Patient Recovery from COVID-19 Infections: Follow-Up of Hair, Nail, and Cutaneous Manifestations

Background. COVID-19 is a pandemic disease worldwide. Although cutaneous manifestations may present in affected patients, there have been limited studies on the cutaneous findings and hair and nail abnormalities after discharge. Objective. To establish the cutaneous manifestations, hair and scalp disorders, and nail abnormalities in patients who recovered from COVID-19 infections. Methods. A retrospective chart review and telephone interviews were conducted to determine the cutaneous manifestations, hair and scalp disorders, and nail abnormalities of patients aged over 18 years who were diagnosed with COVID-19 infections at Siriraj Hospital, Bangkok, Thailand, between January and June 2020. Results. Ninety-three patients with prior COVID-19 infections participated in the study. The COVID-19 severity had been mild for most (71%). Cutaneous manifestations were reported in 8 patients (8.6%), with the common skin conditions being maculopapular rash and urticaria. The onsets of the skin conditions were before admission (1%), during admission (4.3%), and after discharge (3.2%). Increased hair shedding was also reported in 22 patients (23.7%), with a female predominance. Three patients were affected during admission, while the others were affected after discharge. The patients with moderate, severe, and critical COVID-19 infections experienced significantly more hair shedding than those with asymptomatic and mild diseases. Only 2 patients with mild COVID-19 disease reported nail abnormalities (chromonychia and brittle nails). Conclusions. Cutaneous manifestations, hair disorders, and nail abnormalities can occur in patients with COVID-19 after their discharge from hospital. Patients should therefore be followed up in anticipation of dermatological problems.

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Dermatological Manifestation in Coronavirus Disease 2019 Patients in Iraq

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.7095 ◽

2021 ◽

Vol 9 (B) ◽

pp. 1085-1091

Author(s):

Anfal L. Al-Harbawi ◽

Qasim S. Al Chalabi ◽

Hala N. Alsalman ◽

Mohammad S. Saeed

Keyword(s):

Early Recognition ◽

Cutaneous Lesion ◽

Maculopapular Rash ◽

Skin Lesions ◽

Cross Sectional Study ◽

Prodromal Phase ◽

Cross Sectional ◽

Cutaneous Manifestations ◽

High Incidence ◽

Common Skin

Background: Coronavirus disease-19 (COVID-19) is a growing pandemic around the globe that was initially discovered in Wuhan in December 2019. Despite the relatively high incidence of cutaneous manifestations in COVID-19, their role in early recognition and disease progression has not been fully investigated. Aim of this study: To report the possible incidence of the cutaneous lesion in COVID 19 patients and to describe various cutaneous manifestations and their correlation with other clinical features in Covid-19 positive patients to facilitate diagnosis and prognostications toward this virus. Methods: This research was conducted as a cross-sectional study. Skin lesions photography and their analysis were collected by dermatologists from 18 cities in Iraq between September 2020 to January 2021. The data were processed using statistical package SPSS version 23. Results: A total of 3117 confirmed COVID-19 cases were included in this study. Around 268 patients developed skin lesions with age ranged between 8 to 84 years. Of these skin lesions, 46.2% developed during the illness with minority erupting during the prodromal phase, whilst 38.8% appeared after hospitalization. The most common skin lesion was in the form of urticarial 36.74% followed by herpetic lesions 28.4%, maculopapular rash 11.74% and the remainder being candidiasis, oral thrush, chilblains, and other skin conditions. The most affected area was the torso (46%) followed by limbs, face, fingers, and toes. Conclusion: This study demonstrated the high incidence rate of dermatological lesions in different phases of COVID-19 with urticarial rash being the most frequent clinical pattern.

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Factors associated with early and late digital revascularization and replantation failure: A retrospective cohort study

Journal of Hand Surgery (European Volume) ◽

10.1177/17531934211028155 ◽

2021 ◽

pp. 175319342110281

Author(s):

Matthew Florczynski ◽

Shawn Khan ◽

Helene Retrouvey ◽

Ogi Solaja ◽

Heather Baltzer

Keyword(s):

