scholarly journals Dermatologic manifestation of COVID-19: a systematic review

2021 ◽  
Vol 7 (4) ◽  
pp. 565
Author(s):  
Annisa Alviariza ◽  
Luh M. Budiani
Keyword(s):  
Descriptive Analysis ◽  
Case Series ◽  
Signs And Symptoms ◽  
Maculopapular Rash ◽  
Cutaneous Manifestations ◽  
Literature Searches ◽  
Associated Symptoms ◽  
Vesicular Rash ◽  
Polymerase Chain ◽  
Dermatologic Manifestations

<p class="abstract">Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections, causing disease known as COVID-19, has been associated with a myriad of symptoms, including dermatological ones. Despite there has been a consensus on pulmonary and systemic signs and symptoms of COVID-19, the same cannot be said of dermatological ones. We write in attempt to find a common theme of dermatological manifestations of COVID-19. We conducted literature searches from Medline databases as well as Google Scholar using keywords “cutaneous manifestations of COVID-19” and “dermatologic manifestations of COVID-19”. We included case series in our pooled descriptive analysis to describe types of cutaneous eruptions, localizations, and associated symptoms among COVID-19 patients with confirmed real time-polymerase chain reaction (RT-PCR) results. We included 12 case series in our pooled analyses with 2 more analyzed separately due to non-comparable data presentations. The results identified common types of cutaneous eruptions associated with COVID-19 to be maculopapular rash, urticaria, vesicular rash, vascular rash. Eruptions tend to be localized on the trunks, with lesser frequency found on extremities, and eruptions are often accompanied by pruritus of varying intensity. These various eruptions are associated with two distinct pathological pathways, namely inflammation of skin tissues, causing inflammatory rashes, and hypercoagulable state which is associated with vascular rashes. Our literature review identified several common types of cutaneous eruptions associated with COVID-19 with different proposed pathophysiological mechanisms for inflammatory and vascular rashes. This review is limited by its data sources which includes only case series as well as the fact that at this stage in the pandemic, little biomolecular research has been conducted to definitively associate SARS-CoV-2 infection with cutaneous manifestations.</p>

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

2021 ◽  
Vol 9 ◽  
pp. 2050313X2199719
Author(s):  
Juan Carlos Palomo-Pérez ◽  
Maria Elisa Vega-Memije ◽  
David Aguilar-Blancas ◽  
Erik González-Martínez ◽  
Lucia Rangel-Gamboa
Keyword(s):  
Respiratory Symptoms ◽  
Case Series ◽  
Signs And Symptoms ◽  
Skin Lesions ◽  
World Health ◽  
Medical Community ◽  
Atypical Pneumonia ◽  
Cutaneous Lesions ◽  
Cutaneous Manifestations ◽  
Mexican Patients

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.

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

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.

scholarly journals Repeated SARS-CoV-2 Positivity: Analysis of 123 Cases

Viruses ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 512
Author(s):  
Szilárd Váncsa ◽  
Fanni Dembrovszky ◽  
Nelli Farkas ◽  
Lajos Szakó ◽  
Brigitta Teutsch ◽  
...  
Keyword(s):  
Individual Patient Data ◽  
Case Reports ◽  
Severe Disease ◽  
Descriptive Analysis ◽  
Case Series ◽  
Disease Course ◽  
Chain Reaction ◽  
Baseline Characteristics ◽  
Polymerase Chain ◽  
Meta Analyses

Repeated positivity and reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is a significant concern. Our study aimed to evaluate the clinical significance of repeatedly positive testing after coronavirus disease 2019 (COVID-19) recovery. We performed a systematic literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. With available individual patient data reporting on repeatedly SARS-CoV-2 positive (RSP) patients, case reports, and case series were included in this analysis. We performed a descriptive analysis of baseline characteristics of repeatedly positive cases. We assessed the cases according to the length of their polymerase chain reaction (PCR) negative interval between the two episodes. Risk factors for the severity of second episodes were evaluated. Overall, we included 123 patients with repeated positivity from 56 publications, with a mean repeated positivity length of 47.8 ± 29.9 days. Younger patients were predominant in the delayed (>90 days) recurrent positive group. Furthermore, comparing patients with RSP intervals of below 60 and above 60 days, we found that a more severe disease course can be expected if the repeated positivity interval is shorter. Severe and critical disease courses might predict future repeatedly positive severe and critical COVID-19 episodes. In conclusion, our results show that the second episode of SARS-CoV-2 positivity is more severe if it happens within 60 days after the first positive PCR. On the other hand, the second episode’s severity correlates with the first.

scholarly journals Anti-SAE1 Antibodies and Dermatomyositis: A Case Series of Three Patients

2020 ◽  
Vol 4 (6) ◽  
pp. 578-584
Author(s):  
Claire Wilson ◽  
Brandon Roman ◽  
Kurt Ashack ◽  
Iris K Aronson
Keyword(s):  
Interstitial Lung Disease ◽  
Cohort Studies ◽  
Lung Disease ◽  
Patient Population ◽  
Case Series ◽  
Response To Treatment ◽  
Laboratory Findings ◽  
Cutaneous Manifestations ◽  
Associated Symptoms ◽  
Life Threatening

