Adult-onset Still's disease (AOSD) is an auto inflammatory disorder with a variable clinical presentation, and without a pathognomonic diagnostic test, characterized by high spiking fever, arthralgia/arthritis, a suggestive skin rash, elevated white blood cell count 10 G/L (> 80% neutrophils), elevated ferritin, with glycosylated ferritin < 20% and high IL-18. Cutaneous manifestations are very frequent and the commonest description is an evanescent salmon-pink rash, although many atypical skin presentations have been described in literature. We present the case of an atypical cutaneous manifestation of clinically typical AOSD in a 30-year-old man presenting with a slightly pruritic maculopapular and urticarial erythematous rash on the face and limbs, with purpuric features on the lower limbs, which gradually spread to the whole body, associated with overlying nonfollicular pustules. The patient also presented with high spiking fever, odynophagia, diffuse arthralgia, and generalized asthenia. The histological analysis of a skin biopsy showed a few subcorneal collections of neutrophils, a slight epidermal spongiosis, many suprabasal necrotic keratinocytes, and a moderate mixed inflammatory infiltrate in the superficial dermis. Following various investigations ruling out any other diagnosis, we have diagnosed Still's disease, for which the patient has been prescribed corticosteroids, with good initial results.

China's immunization policy was updated in 2020, replacing the sequence of MR (at 8-12 months) and MMR (at 18-24 months) with a comprehensive two-dose MMR schedule.This study aims to evaluate the safety of this policy shift by comparing the incidence of Adverse Events Following Immunization (AEFI) before and after the adjustment.Methods: A retrospective analysis was conducted using AEFI surveillance data from Jiangsu Province. The study compared two cohorts: the "pre-adjustment" group (MR at 8 months, MMR at 18 months) and the "post-adjustment" group (MMR at both 8 and 18 months). Incidence rates of non-serious reactions (fever, fatigue, local redness, and swelling) and serious reactions (allergic rash, febrile seizures, etc.) were analyzed using Chi-square tests and rate ratios (RR). Results: The transition to a two-dose MMR schedule was associated with an increase in reported mild AEFIs. Specifically, at the 8-month dose, the incidence of fever, fatigue, local redness, and swelling was significantly higher in the MMR8 group compared to the MR8 group (P < .001). The incidence of allergic rash also showed a 31% increase in the MMR8 group (45.39 per 100,000) compared to the MR8 group (34.71 per 100,000), though it remained below global safety thresholds. Crucially, there were no statistically significant differences in the incidence of serious AEFIs, such as thrombocytopenic purpura (P = .670) or febrile seizures (P = .915), between the two strategies. Furthermore, serious reactions as a whole category showed no statistically significant difference between MR8 and MMR8 (P = .710). The implementation of a two-dose MMR immunization schedule in Jiangsu Province is safe. While the shift was associated with an increase in mild, self-limiting reactions, it did not lead to an increase in serious adverse events. These findings support the continued use of the two-dose MMR strategy to provide broader protection against measles, mumps, and rubella without compromising vaccine safety.

Multisystem Inflammatory Syndrome in Children is a serious complication associated with coronavirus disease 2019 that commonly affects individuals under 19 years of age. This condition can present with a wide spectrum of clinical manifestations, some of which may be severe or life-threatening. Management can be challenging due to the variability in clinical presentation and response to therapy. This report describes the case of a toddler with no previously documented severe acute respiratory syndrome coronavirus 2 infection who presented with a 30-day relapsing fever that demonstrated partial response to antipyretics and was associated with gastrointestinal symptoms and a skin rash. Following extensive clinical and laboratory investigations, the patient was diagnosed with multisystem inflammatory syndrome in children and was successfully treated with intravenous immunoglobulin and corticosteroids.

BACKGROUND Photo recall dermatitis (PRD) is a phototoxic eruption that occurs in areas of previous ultraviolet-damaged skin following systemic administration of a drug, most commonly chemotherapeutic medications. Although generally considered a self-limited dermatologic phenomenon, its implications in immunocompromised patients have not been well characterized. Secondary infection complicating PRD has not been previously established in the literature. This case is unique because the patient had an unusual rash while neutropenic, then developed a bloodstream infection (BSI), with the skin as her most likely source. CASE REPORT We describe a case of a woman in her 80s with metastatic pancreatic adenocarcinoma enrolled in a clinical trial of a DNA methyltransferase-inhibiting nucleoside analog who presented with fever, neutropenia, and an erythematous rash localized precisely to areas of a recent sunburn. Dermatologic evaluation supported a diagnosis of photo recall dermatitis. Peripheral blood cultures grew Staphylococcus hominis in 1 of 4 bottles, while concurrent port cultures were negative. She developed clinical signs of a true BSI rather than culture contamination, with the presentation consistent with a skin source as the most likely route of entry rather than a central-line-associated BSI (CLABSI) usually observed with S. hominis infections. CONCLUSIONS This case is, to the best of our knowledge, the first reported instance of photo recall dermatitis complicated by bloodstream infection. It highlights the potential for inflammatory skin barrier disruption to serve as a portal of entry in neutropenic patients. Clinicians should be aware that photo recall dermatitis can lead to infections, including BSIs, in immunocompromised hosts.

No evidence suggests that women receiving a vaccine against SARS-CoV-2, the virus that causes COVID-19, is harmful to either the nursing mother or the breastfed infant. Antibodies appear in the milk after maternal vaccination, which may protect the infant against COVID-19. Professional organizations and governmental health authorities have recommended that COVID-19 vaccines be offered to those who are breastfeeding because the potential benefits of maternal vaccination during lactation outweigh any theoretical risks, including mothers with diabetes mellitus.[1-12] Nursing mothers experienced minimal disruption of breastfeeding after vaccination and noticed no serious adverse effects in their infants.[13,14]

The mpox outbreaks observed in 2025 highlighted significant shifts in transmission dynamics, viral clades, and public health responses, particularly in Africa. In contrast, Sierra Leone experienced its largest mpox outbreak that year-Africa's first major Clade IIb epidemic-which ran from 10 January to 17 December 2025. It involved 5,442 confirmed cases among 7,110 suspected cases, a case fatality rate of 1.1%, and 22,536 contacts identified. A public health emergency was declared on 13 January 2025. Transmission peaked in epidemiological week 20 (May 2025) with 654 confirmed cases. The burden was highest in Western Area Urban (55.4%, 3,014 cases), Western Area Rural (19.9%), and Bombali (6.1%). Cases predominantly affected young adults aged 20-39 years (median age 26) and males (52.5%). Key affected groups included sex workers, children under 15 years (6.5%), and pregnant women (1.6%). High population density in Freetown, limited resources, weak coordination, misinformation, and surveillance gaps facilitated spread. Genomic evidence revealed undetected Clade IIb (hMPXV-1 lineage, including G.1) circulating for ~3 months from Nigeria. Environmental contamination affected 13.5% of healthcare surfaces. Symptoms included rash, fever, headache, lymphadenopathy, sore throat, and pain; 28.9% of cases were hospitalized, often delayed by stigma and fear. Among those screened for HIV co-infection (23.6%), 82% of deaths occurred in co-infected individuals. The National Public Health Agency (NPHA) implemented seven response pillars: case management and isolation, infection prevention and control (IPC), risk communication, targeted vaccination (186,470 doses administered from 267,000 received), coordination, surveillance, and research. The outbreak ended after 42 consecutive case-free days, underscoring the importance of early surveillance and genomic monitoring to prevent sustained urban transmission.