Cutaneous manifestations of COVID-19 in Mexican patients: A case series and review of literature

China officially recognized atypical pneumonia outbreak in December 2019; on 11 March 2020, the World Health Organization declared COVID-19 as a pandemic that is produced by a new coronavirus, named SARS-CoV-2, of rapid transmissibility, which can be asymptomatic, with mild to severe respiratory symptoms, and with cardiovascular, neurological, gastrointestinal, and cutaneous complications. Considering that the pandemic prolonged more than initially expected was prognostic, it is essential for the medical community to identify the signs and symptoms of COVID-19. Thus, this work’s objectives were to present cases of cutaneous lesions observed in COVID-19 Mexican patients. We register cutaneous lesions in COVID-19 patients referred from internal medicine and otorhinolaryngology services to dermatology. We presented four interesting cases with cutaneous lesions, including exanthema morbilliform, urticaria, chilblains, ecchymosis, and facial edema, and review the available literature. The most frequent cutaneous markers are rash, chilblains, and urticaria. Skin lesions may be the first manifestation of COVID-19, accompany initial respiratory symptoms, or appear during the disease course. Symptoms associated with vascular changes (livedo reticularis and vasculitis) are considered of poor prognosis.

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Dermoscopy and Trichoscopy in Dermatomyositis—A Cross-Sectional Study

Journal of Clinical Medicine ◽

10.3390/jcm11020375 ◽

2022 ◽

Vol 11 (2) ◽

pp. 375

Author(s):

Magdalena Żychowska ◽

Adam Reich

Keyword(s):

Diagnostic Technique ◽

Skin Lesions ◽

Cross Sectional Study ◽

Cutaneous Lesions ◽

Cross Sectional ◽

Cutaneous Manifestations ◽

Non Invasive ◽

Inflammatory Dermatoses ◽

Curved Vessels ◽

Established Role

Background: (Video)dermoscopy is a non-invasive diagnostic technique that has a well-established role in dermatooncology. In recent years, this method has also been increasingly used in the assessment of inflammatory dermatoses. So far, little is known about the (video)dermoscopic features of dermatomyositis (DM). Methods: Consecutive patients with DM were included in the study and videodermoscopic assessments of the nailfolds, scalp, and active skin lesions were performed. Results: Fifteen patients with DM (10 women and 5 men) were included. Capillaroscopy showed elongated capillaries (90.9%), avascular areas (81.8%), disorganized vessel architecture (81.8%), tortuous capillaries (72.7%), dilated capillaries (72.7%), and hemorrhages (72.7%). The trichoscopic findings included linear branched vessels (80.0%), linear vessels (60.0%), linear curved vessels (53.3%), perifollicular pigmentation (40.0%), perifollicular erythema (33.3%), scaling (20.0%), white (20.0%) or yellow (20%) interfollicular scales, and white (20.0%) or pinkish (13.3%) structureless areas. Polymorphic vessels of an unspecific distribution and white or pink structureless areas were frequently observed under dermoscopy in cutaneous manifestations of DM, including Gottron’s papules and Gottron’s sign. Conclusions: Dermoscopy of the nailfolds (capillaroscopy), scalp (tricoscopy), and active cutaneous lesions may be of value in the preliminary diagnosis of DM.

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Extraoral Sinus Tracts of Odontogenic Origin: A Case Series

Frontiers in Dentistry ◽

10.18502/fid.v17i29.4750 ◽

2020 ◽

Author(s):

Ellahe Azizlou ◽

Mohsen AminSobhani ◽

Sholeh Ghabraei ◽

Mehrfam Khoshkhounejad ◽

Abdollah Ghorbanzadeh ◽

...

