scholarly journals A Systematic Review of Clinical Studies on Mucocutaneous Manifestations of COVID-19: Virus-Related and Drug-Related

2021 ◽  
Author(s):  
Elham Behrangi ◽  
Mohammadreza Ghassemi ◽  
Afsaneh Sadeghzadeh-Bazargan ◽  
Masoumeh Roohaninasab ◽  
Niloufar Najar Nobari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Symptoms ◽  
Skin Lesions ◽  
The Body ◽  
Inclusion Criteria ◽  
Cutaneous Lesions ◽  
Drug Induced ◽  
Skin Biopsies ◽  
Dermatologic Manifestations ◽  
Primary Skin Lesions

Coronavirus could affect almost any part of the body including the skin. In this systematic review, the primary skin lesions resulting from the direct activity of the virus or the medications used for treatment and the changes in the behavior of the virus regarding the occurrence of these symptoms over time were assessed. PubMed/MEDLINE, Embase, PsycINFO, TRIP Cochrane, Cochrane Skin were searched for all published articles from February 19 to July 1, 2020, which met the inclusion criteria. Thirty-six related articles were extracted. Twenty-eight studies reported virus-related mucocutaneous eruptions and 8 articles, the drug-reactions. Data of 583 patients were included. Skin lesions of COVID-19 could be caused by both the virus itself or the influence of drugs used for the treatment. Morbilliform rashes, urticaria, and acral-vasculopathic cutaneous lesions were at the forefront of primary COVID-dependent skin lesions with no significant change during time, Also, Hydroxychloroquine, lopinavir/ritonavir, paracetamol, and antibiotics were reported as the main causes of drug-induced rashes. Since dermatologic manifestations may occur prior or simultaneously/after other COVID clinical symptoms, so they may helpful in patients’ early diagnosis or prediction of internal organ involvements via histopathologic evaluations of skin biopsies especially about vasculopathic and vasculitic, respectively.

Photosensitization Induced by Heterophyllaea pustulata in Goats: Sequential Development of Skin Lesions

2021 ◽  
Vol 58 (3) ◽  
pp. 568-573
Author(s):  
Juan F. Micheloud ◽  
Lluís Luján ◽  
Luis A. Colque-Caro ◽  
Susana C. Núñez-Montoya ◽  
Claudio G. Barbeito ◽  
...  
Keyword(s):  
Cell Death ◽  
Oral Dose ◽  
Skin Lesions ◽  
Crust Formation ◽  
Cutaneous Lesions ◽  
Protein Ratio ◽  
Dermal Fibrosis ◽  
Sequential Development ◽  
Treatment Changes ◽  
Skin Biopsies

Five adult Saanen goats received a single oral dose of Heterophyllaea pustulata containing 42.25 μg/kg rubiadin (anthraquinone) and 3 adult goats were untreated controls. All goats were exposed to sunlight and sequential ear skin biopsies were collected before treatment and at 32 hours, 3 days, 8 days, and 15 days after treatment. Changes at 32 hours after dosing included epidermal spongiosis, single cell death and acantholysis, an increased BAX/BCL-2 protein ratio, and dermal edema. Lesions at day 3 included epidermal and adnexal necrosis, crust formation, and acanthosis. Acanthosis, hyperkeratosis, and dermal fibrosis and neovascularization were present at day 15. The pro-apoptotic (BAX)/anti-apoptotic (BCL-2) protein ratio increased at 32 hours, whereas epidermal and dermal PCNA immunolabeling increased between days 8 and 15 after treatment. The cutaneous lesions were consistent with sunlight-induced damage, and the occurrence in treated but not control goats indicates photosensitization.