To date, few patients with anti-SAE1 dermatomyositis (DM) have been described, and usually in large descriptive cohort studies including all DM subtypes. Thus, it is increasingly important to further describe this rare subtype to solidify cutaneous findings, associated symptoms, and potential therapeutic options. Herein, this case series describes three patients with anti-SAE1 DM with respect to their clinical and laboratory findings, and also their response to treatment. All three patients eventually presented with classic cutaneous manifestations of dermatomyositis, however, Case 2 presented initially with cutaneous manifestations not described in the literature. Furthermore, two patients presented with dysphagia, with Case 2 experiencing a life-threatening dysphagia not typically described in the literature. Two of three patients also presented with early signs of interstitial lung disease. Lastly, cutaneous disease was only responsive to immunosuppressants in one patient. Unfortunately, this observational case-series consisted of only three patients, limiting the generalizability of our results. However, this study provides further support of the recalcitrant nature of this DM subtype, and commonly affected extracutaneous systems including the gastrointestinal and pulmonary systems. Larger studies of this patient population are needed to further confirm our associated findings. 

scholarly journals Cutaneous Manifestations in COVID-19: Report on 31 Cases from Five Countries

Biology ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 54
Author(s):  
Carmen Rodriguez-Cerdeira ◽  
Brianda I. Uribe-Camacho ◽  
Lianet Silverio-Carrasco ◽  
Wennia Méndez ◽  
Ashwini R. Mahesh ◽  
...  
Keyword(s):  
Case Series ◽  
Skin Lesions ◽  
Close Monitoring ◽  
Livedo Racemosa ◽  
Cutaneous Manifestations ◽  
Causal Factors ◽  
Qrt Pcr ◽  
Previous Contact ◽  
Maculopapular Rashes ◽  
Dermatologic Manifestations

The increasingly frequent cutaneous manifestations of coronavirus disease (COVID-19) remain to pose a problem to clinicians. Herein, we aimed to describe the clinical and pathological findings of skin lesions in patients with COVID-19. The case series, which was based on the International Dermatological Registry circulated to dermatologists worldwide, was conducted across organizations and societies belonging to five different countries. We documented 31 patients with dermatologic manifestations associated with COVID-19, including maculopapular rashes (16.10%), urticarial lesions (26.80%), pseudochilblains (22.60%), petechiae/purpura (6.50%), distal ischaemia and necrosis (6.50%), livedo racemosa (12.90%), and others (9.70%). Twenty-six cases (83.90%) were qRT-PCR-confirmed COVID-19 cases, two (6.50%) were serologically confirmed, while two others (9.7%) were suspected cases owing to previous contact with COVID-19-positive patients. Therefore, our findings indicate that a febrile rash or even a rash in an afebrile state in the early stages of the disease may be the only clinical manifestation of COVID-19. In the future, we recommend close monitoring of all patients with skin lesions not attributable to other causal factors; in the diagnostic perspective, clinicians should aim to confirm if the skin lesions are associated with COVID-19.

scholarly journals The spectrum of COVID-19-associated dermatologic manifestations: an international registry of 716 patients from 31 countries

2020 ◽  
Author(s):  
Esther E. Freeman ◽  
Devon E. McMahon ◽  
Jules B. Lipoff ◽  
Misha Rosenbach ◽  
Carrie Kovarik ◽  
...  
Keyword(s):  
Critically Ill ◽  
Case Series ◽  
Hospitalized Patients ◽  
Cutaneous Manifestations ◽  
International Registry ◽  
Key Points ◽  
Dermatologic Manifestations ◽  
Insight Into ◽  
Retiform Purpura

Key PointsQuestionWhat are the cutaneous manifestations associated with COVID-19 and do they provide insight into the pathophysiology or prognosis?FindingsIn this international registry-based case series of 716 patients representing 31 countries, the most common dermatologic morphologies encountered in the 171 COVID-19 confirmed case included morbilliform, pernio-like, urticarial, macular erythema, vesicular, papulosquamous, and retiform purpura. Retiform purpura was seen exclusively in critically ill, hospitalized patients.MeaningCOVID-19 is associated with a spectrum of skin findings in affected patients. These cutaneous manifestations may vary depending on the severity of COVID-19.