Keyword(s):

Correct Diagnosis ◽

Case Series ◽

Signs And Symptoms ◽

Complete Recovery ◽

Cutaneous Lesions ◽

Odontogenic Origin ◽

The Face ◽

History Of ◽

Relationship Of ◽

Dental Infections

Extraoral sinus tracts of odontogenic origin often develop as the result of misdiagnosis of persistent dental infections due to trauma, caries, or periodontal disease. Due to these lesions' imitation from cutaneous lesions, misdiagnosis, and mismanagement, which we frequently encounter, this article aims to describe four cases with manifestations in different parts of the face and the neck. Patients were referred to an endodontist with a history of several surgical procedures and/or antibiotic therapy due to misdiagnosis. After comprehensive examinations, root canal treatment was performed. The resolution of signs and symptoms during the follow-up period confirmed the correct diagnosis. Dermatologists and other physicians should be aware of the possibility of the relationship of extraoral sinus tracts with dental infections. Precise examination and taking a comprehensive history can aid to prevent unnecessary and incorrect therapeutic and/or pharmaceutical interventions. Elimination of dental infection leads to complete recovery in such patients.

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Clinico-epidemiological study of iatrogenic cutaneous manifestations in neonates in intensive care unit in a tertiary care hospital

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20184710 ◽

2019 ◽

Vol 5 (1) ◽

pp. 17

Author(s):

E. S. Sushmitha ◽

D. Manoj ◽

K. Ravindra ◽

G. Guruprasad

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Skin Lesions ◽

Care Hospital ◽

Cutaneous Lesions ◽

Cutaneous Manifestations ◽

Term Neonates ◽

Medical College ◽

Goltz Syndrome ◽

Needle Prick

Background: Neonatal dermatology, by definition, encompasses the spectrum of cutaneous disorders that arise during the first four weeks of life ranging from from physiological and transient to grossly pathological lesions in the skin of a neonate. The aim and objectives of the study were to determine the quantum of iatrogenic problems which can be minimized and prevented.Methods: A total of 1000 neonates admitted in the tertiary care NICU of JJM Medical College were examined and spectrums of pathological cutaneous lesions noted.Results: Among 1000 neonates examined, 101 had iatrogenic cutaneous conditions which were commonly seen in day one of life in 48 neonates and least in newborns between 15-21 days. Skin lesions were commonly seen in full term neonates (59), followed by preterm (39) and post term (3) neonates.Among the iatrogenic injuries needle prick injury (83), thermal burns (12) and bronze baby syndrome (11) were most commonly were noted in LBW and the normal for weight neonates. A variety of other conditions which could not be categorized into any of the above categories accounted for 5 cases. These included albinism, Waardenburg syndrome, TORCH complex and Down’s syndrome and Goltz syndrome.Conclusions: Iatrogenic cutaneous abnormalities among neonates are under reported, with no detailed studies on these variants. Genetic, neonatal, maternal, social and geographic factors seen to influence the patterns of neonatal dermatoses. Hence, it is important for a dermatologist and paediatrician to have a thorough knowledge and to distinguish various iatrogenic manifestations and to minimize the outcomes during their stay in NICU.

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Significance of cutaneous manifestations of COVID-19

10.25259/csdm_8_2021 ◽

2021 ◽

Vol 1 ◽

pp. 5

Author(s):

Malathi M ◽

Devinder Mohan Thappa

Keyword(s):