Invasive cutaneous cryptococcosis of the nasal planum in a cat – case report

2018 ◽  
Vol XXIII (133) ◽  
pp. 56-62
Author(s):  
Ana Cláudia Balda ◽  
Juliana Cristina Gonçalves ◽  
Renata Cristina Menezes ◽  
Ana Cristina Fascetti de Souza ◽  
Guilherme Durante Cruz
Keyword(s):  
Private Practice ◽  
Infectious Agent ◽  
Skin Lesions ◽  
The Body ◽  
Small Animals ◽  
Cutaneous Lesions ◽  
Mixed Breed ◽  
Deep Mycosis ◽  
The City ◽  
Cutaneous Cryptococcosis

Crytococcosis is the most common deep mycosis in cats, despite its rarity in the medical practice of small animals. The infectious agent of the disease is Cryptococcus sp, an opportunistic fungus that can spread throughout the body. An approximately two-year-old mixed breed cat, weighting 3 kg was presented to a private practice in the city of São Paulo, Brazil. Physical examination relealed pyogranulomatous skin lesions, mainly on the nasal planum and the second digit of the left thoracic lim. The animal presented no neurological or respiratory signs. The response to antifulgal on cutaneous lesions was favorable, but the animal did not resist a second sedation and died within twenty-eight days after starting treatment. This report shows an atypical case of cryptococcosis due to the lack of immunodeficiency.

scholarly journals Extensive Lepromatous Lymphadenitis Preceding Lesions on the Face and Earlobes: An Unusual Presentation of Leprosy in Singapore

2018 ◽  
Vol 10 (1) ◽  
pp. 35-40
Author(s):  
Shi Yao Sam Yang ◽  
Wai Mun Sean Leong ◽  
Cruz Maria Teresa Kasunuran ◽  
Jing Xiang Huang ◽  
Sue-Ann Ju Ee Ho ◽  
...  
Keyword(s):  
Early Stage ◽  
Developed Countries ◽  
Skin Lesions ◽  
The Body ◽  
The Other ◽  
Cutaneous Lesions ◽  
Poor Countries ◽  
Geographical Regions ◽  
Resource Poor ◽  
The Face

Leprosy is also known as Hansen disease, as in some countries the diagnosis of leprosy carries a negative stigma and patients fear being shunned as outcasts. Presently, leprosy is primarily limited to specific geographical regions in resource-poor countries. As a result, there is increased difficulty for the younger generation of physicians today to correctly identify leprosy due to a lack of exposure and a low-index of suspicion, particularly in developed countries. In this case, the indurated lesions over the face demonstrated a preference for the outer lateral aspects over the maxillary areas, the nose bridge, and the pinna of the ears consistent with the organism’s preference for cooler regions of the body. This was also evident in the other skin lesions affecting the more acral regions of the limbs in the early stage of disease progression. There is a need to keep this infective condition as an alternate diagnosis to all unusual cutaneous lesions.

Calciphylaxis in a Patient With Non-Hodgkin Lymphoma: Case Report and Literature Review

2018 ◽  
Vol 22 (5) ◽  
pp. 524-526 ◽  
Author(s):  
Meggie Morand ◽  
Myrna Chababi-Atallah ◽  
Sara-Élizabeth Jean ◽  
Carolina Fernandes
Keyword(s):  
Systematic Review ◽  
Hodgkin Lymphoma ◽  
Rare Condition ◽  
Skin Lesions ◽  
Review Of The Literature ◽  
End Stage Kidney Disease ◽  
Cutaneous Lesions ◽  
Non Hodgkin Lymphoma ◽  
End Stage ◽  
High Index Of Suspicion

Background: Calciphylaxis is a well-known entity in end-stage kidney disease and after renal transplant. Cases of nonuremic calciphylaxis (NUC) have also been reported, but data on this rare condition are mainly empirical. Objective: We discuss a case of NUC secondary to spontaneous tumour lysis syndrome in a patient who had chemotherapy for non-Hodgkin lymphoma and present a review of the literature to better characterize malignancy-associated NUC. Methods: We identified 12 published cases of malignancy-associated NUC. Results: This systematic review of malignancy-associated NUC did not show a relationship between the type of malignancy, the distribution of skin lesions, or mortality. However, distal more than proximal involvement seems to be more frequently associated with calcium phosphate imbalance. Conclusion: Clinicians must maintain a high index of suspicion for calciphylaxis when evaluating patients with cutaneous lesions developed in the setting of malignancy.

