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 Cutaneous Complications in Macrolide Prescribing in Pediatrics

2019 ◽  
pp. 1-3
Author(s):  
Debajyoti Saha ◽  
Shatavisa Mukherjee ◽  
Sabnam Ara Begum ◽  
Santanu Kumar Tripathi
Keyword(s):  
Adverse Reactions ◽  
Adult Population ◽  
Case Series ◽  
Common Adverse Effect ◽  
Skin Lesions ◽  
Stevens Johnson Syndrome ◽  
Cutaneous Manifestations ◽  
Johnson Syndrome ◽  
Maculopapular Rashes ◽  
Cutaneous Adverse Reactions

Cutaneous adverse reactions are very common adverse effect of post antibiotic therapy. Cutaneous adverse reactions include skin lesions in the form of rashes urticaria, maculopapular rashes, eythema multiforme, stevens-johnson syndrome and toxic epidermal necrolysis. However macrolides, generally considered safer in this regard, are frequently used to treat both adult and childhood infections, with favorable outcomes. Cutaneous manifestations of this class of antibiotic are scarce. The present case series focuses on conglomeration of few cases of cutaneous reactions due to macrolide therapy in both children and adult population.

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

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.    

scholarly journals Spectrum of cutaneous manifestations in lupus erythematous -a dermatologist perspective

1970 ◽  
Vol 10 (1) ◽  
pp. 8-11 ◽  
Author(s):  
S Bhattarai ◽  
S Agrawal ