VARICELLA LIKE DERMATOLOGICAL MANIFESTATION FOLLOWING SARSCOVID-19 INFECTION :A DIAGNOSTIC DILEMMA

2021 ◽  
pp. 36-37
Author(s):  
Darshankumar Manubhai Raval ◽  
Pallavi Bhogesara
Keyword(s):  
Viral Entry ◽  
Clinical Phenotype ◽  
Normal Skin ◽  
Skin Lesions ◽  
Public Health Emergency ◽  
The Novel ◽  
Diagnostic Dilemma ◽  
Cutaneous Manifestations ◽  
Skin Affection ◽  
Retiform Purpura

The infection caused by the novel SARS-CoV-2 is a public health emergency of international concern. Although, COVID-19, mainly affects the lungs, the infection can spread to extrapulmonary tissues, causing multiorgan involvement in severely ill patients. The infectivity of SARS-CoV-2 is related to the pattern of expression of the viral entry factors ACE2 and TMPRSS2 in human tissues. As such, the respiratory and gastrointestinal tracts are at high risk for SARS-CoV-2 infection due to their high expression of ACE2 and TMPRSS2, which explains the clinical phenotype described in the vast majority of infected patients that includes pneumonia and diarrhea. Recently, concern regarding virus to infect the skin has been raised by dermatologists due to the increasing observations of cutaneous manifestations in patients with SARS-CoV-2 infection. Although there is little evidence of the expression of ACE2 and TMPRSS2 in the normal skin, the dermatological ndings observed among COVID-19 patients warrants further investigation to delineate the mechanisms of skin affection after SARS-CoV-2 infection[1]. The frequency of skin lesions in these patients varies between 1.8 % and 20.4 % . The major dermatologic morphologies described in CoVID-19 cases were morbilliform, pernio-like, urticaria, macular erythema, vesicle, papulosquamous and retiform purpura

scholarly journals Nigerian Female with Skin Lesions in the Leg and Face: Herpetic Sycosis Folliculitis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Dominique Dilorenzo ◽  
Naganna Channaveeraiah ◽  
Patricia Gilford ◽  
Bruce Deschere
Keyword(s):  
Normal Skin ◽  
The United States ◽  
Skin Lesions ◽  
Unusual Presentation ◽  
Diagnostic Dilemma ◽  
Lower Lip ◽  
Hiv Test ◽  
Mucus Membrane ◽  
The Face ◽  
The Right

Nongenital HSV 1 presents outside the mucus membrane. Our patient had unusual presentation that caused diagnostic dilemma. 30-year-old native Nigerian female coming with fiancée to the United States presented to our service one day after arrival through ER with a lesion on her right ankle. She was diagnosed with cellulitis, started on antibiotics, and admitted to hospital. She had fever of 39.1°C. Head and neck exam showed multiple sized lesions over tongue and palate and inner aspect of lower lip. Abdomen and genital exam was normal. Skin exam showed lesions over the face and lesions over the lateral aspect of the right leg. There was ulcerated lesion over the right lateral malleolus with surrounding erythema and edema. Her tests showed elevated ESR of 98; HIV test was negative; CT scan of the ankle showed no abscess or osteomyelitis. TB quantiferon was indeterminate; AFB stain and culture were negative; HSV IgM was elevated at 1 : 16; RPR was negative; ANA was negative; malaria screen was negative, and blood cultures were negative for bacteria, fungus, and virus. Debrided wound had no growth of bacteria or fungus or virus. This case illustrates the unusual presentation of the HSV1 outside the mucus membrane and how it can be confused with other conditions that required extensive tests. Therapeutic trail with antiviral medications resolved lesions over the leg and face.

Utility of photography to confirm skin lesion response assessed using a severity weighted assessment tool (SWAT) in cutaneous T-cell lymphoma (CTCL)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6579-6579
Author(s):  
B. S. Mann ◽  
J. R. Johnson ◽  
K. He ◽  
R. Sridhara ◽  
A. T. Farrell ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Small Sample Size ◽  
Normal Skin ◽  
Skin Lesions ◽  
Small Sample ◽  
Whole Body ◽  
Cutaneous Manifestations ◽  
Technological Advances ◽  
Duration Of Response ◽  
Blurred Image