Retrospective Chart Review ◽

Early Postoperative Period ◽

Early Failure ◽

Level Of Evidence ◽

Factors Associated ◽

Late Failure ◽

Hospital Patients ◽

Early Failures ◽

Crush Injuries ◽

Discharge From Hospital

Factors associated with failure of digital revascularization and replantation procedures have been well characterized, but studies have not investigated failures occurring beyond the early postoperative period. A single-centre retrospective chart review included 284 patients (434 digits) who underwent digital revascularization or replantation. Patient-, injury- and surgery-related characteristics were compared among successful procedures, digits that failed while in hospital (early failure), and initially viable digits that failed after hospital discharge (late failure). Overall, 202 patients had successful procedures (71%). There were 51 early failures (18%) and 31 late failures (11%). Crush injuries and vein grafting were associated with early failure only. Complete amputations and leeching were strongly associated with both early and late failure. This study revealed that a substantial proportion of initially viable digits fail after discharge from hospital. Patients with signs of venous congestion may benefit from longer observation periods in hospital to avoid late failure. Level of evidence: IV

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Cutaneous Manifestations in Biological-Treated Inflammatory Bowel Disease Patients: A Narrative Review

Journal of Clinical Medicine ◽

10.3390/jcm10051040 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1040

Author(s):

Jo L. W. Lambert ◽

Sofie De Schepper ◽

Reinhart Speeckaert

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Cutaneous Manifestations ◽

Cutaneous Infections ◽

Tnf Α ◽

Common Skin ◽

Receptor Blockers ◽

Infusion Reactions ◽

Inflammatory Bowel ◽

Lichenoid Reactions

The biologic era has greatly improved the treatment of Crohn’s disease and ulcerative colitis. Biologics can however induce a wide variety of skin eruptions, especially those targeting the TNF-α and Th17 pathway. These include infusion reactions, eczema, psoriasis, lupus, alopecia areata, vitiligo, lichenoid reactions, granulomatous disorders, vasculitis, skin cancer, and cutaneous infections. It is important to recognize these conditions as treatment-induced adverse reactions and adapt the treatment strategy accordingly. Some conditions can be treated topically while others require cessation or switch of the biological therapy. TNF-α antagonists have the highest rate adverse skin eruptions followed by ustekinumab and anti-integrin receptor blockers. In this review, we provide an overview of the most common skin eruptions which can be encountered in clinical practice when treating IBD (Inflammatory bowel disease) patients and propose a therapeutic approach for each condition.

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Severe urticarial rash as the initial symptom of COVID-19 infection

BMJ Case Reports ◽

10.1136/bcr-2021-241793 ◽

2021 ◽

Vol 14 (3) ◽

pp. e241793

Author(s):

Sandeep Pagali ◽

Riddhi S Parikh

Keyword(s):

Maculopapular Rash ◽

Initial Symptom ◽

Shortness Of Breath ◽

Cutaneous Manifestations ◽

Urticarial Rash ◽

Vesicular Rash ◽

Recommended Therapy ◽

Pcr Test

A 54-year-old woman presented with pruritic rash and hives of 3 days’ duration followed by shortness of breath for 1 day. SARS-CoV-2 PCR test for COVID-19 was positive. Cutaneous manifestations of COVID-19 include acral lesions, urticarial rash, erythematous maculopapular rash, vascular rashes and vesicular rash. The cutaneous manifestations are mostly described as self-limiting. Urticarial rashes are not reported as the initial presentation symptom of COVID-19 infection but mostly noted to occur at the same time or after the onset of non-cutaneous symptoms. Management of cutaneous manifestations of COVID-19 affecting quality of life has not been well studied. Antihistamine therapy is the primary recommended therapy. Role of antiviral therapy for severe cases of rash needs to be further assessed.

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The Influence of Provider Behavior, Parental Characteristics, and a Public Policy Initiative on the Immunization Status of Children Followed by Private Pediatricians: A Study From Pediatric Research in Office Settings

PEDIATRICS ◽

10.1542/peds.99.2.209 ◽

1997 ◽

Vol 99 (2) ◽

pp. 209-215 ◽

Cited By ~ 4

Author(s):

James A. Taylor ◽

Paul M. Darden ◽

Eric Slora ◽

Cynthia M. Hasemeier ◽

Linda Asmussen ◽

...

