Expanding Inclusivity: Tranexamic Acid for the Treatment of Melasma in Males

Tranexamic acid (TXA) is an antifibrinolytic medication largely known for its efficacy in managing menorrhagia, or heavy periods, making it a medication predominantly used by women.

COVID Arm: Delayed Hypersensitivity Reactions to SARS-CoV-2 Vaccines Misdiagnosed as Cellulitis

The term “COVID arm” has been coined to describe a harmless delayed hypersensitivity reaction occurring approximately a week after administration of the novel SARS-CoV-2 mRNA vaccine. It appears as a red, warm, pruritic, indurated, or swollen area in the vicinity of the vaccine site. These reactions, especially if accompanied by systemic symptoms, have been mistaken for cellulitis. We report 3 cases of COVID arm, 2 of which were mistaken for cellulitis. Distinguishing features of COVID arm from cellulitis include pruritus as a common finding, occurrence approximately a week after vaccination, a lack of progression of symptoms, rapid response to topical steroids, and/or spontaneous resolution usually over 4 to 5 days.

Practice Points:

• Patients receiving SARS-CoV-2 vaccines may experience delayed hypersensitivity reactions characterized by erythema, swelling, and itching occurring near the vaccination site (COVID arm), approximately a week after vaccination.

• Clinicians can distinguish SARS-CoV-2 vaccine reactions from cellulitis by the time of onset (approximately a week vs 5 days), by the lack of progression of symptoms, and resolution over 4 to 5 days.

• Severe cases of COVID arm may be treated with topical steroids.

Cell Thumb Replaces Writer's Bump: Changing Times, Changing Callouses

Common callouses are formed by the accumulation of keratinocytes in the stratum corneum in response to excess pressure or friction. We report 2 cases of unusual callous formation and an additional 25 more sequential cases that were due to excessive cell phone grip.