scholarly journals Erythema Multiforme Major Associated With Community-Acquired Pneumonia: Lessons From a Case Report

2021 ◽  
Vol 9 ◽  
Author(s):  
Xiaomei Fan ◽  
Yong Luo ◽  
Jieluan Lu ◽  
Jinji Xu ◽  
Qing Chen ◽  
...  
Keyword(s):  
Case Report ◽  
Erythema Multiforme ◽  
Clinical Symptoms ◽  
Specific Treatment ◽  
Human Leukocyte ◽  
Community Acquired Pneumonia ◽  
The Body ◽  
Drug Induced ◽  
Chemical Structures ◽  
Erythema Multiforme Major

Background: Erythema multiforme (EM) is an acute immune-mediated inflammatory mucinous skin disorder. The etiology of pediatric EM involves infections, medications, autoimmune diseases, and genetic factors.Case Report: An 8-year-old girl with Mycoplasma pneumoniae (MP) associated community-acquired pneumonia developed erythema target-like symptoms 1 week after azithromycin administration. The erythema quickly spread throughout the body involving the oral and ocular mucous membranes, the trunk, and the extremities, and eventually developed into erythema multiform major (EMM). Through drug withdrawal and specific treatment including systemic corticosteroids and supportive care, her clinical symptoms were improved. After 31 days, most of the mucocutaneous symptoms were relieved, except pigmentation. Human leukocyte antigen (HLA) gene sequencing was performed and 20 HLA genotypes were identified. The patient follow-up lasted for 18 months. Rashes appeared on her trunk when receiving azithromycin orally after discharge and then disappeared after azithromycin withdrawal.Conclusions: Pediatric EM is a rare disease and recognition of its etiology is important for EM management. In this case, azithromycin and HLA-DQB1*03:01 genotype may contribute to EMM.Lesson: For drug-induced EM, rapid identification and withdrawal of the causative drugs is critical. Re-exposure to the same drug or exposure to drugs with similar chemical structures should also be avoided. Patient education and rational use of medicines are essential for pediatric patients.

scholarly journals Hematologic Features of Children and Adolescent Patients with Acute Hypersensitivity Reactions on Drugs and Food

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Tatyana I. Eliseeva ◽  
Ivan I. Balabolkin ◽  
Natalia A. Geppe ◽  
Elena V. Tush ◽  
Dmitry Yu. Ovsyannikov ◽  
...  
Keyword(s):  
Biochemical Markers ◽  
Clinical Symptoms ◽  
Hematological Parameters ◽  
Drug Hypersensitivity ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Hypersensitivity Reactions ◽  
Drug Induced ◽  
Children And Adolescent ◽  
Adolescent Patients

Hematological parameters and blood biochemical markers were measured in 131 children and adolescent patients (70 boys) aged 2 to 17 years with acute hypersensitivity reactions induced by food (59 patients) and medicines (72 patients) in order to establish differences in clinical manifestations and hematological parameters in children with food and drug hypersensitivity and to elaborate the hematological criteria for differentiating the possible pathophysiological mechanisms of various types of hypersensitivity. Both groups of patients had comparable clinical symptoms with a predominance of skin lesions. The significant differences between the groups with drug- and food-induced hypersensitivity reactions were found in their red blood characteristics. In patients with hypersensitive reactions to drugs, significantly lower levels of erythrocytes and hemoglobin were found, while the median values of these parameters did not exceed the limits of reference values. These differences persisted also in the analysis of hemoglobin values, analyzed with accounting for the age and sex of patients. The reduction of hemoglobin was not accompanied by an increase in bilirubin in these patients. Thus, this fact does not support the assumption about the drug-induced hemolysis as a main effect influencing the hematological parameters. Hemogram evaluation performed during 7–10 days after admission demonstrated a higher level of hemoglobin in both groups. The biochemical markers were not significantly distinguished except bilirubin and alkaline phosphatase which were higher in patients with food-induced hypersensitivity.

scholarly journals Regional variations in antigenic properties of skin. A possible cause for disease-specific distribution of skin lesions.