Keyword(s):

Retrospective Chart Review ◽

Pediatric Research ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Provider Behavior ◽

Telephone Interviews ◽

Immunization Status ◽

Immunization Rates ◽

Parental Characteristics ◽

Education Levels

Objectives. To determine the relative impact of parental characteristics, provider behavior, and the provision of free vaccines through state-sponsored vaccine volume programs (VVPs) on the immunization status of children followed by private pediatricians. Study Design. Retrospective and cross-sectional surveys of immunization data. Setting. The offices of 15 private pediatricians, from 11 states, who were members of the Pediatric Research in Office Settings network. Seven of these physicians used vaccines provided through VVPs. Patients. Children 2 to 3 years old followed by the participating physicians. Methods. The immunization status of children was assessed from two separate samples. For sample 1, immunization data were abstracted from the medical records of 60 consecutive eligible children seen in each office. Parents of the selected children indicated the method of payment for immunizations and the education levels of the mothers. Because this cross-sectional survey might have oversampled frequent health care users, a retrospective chart review of up to 75 randomly selected children in each pediatrician's practice was also conducted (sample 2). Additional data were collected from the parents of children in sample 2 by telephone interviews. For both samples, patients were considered to be fully immunized if they had received four diphtheria-tetanus-pertussis/diphtheria-tetanus vaccines, three oral poliovirus/inactivated poliovirus vaccines, and one measles-mumps-rubella vaccine before their second birthdays. Before collecting vaccination data, pediatricians completed a survey detailing their immunization beliefs and practices. Logistic regression was used to identify factors that were independently associated with a child being fully immunized. Results. For sample 1, 81.7% of the 857 children surveyed were fully immunized. Practitioner-specific immunization rates varied widely, ranging from 51% to 97%. The immunization rate of children who received vaccines provided by VVPs was similar to that of children whose immunizations were not provided by VVPs (81.2% vs 82.2%; odds ratio [OR] for a VVP as a predictor for being fully immunized, 0.94, 95% confidence interval [CI], 0.66 to 1.32). In addition, parents who paid for immunizations out of pocket were as likely to have fully immunized children as those who had little or no out-of-pocket expenditures for vaccines (OR, 1.13; 95% CI, 0.75 to 1.13). In the logistic model, only individual pediatrician and size of the metropolitan area in which the pediatrician's practice was located were significant predictors of a child's immunization status. The results from sample 2 were similar; 82.1% of the 772 surveyed patients were fully immunized. With sample 2, individual pediatrician and age of the child at the time of the survey were the only predictors of immunization status. The OR of a VVP as a predictor of a child being fully immunized was 1.37 (95% CI, 0.65 to 2.90). Conclusions. Individual provider behavior may be the most important determinant of the immunization status of children followed by private pediatricians. In our samples, the effect of parental characteristics was limited. State-sponsored VVPs were not associated with higher immunization rates, perhaps because cost of vaccines did not seem to be a significant barrier to immunization in this population.

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Skin health care A) Normal skin function and managing common skin conditions

Developing Practical Skills for Nursing Children and Young People ◽

10.1201/b13431-25 ◽

2009 ◽

pp. 324-339

Keyword(s):

Health Care ◽

Normal Skin ◽

Common Skin ◽

Skin Conditions ◽

Skin Function

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Cutaneous manifestations in obese patients and non-obese controls in a tertiary care centre: a case-control study

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20194633 ◽

2019 ◽

Vol 5 (4) ◽

pp. 695

Author(s):

Raghuveer Chekuri ◽

Thameena Mohamed

Keyword(s):

Acanthosis Nigricans ◽

Tertiary Care ◽

Control Group ◽

Obese Patients ◽

Striae Distensae ◽

Tertiary Care Centre ◽

Cutaneous Manifestations ◽

High Prevalence ◽

Skin Conditions ◽

And Function

Background: Obesity has emerged as one of the most serious public health concerns in the 21st century. It is responsible for varied changes in structure and function of different components of skin. Skin care of obese patients deserves particular attention, not only because of high prevalence of cutaneous alteration but mainly because many of these disorders are preventable and could be treated, improving patient’s quality of life.Methods: Two hundred patients with BMI ≥30 kg/m2 and two hundred age and sex matched controls (BMI: 18.5-24.9 kg/m2) were included in this study.Results: Compared to the control group, obese patients were having higher prevalence of various skin conditions of which most common were acanthosis nigricans, acrochordons, striae distensae, frictional hyperpigmentation and infections.Conclusions: There is increased incidence and severity of cutaneous manifestations like acanthosis nigricans, acrochordons, striae distensae, frictional hyperpigmentation and infections in obese patients than control subjects. These can be used as markers for the early detection of various components of metabolic syndrome.