6579 Background: In Oct 2006, FDA approved vorinostat for treatment of cutaneous manifestations of CTCL–based on response rate and duration of response observed in CTCL skin lesions. Response was determined by change in SWAT score at follow up compared to the baseline score. SWAT Score: sum of % Body Surface Area weighted by factor 1, 2, or 4 for patch (no elevation from normal skin), plaque (< 5 mm elevation) and tumor (= 5 mm elevation), respectively. All responses but one were partial. A partial response required = 50% reduction in whole body SWAT score lasting = 4 weeks. FDA also reviewed serial photographs of all patients (standard whole body views and close-ups of skin lesions), submitted as supportive evidence. Methods: An expert external reviewer, blind to SWAT scores, adjudicated responses by examining photographs and response determinations by photographs and by SWAT scores were compared. Results: Based on SWAT scores, skin lesions in 18 of 61 stage = IIB CTCL patients responded to vorinostat; there were 17 partial and 1 complete responses. Blinded reviewer adjudicated 4 photographs not evaluable (reasons: blurred image, color or light problem, wrong label), easily confirmed 7 responses, and called 7 responses equivocal. Responses seemed easier to determine in skin lesions with tumors or ulcers. Predominantly patch or plaque lesions were harder to evaluate: patches due to poor color reproduction and plaques due to inability to palpate. A response from plaque to patch morphology decreases SWAT score 50%, but the change may not manifest adequately in a photograph. Small sample size did not allow a reliable statistical analysis for correlation between different lesion types and ability to confirm objective responses (based on SWAT scores) by photography. Conclusions: Photography allows a limited evaluation of skin lesions in CTCL: inability to measure lesion thickness in photographs limits direct confirmation of SWAT scores. Photography complements SWAT evaluation: in half the cases in the vorinostat pivotal trial, a response by SWAT score was easily confirmed by the reviewer blind to SWAT scores. Further experience and technological advances in photography may reduce the number of not evaluable photographs. No significant financial relationships to disclose.

scholarly journals Dermatological Manifestations of COVID-19: A Brief Review

2020 ◽  
Author(s):  
Harsimran Kaur
Keyword(s):  
Wide Spectrum ◽  
National Level ◽  
Skin Lesions ◽  
The Novel ◽  
Cutaneous Manifestations ◽  
Remote Areas ◽  
Proven Case ◽  
Novel Virus ◽  
Novel Coronavirus ◽  
Dermatological Side Effects

AbstractThe emphasis so far during the COVID-19 pandemic has been on the respiratory manifestations with little attention being paid to cutaneous manifestations. The novel coronavirus has a wide spectrum of cutaneous manifestations which are broadly divided into exanthematous and vasculopathic type of lesions. The effects of this novel virus on the integumentary system cannot be underestimated as it can mimic various types of viral skin lesions. Thus, dermatologists should have knowledge about COVID-19 disease presentations and which differential diagnosis to consider if they encounter skin lesions in a patient who is known or suspected to have COVID-19. Patient evaluation and workup also needs to be modified during the time of this pandemic. Immunosuppressive/immunomodulatory drugs which are rampantly used in dermatological practice, must be used only after weighing their risks and benefits during the COVID-19 era. Personal Protective Equipment has to be worn when coming in contact with a suspected or a proven case of COVID-19. However, its use itself is associated with dermatological side effects which should be known to dermatologist practising during the COVID-19 era. Teledermatology can go a long way in circumventing these issues and it should be made more accessible, especially in remote areas. Another future recommendation could be setting up of a national level organization or group for recording dermatological data related to COVID-19.

scholarly journals Leukocytoclastic Vasculitis as a Cutaneous Manifestation of COVID-19 Infection with a Positive Skin Antigen Test

2021 ◽  
pp. 1-5
Author(s):  
Oghowan Abdelrahman ◽  
Andleeb Shadan ◽  
Laila Al Dabal ◽  
Tasnim R. Keloth
Keyword(s):  
Lower Respiratory Tract ◽  
Clinical Presentation ◽  
Leukocytoclastic Vasculitis ◽  
Skin Lesions ◽  
Public Health Emergency ◽  
Antigen Test ◽  
Positive Skin ◽  
Cutaneous Manifestations ◽  
Common Presentation ◽  
Respiratory Tract Illness

On 11 March 2020, WHO declared the SARS-CoV-2 outbreak as a pandemic, representing a public health emergency of unprecedented dimension. COVID-19 is a multisystem Novel viral infection with protean manifestations and variable degrees of clinical presentation. The most common presentation is upper and lower respiratory tract illness. Cutaneous manifestations of COVID-19 have rarely been described. In this case report, we present a 41-year-old male patient who presented with fatigue and follicular skin rash followed almost 2 weeks later with fever, left upper limb transient weakness, and pneumonia. Of interest is that the patient’s skin lesions tested positive on COVID-19 antigen test. The patient received a course of anti-COVID-19 treatment as per our national guideline, and he made a full clinical and radiology recovery.

Life Lessons of the Pandemic ”Covid - 19”

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 469-471 ◽  
Author(s):  
Bhagyashri Vijay Chaudhari ◽  
Priya P. Chawle
Keyword(s):  
Public Health ◽  
Review Article ◽  
Public Health Emergency ◽  
The Novel ◽  
Global Public Health ◽  
Strange Situation ◽  
Republic Of China ◽  
Lifetime History ◽  
The People ◽  
Life Lessons

“A lesson learned the hard way is a lesson learned for a lifetime.” Every bad situation hurts; however, it sure does teach us something a lesson. In the same manner of a new lesson for Human lifetime, history is observing 'The Novel COVID-19 ’, a very horrible and strange situation created due to fighting with a microscopic enemy. WHO on 11 February 2020 has announced a name for new disease as - 19 and has declared as a global public health emergency and subsequently as pandemic because of its widespread. This began as an outbreak in December 2019, with its in Wuhan, the People Republic of China has emerged as a public health emergency of international concern. is the group of a virus with non-segmented, single-stranded and positive RNA genome. This bad situation of pandemic creates new scenes in the life of people in a different manner, which will be going to be life lessons for them. Such lessons should be kept in mind for the safety of living beings and many more things. In this narrative review article, reference was taken from a different article published in various databases which include the view of different authors and writers on the &quot;Lessons to be from Corona&quot;.