Early Recognition ◽

Severe Disease ◽

World Health ◽

Disease Stage ◽

Cutaneous Lesions ◽

Cutaneous Manifestations ◽

Diagnosis And Prognosis ◽

Viral Particles ◽

Tract Disease ◽

Health Organization

The COVID-19 pandemic has brought the whole world to a grinding halt. With the pandemic still ongoing, it is worthwhile to recapitulate the cutaneous manifestations for dermatologists, their significance, and spectrum of COVID-19 disease. COVID-19 is a highly contagious respiratory tract disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first reported on December 1, 2019, from Wuhan, China and was declared a pandemic by the World Health Organization on March 11, 2020. COVID-19 indirectly involves the skin just like any other viral infection and is independent of the disease stage or severity. Cutaneous manifestations of COVID-19 may present a few days before or after the first general symptoms of the disease. The appearance of cutaneous manifestations before early respiratory symptoms can promote early recognition of COVID-19 in such cases. The pathophysiology of cutaneous lesions in COVID-19 is still unclear. It is attributed to immune dysregulation, vasculitis, vessel thrombosis, neogenesis, hypercoagulable states, or simple hypersensitivity in COVID-19. Endothelial swelling with the presence of SARS-CoV-2 viral particles in the endothelial cells has also been seen on electron microscopy. Thus, the clinical features indicative of viral exanthems/enanthems which can be found in other diseases therefore fail to provide specific clues for diagnosis and prognosis of COVID-19. On the other hand, vasculopathy-related skin manifestations may provide prognostic values by indicating severe complications due to COVID-19 and may help in monitoring disease severity. Early detection of cutaneous signs associated with severe disease is crucial to improve patient outcomes.

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A clinical study of various cutaneous manifestations in neonates

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20185513 ◽

2019 ◽

Vol 5 (1) ◽

pp. 8

Author(s):

Shams Zia Usmani ◽

Kshitij Saxena ◽

Venkatarao Koti ◽

Shrish Bhatnagar ◽

Gaurav Paliwal ◽

...

Keyword(s):

Neonatal Period ◽

Cutaneous Lesion ◽

Skin Lesions ◽

Good Prognosis ◽

Cutaneous Lesions ◽

Cutaneous Manifestations ◽

Medical College ◽

Variable Nature ◽

Detailed Assessment ◽

Neonatal Skin

Background: Cutaneous manifestations are common in neonates. Transient and pathological neonatal dermatoses should be differentiated to avoid unnecessary treatment and thus considering the variable nature and severity of neonatal skin lesions, it is important to be aware of the transient skin lesions in newborn and to differentiate these from other serious conditions which will avoid unnecessary therapy to the neonates and the parents can be assured of good prognosis of these skin manifestations. The present study has been carried out to study the clinical pattern of cutaneous lesion in neonatal period.Methods: A total of 255 neonates from Department of Dermatology in collaboration of Department of Pediatrics, Era’s Lucknow Medical College and Hospital were evaluated for cutaneous manifestations. A detailed assessment regarding history, clinical examination and investigations were recorded and analyzed.Results: Out of 255 neonates, 138 (54.1%) were males and 117 (45.9%) were females. The sex ratio (M:F) was 1.18. The most common dermatoses were physiological desquamation (54.1%) and mongolian spots (37.6%) followed by milia (19.6%), miliaria (14%), epstein pearls (10.2%).Conclusions: The physiological and transient cutaneous lesions are common are in neonates. Physiological cutaneous manifestations were quite frequent apart from birthmarks/congenital cutaneous manifestations. An understanding of these manifestations helps in managing and deciding the appropriate manifestation.

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Atypical Presentation of PKDL due toLeishmania infantumin an HIV-Infected Patient with Relapsing Visceral Leishmaniasis

Case Reports in Infectious Diseases ◽

10.1155/2014/370286 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Benedetto Maurizio Celesia ◽

Bruno Cacopardo ◽

Daniela Massimino ◽

Maria Gussio ◽

Salvatore Tosto ◽

...

Keyword(s):

