characterization of the oxidation of the oil from sacha inchi seeds (Plukenetia volubilis) under accelerated conditions at 60 ºC for 15 days. Five samples were monitored: three supplemented with 200 ppm of non-hydrolyzed or partially hydrolyzed (for 4 and 9 hours) extracts from tara (Caesalpinia spinosa) pods, one without antioxidant and one with 200 ppm of BHT. Several conventional tech­niques (induction time, peroxide value, conjugated dienoic acid, p-anisidine value, total unsaturated fatty acids and α-linolenic acid contents) and the MIR spectroscopy coupled with chemometric tools were used and com­pared. The results revealed that whatever the antioxidant added, the oil from sacha inchi is fairly stable over time. The results also pointed out that extracts from tara pods, mainly those partially hydrolyzed, were more efficient than BHT against oil oxidation for up to 7 days. Finally, this paper shows that MIR spectroscopy pres­ents an interesting alternative technique for the monitoring of the oxidation of the oil from sacha inchi.

Itching in patients with chronic hand eczema: data from the CARPE registry

BACKGROUND

Itching is a leading symptom of chronic hand eczema (CHE) having a great impact on patients. The determinants of itching in CHE are unclear.

OBJECTIVE

We performed a cross-sectional analysis investigating factors associated with the presence and severity of itch in CHE patients from the CARPE registry.

METHODS

We present baseline data on itch in relationship with sociodemographic factors, severity of CHE, atopy, contact allergy, treatment and patient- reported outcomes including health-related quality of life (HRQoL).

RESULTS

Of 1,051 patients with CHE, 78.1% reported itching. Significant positive associations with itching were observed for younger age groups (17-25 and 26-45 years), for moderate, severe and very severe CHE and for small/moderate impairment in HRQoL. Atopic skin diathesis, hardly being able to realize treatment recommendations and very or extremely large impairments in HRQoL were associated with itch severity.

CONCLUSION

Taking the identified variables into account may help identify vulnerable groups most affected by (severe) itch.