Local hospital experience of emergency management in the response to SARS (Preprint)

2020 ◽  
Author(s):  
Ying Yan
Keyword(s):  
Emergency Management ◽  
Infection Prevention ◽  
Public Health Emergency ◽  
The Novel ◽  
Prevention Measures ◽  
Hospital Emergency ◽  
Local Hospital ◽  
Referral Network ◽  
Novel Coronavirus ◽  
Hospital Transmission

UNSTRUCTURED The ongoing outbreak of SARS-CoV-2 infection was first identified in Wuhan, China at the late of 2019. Following the acceleration of the novel coronavirus spreading, person-person transmissions in family residences, hospitals and other public environments have led to a major public hazard in China. Currently, the SARS-CoV-2 outbreak has been further developed into a public health emergency of international concern. In response to an occurring pandemic, hospitals need an emergency strategy and plan to manage their space, staff, and other essential resources, therefore, to provide optimum care to patients involved. In addition, infection prevention measures urgently need to be implemented to reduce in-hospital transmission and avoid the occurrence of virus super-spreading. For hospitals without capacity to manage severe patients, a referral network is often needed. We present our successful field experience regarding hospital emergency management and local hospitals network model in response to SARS-CoV-2 emerging epidemic.

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 Inhibition of Hippo Signaling Improves Skin Lesions in a Rosacea-Like Mouse Model

2021 ◽  
Vol 22 (2) ◽  
pp. 931
Author(s):  
Jihyun Lee ◽  
Yujin Jung ◽  
Seo won Jeong ◽  
Ga Hee Jeong ◽  
Gue Tae Moon ◽  
...  
Keyword(s):  
Mouse Model ◽  
Signaling Pathway ◽  
Normal Skin ◽  
Skin Lesions ◽  
Hippo Signaling ◽  
Vascular Endothelial ◽  
Expression Levels ◽  
Hippo Signaling Pathway ◽  
Endothelial Growth Factor

The Hippo signaling pathway plays a key role in regulating organ size and tissue homeostasis. Hippo and two of its main effectors, yes-associated protein (YAP) and WWTR1 (WW domain-containing transcription regulator 1, commonly listed as TAZ), play critical roles in angiogenesis. This study investigated the role of the Hippo signaling pathway in the pathogenesis of rosacea. We performed immunohistochemical analyses to compare the expression levels of YAP and TAZ between rosacea skin and normal skin in humans. Furthermore, we used a rosacea-like BALB/c mouse model induced by LL-37 injections to determine the roles of YAP and TAZ in rosacea in vivo. We found that the expression levels of YAP and TAZ were upregulated in patients with rosacea. In the rosacea-like mouse model, we observed that the clinical features of rosacea, including telangiectasia and erythema, improved after the injection of a YAP/TAZ inhibitor. Additionally, treatment with a YAP/TAZ inhibitor reduced the expression levels of YAP and TAZ and diminished vascular endothelial growth factor (VEGF) immunoreactivity in the rosacea-like mouse model. Our findings suggest that YAP/TAZ inhibitors can attenuate angiogenesis associated with the pathogenesis of rosacea and that both YAP and TAZ are potential therapeutic targets for patients with rosacea.

scholarly journals MutationTaster2021

2021 ◽  
Author(s):  
Robin Steinhaus ◽  
Sebastian Proft ◽  
Markus Schuelke ◽  
David N Cooper ◽  
Jana Marie Schwarz ◽  
...  
Keyword(s):  
Prediction Model ◽  
Clinical Phenotype ◽  
The Novel ◽  
User Friendliness ◽  
Major Overhaul ◽  
Splice Site Prediction ◽  
Disease Mutations ◽  
Many Sources ◽  
Variant Effect Prediction ◽  
Mutation Search

Abstract Here we present an update to MutationTaster, our DNA variant effect prediction tool. The new version uses a different prediction model and attains higher accuracy than its predecessor, especially for rare benign variants. In addition, we have integrated many sources of data that only became available after the last release (such as gnomAD and ExAC pLI scores) and changed the splice site prediction model. To more easily assess the relevance of detected known disease mutations to the clinical phenotype of the patient, MutationTaster now provides information on the diseases they cause. Further changes represent a major overhaul of the interfaces to increase user-friendliness whilst many changes under the hood have been designed to accelerate the processing of uploaded VCF files. We also offer an API for the rapid automated query of smaller numbers of variants from within other software. MutationTaster2021 integrates our disease mutation search engine, MutationDistiller, to prioritise variants from VCF files using the patient's clinical phenotype. The novel version is available at https://www.genecascade.org/MutationTaster2021/. This website is free and open to all users and there is no login requirement.

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