Visceral Leishmaniasis ◽

Hiv Infection ◽

Leishmania Infantum ◽

Plasma Cells ◽

Case Reports ◽

Case Series ◽

Skin Lesions ◽

Secondary Prophylaxis ◽

Complete Disappearance ◽

Cutaneous Lesions

We describe the case of an Italian patient with HIV infection who developed an atypical rash resembling post-kala-azar dermal leishmaniasis (PKDL) when receiving liposomal Amphotericin B (L-AMB) for secondary prophylaxis of visceral leishmaniasis (VL). At the time of PKDL appearance, the patient was virologically suppressed but had failed to restore an adequate CD4+ T-cell count. Histology of skin lesions revealed the presence of a granulomatous infiltrate, with lymphocytes, plasma cells, and macrophages, most of which containedLeishmaniaamastigotes. Restriction fragment length polymorphism-polymerase chain reaction was positive forLeishmania infantum. Paradoxically, cutaneous lesions markedly improved when a new relapse of VL occurred. The patient received meglumine antimoniate, with a rapid clinical response and complete disappearance of cutaneous rash. Unfortunately, the patient had several relapses of VL over the following years, though the interval between them has become wider after restarting maintenance therapy with L-AMB 4 mg/kg/day once a month. Even if rare, PKDL due toLeishmania infantummay occur in Western countries and represents a diagnostic and therapeutic challenge for physicians. The therapeutic management of both PKDL and VL in HIV infection is challenging, because relapses are frequent and evidence is often limited to small case series and case reports.

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Skin Lesions Associated with Nutritional Management of Maple Syrup Urine Disease

Case Reports in Dermatological Medicine ◽

10.1155/2017/3905658 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

Jaraspong Uaariyapanichkul ◽

Puthita Saengpanit ◽

Ponghatai Damrongphol ◽

Kanya Suphapeetiporn ◽

Sirinuch Chomtho

Keyword(s):

Zinc Deficiency ◽

Maple Syrup Urine Disease ◽

Clinical Status ◽

Extended Period ◽

Skin Lesions ◽

Cutaneous Lesions ◽

Cutaneous Manifestations ◽

Maple Syrup ◽

Natural Protein ◽

Urine Disease

Introduction. Maple syrup urine disease (MSUD) is an inborn error of branched chain amino acids (BCAAs) metabolism. We report an infant with MSUD who developed 2 episodes of cutaneous lesions as a result of isoleucine deficiency and zinc deficiency, respectively. Case Presentation. A 12-day-old male infant was presented with poor milk intake and lethargy. The diagnosis of MSUD was made based on clinical and biochemical data. Management and Outcome. Specific dietary restriction of BCAAs was given. Subsequently, natural protein was stopped as the patient developed hospital-acquired infections which resulted in an elevation of BCAAs. Acrodermatitis dysmetabolica developed and was confirmed to be from isoleucine deficiency. At the age of 6 months, the patient developed severe lethargy and was on natural protein exclusion for an extended period. Despite enteral supplementation of zinc sulfate, cutaneous manifestations due to zinc deficiency occurred. Discussion. Skin lesions in MSUD patients could arise from multiple causes. Nutritional deficiency including isoleucine and zinc deficiencies can occur and could complicate the treatment course as a result of malabsorption, even while on enteral supplementation. Parenteral nutrition should be considered and initiated accordingly. Clinical status, as well as BCAA levels, should be closely monitored in MSUD patients.

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Handling of Cadavers in a Mortuary amidst COVID-19 Pandemic

Annals of the National Academy of Medical Sciences (India) ◽

10.1055/s-0040-1721555 ◽

2020 ◽

Vol 56 (04) ◽

pp. 224-226

Author(s):

Rimpi Gupta ◽

Deepak Goyal ◽

Virendra Budhiraja ◽

Shveta Swami ◽

Swati Bansal ◽

...

Keyword(s):

Health Care ◽

Health Care Professionals ◽

Signs And Symptoms ◽

Health Care Facilities ◽

World Health ◽

Medical Community ◽

Family Welfare ◽

Professional Judgment ◽

Dead Body ◽

Route Of Transmission

AbstractCoronavirus disease 2019 (COVID-19) caused by severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) has been declared as a pandemic by the World Health Organization (WHO). This new disease is a challenge for the managers of health care facilities and mortuaries. It has impacted the practice of whole medical community. Though there is literature available on route of transmission of virus and time span for which virus is active on surfaces but there is no data available on how long the virus lives in and is active on the surface of a dead body. Thus, the health care professionals who handle cadavers and their specimens should use professional judgment to determine if a decedent had signs and symptoms compatible with COVID-19 during life and if autopsy is mandatory. Ministry of Health and Family Welfare and Centre for Disease Control & Prevention (CDC) have issued guidelines on dead body management and collection of postmortem specimens which should be observed in mortuary area and laboratories to limit the spread of disease among health care workers.