1986 ◽  
Vol 164 (6) ◽  
pp. 2125-2130 ◽  
Author(s):  
L Sison-Fonacier ◽  
J C Bystryn
Keyword(s):  
Regional Differences ◽  
Skin Diseases ◽  
Pemphigus Vulgaris ◽  
Skin Lesions ◽  
The Body ◽  
Cutaneous Lesions ◽  
Specific Distribution ◽  
Antigenic Properties ◽  
Possible Cause ◽  
Disease Specific

The possibility that the distribution of skin lesions in some cutaneous diseases is due to variations in the antigenic properties of skin was investigated by mapping the expression of the skin-specific pemphigus vulgaris and bullous pemphigoid antigens in different regions of the body. The expression of both antigens was relatively stable within the same region, but varied between regions in a pattern that was distinct for each antigen. For each antigen there was a correlation between regions of high expression and location of skin lesions in autoimmune diseases involving the antigen. The results indicate that there are marked regional differences in the antigenic properties of skin and suggest this may influence the distribution of cutaneous lesions in some skin diseases.

scholarly journals Repurposing ciclopirox as a pharmacological chaperone in a model of congenital erythropoietic porphyria

2018 ◽  
Vol 10 (459) ◽  
pp. eaat7467 ◽  
Author(s):  
Pedro Urquiza ◽  
Ana Laín ◽  
Arantza Sanz-Parra ◽  
Jorge Moreno ◽  
Ganeko Bernardo-Seisdedos ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Ex Vivo ◽  
The Body ◽  
Missense Mutations ◽  
Allosteric Site ◽  
Cutaneous Lesions ◽  
Pharmacological Chaperone ◽  
Genetic Mouse Model ◽  
Congenital Erythropoietic Porphyria

Congenital erythropoietic porphyria is a rare autosomal recessive disease produced by deficient activity of uroporphyrinogen III synthase, the fourth enzyme in the heme biosynthetic pathway. The disease affects many organs, can be life-threatening, and currently lacks curative treatments. Inherited mutations most commonly reduce the enzyme’s stability, altering its homeostasis and ultimately blunting intracellular heme production. This results in uroporphyrin by-product accumulation in the body, aggravating associated pathological symptoms such as skin photosensitivity and disfiguring phototoxic cutaneous lesions. We demonstrated that the synthetic marketed antifungal ciclopirox binds to the enzyme, stabilizing it. Ciclopirox targeted the enzyme at an allosteric site distant from the active center and did not affect the enzyme’s catalytic role. The drug restored enzymatic activity in vitro and ex vivo and was able to alleviate most clinical symptoms of congenital erythropoietic porphyria in a genetic mouse model of the disease at subtoxic concentrations. Our findings establish a possible line of therapeutic intervention against congenital erythropoietic porphyria, which is potentially applicable to most of deleterious missense mutations causing this devastating disease.

scholarly journals Lymphomatoid Papulosis in a Case of Atypical Secondary Syphilis

2019 ◽  
Vol 14 (4) ◽  
pp. e32-e33
Author(s):  
Xin (Peter) Mu ◽  
Ian Mazzetti
Keyword(s):  
Clinical History ◽  
Skin Lesions ◽  
Secondary Syphilis ◽  
Low Grade ◽  
Cutaneous Lesions ◽  
Syphilis Infection ◽  
Lymphomatoid Papulosis ◽  
History Of ◽  
Skin Biopsies ◽  
Syphilis Serology

