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84%, 43 of 77 patients) and skin-related fearful thoughts (54.55%, 42 of 77 patients). Sleep disorders reduced daytime performance in 68.70% (79 of 115 patients) and sleep quality of relatives in 20.87% (24 of 115 patients). The prevalence of insomnia among different diagnostic categories ranged from 20.31% to 50.00%. The most common strategy to improve sleep was taking sleep medication (57.39%, 66 of 115 patients). We conclude that sleep disorders are highly prevalent in dermatology patients, often leading to reduced daytime performance, impaired sleep among the patients' relatives, and increased use of substances.Trench mouth, as it occurred especially in World War I in soldiers, is a necrotizing ulcerative gingivitis (NUG) in people who have poor oral hygiene, malnutrition, vitamin deficiency, a smoking history, and psychic stress. When not treated properly, this condition can lead to noma. NUG and noma are mainly seen today in severely malnourished, poorly cared for, and immunocompromised children in extremely poor living conditions, mainly in sub-Saharan Africa. In 20th century history, the occurrence of noma in Turkey was described by Albert Eckstein (1891-1959), but noma is particularly linked to the atrocious living conditions in the Nazi exterminations camps, such as Auschwitz, where large numbers of patients with noma were treated in Berthold Epstein's (1890-1962) Noma Department in the Zigeunerlager (Gypsy Camp) under the supervision of SS physician Josef Mengele (1911-1979). Although these patients were treated successfully, all of them, mostly children, were ultimately killed. The protocols of the noma research are lost, and descriptions from Auschwitz are scarce. Fortuitously, there are some testimonies, especially from postwar trials, that give insight on this ambiguous and repressed topic.The terrorist attacks on September 11, 2001, caused a significant loss of life and resulted in injuries, plus other health issues that continue to plague many survivors and responders to this day. With the 20th anniversary of this tragedy approaching, this contribution looks at the dermatologic injuries suffered on the day of the attacks, including burns and lacerations, along with the chronic skin conditions that have afflicted survivors and responders during the nearly two decades since. These chronic illnesses include sarcoidosis, autoimmune disease, ill-defined skin lesions and irritation, nonmelanoma skin cancer, and melanoma. We also recognize the heroism of first responders who struggled to save the lives of those injured at the World Trade Center and the Pentagon, many of whom have suffered health consequences that continue to have lasting effects on them and on the people they treated.A total of 22 patients who had developed an adverse cutaneous reaction to the Moderna or Pfizer vaccine underwent biopsies. Each patient was assessed light microscopically, and, in select biopsies, spike glycoprotein and cytokine assessment were also conducted. The patients developed self-limited cutaneous reactions often described clinically as urticarial or eczematous within 1 day to 4 weeks after receiving the first or second dose of the Pfizer or Moderna vaccine. Classic clinical and morphologic depictions of type IV cutaneous hypersensitivity with features of eczematous dermatitis, interface dermatitis, granulomatous inflammation, and/or lymphocytic vasculitic component were observed. Clinical and/or histologic features of perniosis, pityriasis rosea, pityriasis rubra pilaris, and guttate psoriasis were seen in select cases. In 2 cases the dominant picture was urticarial vasculitis, possibly reflective of an Arthus type III immune complex action. The biopsy specimens of normal skin post vaccine and of skin affected by the post-vaccine eruption showed rare deep microvessels positive for spike glycoprotein with no complement deposition contrasting with greater vascular deposition of spike protein and complement in skin biopsies from patients experiencing severe coronavirus disease 2019 (COVID-19). It is concluded that self-limited hypersensitivity reactions to the vaccine occur possibly owing to a substance found in the vaccine vehicle (eg, polyethylene glycol). An immune response that is directed against human-manufactured spike has to be considered because some of the reactions clinically and or histologically closely resemble mild COVID-19. Finally, vaccine-associated immune enhancement largely attributable to the adjuvant properties of the vaccine may unmask certain inflammatory milieus operational in psoriasis, atopic dermatitis, and subclinical hypersensitivity.Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiologic agent of coronavirus disease 2019 (COVID-19), is a single-stranded RNA virus whose sequence is known. COVID-19 is associated with a heterogeneous clinical phenotype ranging from asymptomatic to fatal disease. It appears that access to nasopharyngeal respiratory epithelia expressing angiotensin-converting enzyme (ACE) 2, the receptor for SARS-CoV-2, is followed by viral replication in the pulmonary alveolar septal capillary bed. We have demonstrated in earlier studies that incomplete viral particles, termed pseudovirions, dock to deep subcutaneous and other vascular beds, potentially contributing to the prothrombotic state and systemic complement activation that characterizes severe and critical COVID-19. A variety of skin eruptions have been described in the setting of SARS-CoV-2 infection and more recently, after COVID-19 vaccination. The vaccines deliver a laboratory-synthesized mRNA that encodes a protein that is identical to the saneous vaccine reactions that manifest a clinical and morphologic parallel with similar eruptions observed in patients with mild and moderate COVID-19 and in some cases represent systemic eczematoid hypersensitivity reactions to a putative vaccine-based antigen versus unmasking