These substances should be avoided by carriers of pathogenic variants since this pattern increases the risk of adverse cardiac events

Moreover, in their study of heavy cannabis users, Taylor et al. found that 77% had traces of THC in their hair, 73% had CBN, and 19% had CBD . Similarly, Franz et al. found that THC-OH concentrations in participants’ hair varied between 0.05 and 37.6 pg/mg . The research indicates that exposure to high levels of undeclared tetrahydrocannabinol can adversely affect consumer health, particularly in the form of cannabinoid sensitisation or the development of a cannabinoid allergy, with symptoms ranging from mild to potentially fatal reactions. This sensitisation is particularly of concern because of cross-reactivity with similar substances, such as latex, tobacco, or alcoholic beverages derived from plants or other foods . There is also evidence of cannabis arteritis among young cannabisconsuming adults, which is a severe peripheral vascular disease that can cause a loss of limb use .

Moreover, preclinical research has indicated that although cannabinoids can have antineoplastic effects, they might contribute to the early stages of malignant trans-formation . Based on the abovementioned evidence, there is a clear need to conduct thorough research into the effects of cannabinoid use and to ensure that these effects are used solely for the treatment of dermatological conditions. Of particular concern is this study’s fifinding that cosmetic products meant to be left on tend to have a higher total tetrahydrocannabinol content than those that are rinsed off. This may be the result of most of the products tested here being marketed as treatments for atopic dermatitis and eczema. These dermatological conditions imply inflflammatory dermatoses that can cause the skin barrier to weaken, meaning an increased risk of skin infection for consumers of cosmetic or personal care products adulterated with undeclared tetrahydrocannabinol. In addition, more vulnerable groups, such as the elderly, children below three years of age, and immunocompromised individuals, are particularly susceptible to the effects of adulterated cannabinoid-based products .

Finally, products marketed as suitable for application near the eyes are a particular issue due to the fragility of periocular skin . This study has revealed that although cannabinoid-based cosmetics offer potential treatment methods for a variety of inflflammatory conditions, there are still several areas of concern. For example, only limited research has demonstrated their effificacy and safety, with most data emerging from preliminary animal studies. In addition, the frequent adulteration of these products with undeclared tetrahydrocannabinol is an important issue. Therefore, it is strongly recommended that current regulations be revised and updated to ensure better compliance for cannabinoid-based cosmetic products. Sudden death can be defined as the unexpected natural death of a healthy individual occurring within the first hour after the onset of symptoms or, if death is unwitnessed, within 24 h of the victim being seen in a healthy state. Albeit SD can have many causes, it is normally of cardiac origin, and in those younger than 35 years, it is mainly due to cardiomyopathies and channelopathies . Brugada syndrome is the second most common channelopathy after Long QT syndrome. Sudden death is often the first clinical manifestation of BrS, and this syndrome is not associated with macroscopic/microscopic anomalies, albeit recurrent flogosis and fibrosis in some cardiac districts have been reported .

BrS is characterized by autosomal dominant pattern of inheritance, incomplete penetrance and variable expressivity . SCN5A, which encodes the pore-forming ion-conducting α-subunit of the cardiac sodium channel , is the most frequently mutated gene in BrS cases . In particular, the level of expression of Nav1.5 sodium channels is a critical determinantof the arrhythmogenic process, and its decrease may be a sign of BrS in heterozygous patients . In particular, SCN5A variants can cause late Na+ current and thus the clinical manifestations of both BrS and Long QT syndrome.The only diagnostic ECG pattern of BrS can occur either spontaneously or in response to many licit and illicit drugs.Despite there being not strong evidence of an association between cannabis use and type 1 Brugada ECG pattern, a potential favoring role of this substance has been described . In this paper, we report a case of sudden death in a young consumer of cannabis in which the autopsy revealed a long and thick myocardial bridging , adipositas cordis, fibrosis of the sino-atrial node, and postmortem genetic testing found a variant previously associated to BrS.

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