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Cutaneous Manifestations of Cystic Fibrosis

Journal of Interdisciplinary Medicine ◽

10.2478/jim-2018-0005 ◽

2018 ◽

Vol 3 (1) ◽

pp. 39-44

Author(s):

Anca Chiriac ◽

Laura Trandafir ◽

Cristian Podoleanu ◽

Simona Stolnicu

Keyword(s):

Cystic Fibrosis ◽

Autosomal Recessive ◽

Skin Lesions ◽

Nutritional Deficiencies ◽

Transmembrane Conductance Regulator ◽

Transmembrane Conductance ◽

Cutaneous Lesions ◽

Cutaneous Manifestations ◽

Cystic Fibrosis Transmembrane

Abstract Cystic fibrosis (CF) is an autosomal recessive affliction triggered by genetic mutations in the cystic fibrosis transmembrane conductance regulator. The lung and pancreas are the most frequently affected organs in cystic fibrosis, cutaneous involvement is undervalued and underdiag-nosed. Skin lesions observed in patients diagnosed with cystic fibrosis are not well known and can create confusions with other dermatological diseases. The diagnosis of cutaneous lesions as signs of cystic fibrosis by pediatricians or dermatologists, despite their overlapping with different nutritional deficiencies, would allow earlier diagnosis and proper treatment and could improve quality of life and outcomes.

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Cutaneous Manifestations of COVID-19: A Case Series from Brazil

Revista da Sociedade Portuguesa de Dermatologia e Venereologia ◽

10.29021/spdv.78.4.1281 ◽

2020 ◽

Vol 78 (4) ◽

pp. 329-334

Author(s):

David De Almeida Souza ◽

Daniela Alves Pereira Antelo

Keyword(s):

Case Series ◽

Skin Lesions ◽

Daily Routine ◽

Skin Involvement ◽

Cutaneous Manifestations ◽

Infected People ◽

Maculopapular Eruption ◽

The World ◽

Systemic Symptoms ◽

Epidemiological Characteristics

Introduction: Brazil has presented alarming and growing data on infection and deaths from SARS-CoV-2. There are more than 4 500 000 confirmed cases and more than 137 000 deaths ranking second in the world ranking of infected people. In addition to the involvement of the respiratory, cardiovascular, renal and neurological systems, this virus also causes non-specific skin lesions in same patients. Little is known about the pathophysiology of cutaneous involvement. At this moment, we cannot predict a difference in prognosis based on skin lesions. Methods: We conducted an observational case study of 25 patients affected by SARS-CoV-2 who had dermatological lesions. We described the clinical and epidemiological characteristics of each case, demonstrating the polymorphism of the skin lesions and also making a correlation with the chronology of presented systemic symptoms. Results: Twenty five cases of COVID-19 with cutaneous manifestations (urticaria, erythematous rash, maculopapular eruption, pruritus, erythema multiforme-like lesions, dyshidrotic eczema) were observed during, after and before systemic symptoms. A few cases with skin involvement were also observed as isolated symptoms of the viral infection. These data demonstrate the clinical polymorphism related to skin involvement of patients infected with SARS-CoV-2, emphasizing the importance of clinical suspicion by dermatologists when handling suspected cases in the current epidemiological scenario. Conclusion: Although the number of cases in the world stage seems to be regressing, infection by SARS-CoV-2 will be part of the dermatologist's daily routine. As long as we do not have a widely available vaccine and the pandemic takes on an endemic profile, we need to be aware of these manifestations, not only for the proper diagnosis, indication of patient isolation, as well as all the necessary biosafety procedures in dermatology clinics.

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