AbstractLymphomatoid papulosis is an indolent cutaneous lymphoproliferative disorder that presents as recurrent self-resolving papulonodular skin lesions. Currently, there are no known causes for lymphomatoid papulosis and definitive diagnosis is only made histologically. A 64-year-old man presented with a 6-week history of bilateral leg pains, low-grade fevers, and a widespread eruption of painless erythematic papules. Despite testing positive for syphilis serology, he lacked the typical clinical history for classic syphilis and therefore, skin biopsies were performed to confirm the diagnosis. Unexpectedly, the skin biopsies revealed lymphomatoid papulosis which resolved with antibiotic treatments for syphilis. Considering the synchronous resolution of the patient’s syphilis infection and his cutaneous lesions, this is the first report of findings to suggest syphilis as a possible cause for lymphomatoid papulosis. Clinicians should appreciate the possibility of alternative diagnosis for cutaneous presentations in settings of confirmed syphilis infections. RESUMELa papulose lympho-matoïde est un trouble lymphoprolifératif cutané indolent qui se présente sous la forme de lésions cutanées papulonodulaires auto-résolutives récurrentes. Actuellement, il n’y a pas de causes connues de la papulose lymphomatoïde et le diagnostic définitif n’est posé que sur le plan histologique. Un homme de 64 ans a présenté une histoire de 6 semaines de douleurs bilatérales aux jambes, de fièvres de bas grade et d’éruptions généralisées de papules érythémateuses indolores. Malgré un test sérologique positif pour la syphilis, il n’avait pas les antécédents cliniques typiques de la syphilis classique et des biopsies cutanées ont donc été effectuées pour confirmer le diagnostic. De façon inattendue, les biopsies cutanées ont révélé une papulose lymphomatoïde qui s’est résorbée grâce à des traitements antibiotiques contre la syphilis. Compte tenu de la résolution synchrone de l’infection syphilitique du patient et de ses lésions cutanées, il s’agit du premier rapport de résultats suggérant que la syphilis est une cause possible de papulose lymphomatoïde. Les cliniciens devraient apprécier la possibilité d’un diagnostic alternatif pour les présentations cutanées dans les contextes d’infections syphilitiques confirmées.

scholarly journals Clinical and Histopathological Features and Potential Pathological Mechanisms of Skin Lesions in COVID-19: Review of the Literature

2020 ◽  
Vol 7 (1) ◽  
pp. 3-16 ◽  
Author(s):  
Gürkan Kaya ◽  
Aysin Kaya ◽  
Jean-Hilaire Saurat
Keyword(s):  
Clinical Symptoms ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Vascular Lesions ◽  
Cutaneous Lesions ◽  
Cutaneous Manifestations ◽  
Histopathological Features ◽  
Pubmed Database ◽  
The Mean

In recent weeks, several reports have emerged of skin lesions with different clinical presentations in COVID-19 cases. All dermatologists should be aware of these cutaneous lesions, which may be early clinical symptoms of infection. We reviewed the literature on cutaneous manifestations in the PubMed database from December 2019 and June 2020. From the cases described as case reports or series in 57 recent articles, it appears that skin lesions (i) are highly varied, (ii) may not be related to the severity of the condition and (iii) resolve spontaneously in a few days. The frequency of these lesions in COVID-19 patients varies between 1.8% and 20.4%. The major clinical forms described were maculopapular eruptions, acral areas of erythema with vesicles or pustules (pseudochilblain), urticarial lesions, other vesicular eruptions and livedo or necrosis. The lesions were mainly localized in the trunk and extremities. The majority of patients were male, aged between 4.5 and 89 years. A minority of the patients were children presenting with acral, chilblain-like lesions, papulo-vesicular eruptions or Kawasaki disease-like pediatric inflammatory multisystem syndrome. The mean duration of the lesions was a few days, but some lasting as little as 20 min and others as long as four weeks have been reported. The mean latency time in the majority of cases was between 1 and 14 days; however, in some patients, lesions appeared 2 to 5 days before the onset of COVID-19 symptoms. The histopathological features of these lesions also vary, corresponding to the diversity of clinical manifestations. These features underline the nature of epidermal and dermal vascular lesions—and in severe cases, microvascular injury and thrombosis—associated with COVID-19, and provide important clues to their pathological mechanisms.

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