Dermatologic manifestations of coronavirus disease 2019 (COVID-19)

ANALES RANM ◽  
2020 ◽  
Vol 137 (137(02)) ◽  
pp. 213-221
Keyword(s):  
Skin Lesions ◽  
Coagulation Cascade ◽  
Cutaneous Manifestations ◽  
Skin Manifestations ◽  
Viral Particles ◽  
Polymerase Chain ◽  
Immunohistochemical Techniques ◽  
Dermatologic Manifestations ◽  
Pcr Techniques ◽  
Maculopapular Exanthema

The cutaneous manifestations associated with coronavirus disease 2019 (COVID-19) are frequent and varied. Knowing these manifestations facilitates the diagnosis of asymptomatic or mildly symptomatic cases, contributing to reduce the spread of the virus. There are 5 main presentation patterns: acral areas of erythema-oedema with vesicles or pustules (pseudo-perniosis), other vesicular eruptions, urticarial lesions, maculopapular eruptions and livedo or necrosis. Most patterns can be further subdivided. The prognosis depends on the age of the patient and the severity of the respiratory clinic, not on the skin manifestation itself. Pseudo-chilblain lesions and vesicular eruptions are considered suggestive of COVID-19, while the rest of manifestations are unspecific and could occur in the context of other diseases. The physiopathological mechanisms involved in the appearance of skin lesions have yet to be categorized. There are 3 main hypotheses: hyperactive immune response, activation of the complement pathway and alterations in the coagulation cascade. Different alterations in each pathway would justify the great variety in the way that the different skin manifestations are presented. The causal relationship between some of the skin manifestations and COVID-19 is not yet fully demonstrated, since there are other factors such as drugs or fever that could be confounding factors. The presence of viral particles has been demonstrated by immunohistochemical techniques in pseudo-chilblain lesions, purpuric maculopapular exanthema and erythema multiforme. However, polymerase chain reaction (PCR) techniques from the skin samples have been negative in every conducted study.

scholarly journals COVID-19 and Cutaneous Disorders: What’s Being Reported? A Meta-Analysis from Observational Studies and Case Reports

2020 ◽  
Vol 78 (4) ◽  
pp. 335-343
Author(s):  
Kelvin Oliveira Rocha ◽  
Virgínia Vinha Zanuncio ◽  
Flávia Diniz Valadares ◽  
Luciana Moreira Lima
Keyword(s):  
Skin Disorder ◽  
Observational Studies ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Signs And Symptoms ◽  
Maculopapular Rash ◽  
Continuous Variables ◽  
Skin Disorders ◽  
Weighted Mean

Background: Coronavirus disease (COVID-19) is related to several extrapulmonary disorders; however, little is known about the skin disorders characteristics and prevalence. Objetive: Summarize and evaluate the skin disorders’ characteristics and prevalence reported in the literature. Methods: We conducted a search on PubMed, SciELO and ScienceDirect between 01/01/2020 to 09/28/2020. The target population was patients with skin disorder and a positive diagnosis for COVID-19. All observational studies, research letters, case series and case reports were selected. We evaluated observational studies using Random- effects models to calculate the weighted mean prevalence and 95% confidence interval (CI). We evaluated the case studies using the chi-square test for dichotomous variables and the Mann-Whitney test for continuous variables. Results: Eighty-seven patients from case reports and six observational studies with 363 patients were selected. Eleven types of skin disorders in COVID-19 confirmed patients are described. Skin disorder weighted mean prevalence was 9.9% (95% CI: 3.7-24.1). Maculopapular rash was the most prevalent disorder (37.5%; 95% CI: 21-57%). Latency was significantly lower in patients over 60 years old (p=0.041). Conclusion: Each cutaneous manifestation has its particularities and may or may not accompany other signs and symptoms. It is possible for the elderly to have COVID-19- related skin disorders early.

Clinical Characteristics of Patients Diagnosed with Strongyloidiasis in a United States Urban Outpatient Dermatology Department: A Case Series

2017 ◽  
Vol 1 (3) ◽  
pp. 156-160
Author(s):  
Jacqueline Watchmaker ◽  
Sean Legler ◽  
Dianne De Leon ◽  
Vanessa Pascoe ◽  
Robert Stavert
Keyword(s):  
United States ◽  
Case Series ◽  
The United States ◽  
Screening Tools ◽  
Dermatology Department ◽  
Cutaneous Manifestations ◽  
Serologic Testing ◽  
Patient Reported ◽  
History Of ◽  
Endemic Areas

Background: Although considered a tropical disease, strongyloidiasis may be encountered in non-endemic regions, primarily amongst immigrants and travelers from endemic areas.  Chronic strongyloides infection may be under-detected owing to its non-specific cutaneous presentation and the low sensitivity of commonly used screening tools. Methods: 18 consecutive patients with serologic evidence of strongyloides infestation who presented to a single urban, academic dermatology clinic between September 2013 and October 2016 were retrospectively included.  Patient age, sex, country of origin, strongyloides serology titer, absolute eosinophil count, presenting cutaneous manifestations, and patient reported subjective outcome of pruritus after treatment were obtained via chart review.  Results: Of the 18 patients, all had non-specific pruritic dermatoses, 36% had documented eosinophila and none were originally from the United States. A majority reported subjective improvement in their symptoms after treatment. Conclusion:  Strongyloides infection and serologic testing should be considered in patients living in non-endemic regions presenting with pruritic dermatoses and with a history of exposure to an endemic area.Key Points:Chronic strongyloidiasis can be encountered in non-endemic areas and clinical manifestations are variableEosinophilia was not a reliable indicator of chronic infection in this case series Dermatologists should consider serologic testing for strongyloidiasis in patients with a history of exposure and unexplained pruritus

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