subclinical hypersensitivity due to immune enhancing effects of the vaccine. Finally, we demonstrate for the first time the localization of human synthesized spike glycoprotein after the COVID-19 vaccine to the cutaneous and subcutaneous vasculature confirming the ability of SARS-CoV-2 spike glycoprotein to bind endothelium in the absence of intact virus.On January 9, 2014, I received a call at my home in the small town of Alfeld (Leine), Central Germany. On the phone was Barbara Riepl, an acquaintance from Munich, and she had a truly exciting story waiting for me.1 The grandfather of her best friend Nicole had been a prominent Hungarian Jew who had been deported to Auschwitz during World War II. There, he became a prisoner doctor forced to assist the notorious Nazi doctor Josef Mengele in his infamous human experiments. Several years after the war, he deposited a slew of documents in a Swiss safe. That safe had remained untouched for decades, but it was to be unsealed soon. Riepl went on to claim that her friend had entrusted her personally with these documents and asked if I, as a historian, would be interested in examining the documents and-if need arose-help to publish them.The history of the restoration of the masterpiece the Virgin and Child with Canon van der Paele by Jan van Eyck focuses on the expertise of an acute observer, a dermatologist, who noted the removal of an important clinical skin detail-a lesion on the lower lip. The author's re-evaluation of the historic images before and after the restoration confirms the observation made by Jules Desneux, a Belgian dermatologist, in 1951. The author read the book that Cesare Brandi, an Italian restorer, published in 1960 technically detailing the error and the inattentive restoration. In addition, the author found and read the book published in 1951 by Desneux, in which the dermatologist accurately and brilliantly reports the skin lesions of the aged canon and brings to life the absence of the nodule of the lip.It has been widely accepted that ergot is a fungal disease caused by infection with the parasitic Claviceps purpurea leading to the development of typical black kernels n the plant. Ingestion of infected rye grains containing ergot alkaloids-usually in the form of contaminated rye bread-causes poisoning, also known as ergotism. The negative impacts of ergot contamination of grain on the health of humans and animals were first documented in ancient times. The history of ergotism shows the influence of food on human health. Although ergot has been known for ages, until the 18th century, its nature was not recognized. It was a part of the rye plant and it was used in traditional medicine. The diet was based was mostly on rye that led to neurologic disorders and gangrene. In the Middle Ages, in regions where rye was a dietary staple, many cases of a peculiar epidemic were recorded. Two names are usually used to describe it "Saint Anthony's fire" and "holy fire," although there are many more appellations. The history of ergotism is a very important part of history of dermatology. The saint who people prayed to for protection against the disease was Anthony the Great (251-356). Monks of the Order of Saint Anthony played a particular role in treating ergotism by natural methods and specialized in treating skin diseases. Ergot alkaloids still pose a risk to human and animal safety if they appear in food.Data on the tolerability and response to biologic therapies for type 2 immune disorders in the context of coronavirus disease 2019 (COVID-19) are currently lacking. Our survey aimed at assessing the adherence of patients to dupilumab therapy and the risk of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A total of 80 patients with atopic dermatitis treated with dupilumab completed a web-based survey. Of the 80 patients, 7 discontinued dupilumab owing to concerns and difficulties related to COVID-19. Our sample was highly susceptible to viral infection owing to the frequency of risk factors including living in high SARS-CoV-2 burden areas, such as in Northern Italy; having comorbidities, such as asthma, diabetes, and cardiovascular disease; and being of advanced age. Older patients in our sample are particularly exposed to the risk of COVID-19-related cytokine storm, triggered by excessive interleukin-4 production and type 2 immune response. One patient contracted SARS-CoV-2 infection without the progression of COVID-19 despite continuing scheduled dupilumab treatment. Because evidence on the appropriate management of biologic therapy in the setting of COVID-19 is lacking, the collection of clinical data from patients in treatment with dupilumab is a valuable addition to current clinical practice. Our survey provides a contribution to the understanding of the tolerability and response to dupilumab during COVID-19 and suggests a feasible and effective approach to patients being treated with biologics even when social distancing is required.Sir Erasmus Wilson was a pioneer in dermatology and one of the most famous doctors in Victorian England. He enjoyed a sterling professional reputation, with one exception. During the 1860s, his name appeared in a wide variety of cosmetic advertisements endorsing commercial products such as Pears soap, which is still marketed today, as well as hair washes and pomades. Questions were raised in The Lancet about the propriety of Wilson's involvement with such commercial products. Wilson denied in a letter to The Lancet any connection with these advertisements; nonetheless, some confusion has lingered over the years about whether Wilson received any financial compensation from the Pears Soap Company in return for his product endorsements, and whether he enjoyed a business relationship with cosmetic companies that added to his wealth. This contribution presents a comprehensive review of Erasmus Wilson's relationship with cosmetic companies and his struggle to distance himself from them.