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MEDICAL MANAGEMENT OF TINEA INFECTION THROUGH SHODHANA AND SHAMANA – A CASE SERIES

November 2020 - International Ayurvedic Medical Journal ◽

10.46607/iamj1509092021 ◽

2021 ◽

Vol 9 (9) ◽

pp. 2029-2036

Author(s):

Asha A Bhat ◽

Prashanth A S

Keyword(s):

Case Series ◽

Skin Condition ◽

Wilcoxon Rank Sum Test ◽

Common Skin ◽

Skin Conditions ◽

Almost All ◽

Continuous Use ◽

Present Case Study

Skin is one of the most beautiful organs God has ever blessed to anyone. Everyone craves for beautiful skin and makes all possible efforts to make it glow. To achieve this, they are engaged in continuous use of creams, moist- urizers and other cosmetic articles which lead to immediate or long-term skin issues. Itching being the predomi- nant symptom of these cosmetic issues make people highly embarrassed in society. In Ayurveda, almost all skin conditions are explained under one umbrella called Kushta. It is broadly classified into Mahakushta and Kshudra- kushta1. Dadru Kushta one among the Kshudra Kushta is the most common skin condition accounts for 20% in all consultation in general practice2. North Karnataka is well known for its hot and humid conditions making its population at risk of many Tinea infections. Kandu, Raga and Atasi Pushpa Sankashavat Mandala are the cardi- nal features of Dadru3. In the present case study, 40 patients of Dadru Kushta were taken according to inclusion criteria. The combined effect of both Shodhana and Shamana was assessed. Keywords: Dadru Kushta, Aupasargika, Anushangi, Wilcoxon Rank Sum Test

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Diaper dermatitis: differential diagnosis and prevention issues

Medical Council ◽

10.21518/2079-701x-2021-1-14-19 ◽

2021 ◽

pp. 14-19

Author(s):

Irina N. Zakharova ◽

Irina I. Pshenichnikova ◽

Tatiana M. Tvorogova

Keyword(s):

Seborrheic Dermatitis ◽

Diaper Dermatitis ◽

Japanese Company ◽

Microbial Invasion ◽

Prolonged Contact ◽

Common Skin ◽

Functional Immaturity ◽

Skin Conditions ◽

Disposable Diapers ◽

Allergic Contact

The skin of newborns and infants is characterized by structural and functional immaturity. Diaper dermatitis is one of the most common skin conditions in this age period. This condition has a complex and multifactorial etiology. The interaction of several causes, including high humidity under the diaper, skin maceration, and prolonged contact with irritants, leads to destruction of the immature epidermal barrier, microbial invasion, and inflammation. Diaper dermatitis should be differentiated from allergic contact dermatitis, candidiasis, atopic dermatitis, seborrheic dermatitis, psoriasis. Effective measures to prevent diaper dermatitis are to keep the skin dry, reduce friction, limit the time of contact with urine and feces, as well as the topical application of protective products. Today, of all the disposable diapers on the market, the high quality disposable diapers developed and produced by the Japanese company KAO Corporation are proven effective in preventing diaper dermatitis.

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Necrotizing leukocytoclastic vasculitis mimicking necrotizing fasciitis: a case report

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20163130 ◽

2016 ◽

Vol 2 (3) ◽

pp. 193

Author(s):

Mehmet Salih Soylemez ◽

Korhan Ozkan ◽

Bulent Kılıc ◽

Samet Erinc ◽

Irfan Esenkaya ◽

...

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Laboratory Test ◽

Necrotizing Fasciitis ◽

Immunofluorescence Microscopy ◽

Leukocytoclastic Vasculitis ◽

Maculopapular Rash ◽

Skin Manifestation ◽

Biopsy Specimens ◽

Common Skin

There are several subtypes of necrotizing leukocytoclastic vasculitis, which are classified according to their morphological features in biopsy specimens using immunofluorescence microscopy. Necrotizing leukocytoclastic vasculitis is limited to the skin, predominantly that of the lower extremities, and usually spares the palms and soles. The most common skin manifestation is palpable purpura. Other skin manifestations include maculopapular rash, bullae, papules, nodules, ulcers and livedo reticularis. There is no specific laboratory test to determine the diagnosis. There are various diseases presenting with these nonspecific symptoms, and a rapid differential diagnosis must be conducted, because the appropriate differentiation and diagnosis markedly influence the treatment strategy and survival of patients. In this study, we report a case of necrotizing leukocytoclastic vasculitis presenting with internal organ involvement and symptoms of necrotizing fasciitis, with emphasis on the clinical differentiation.

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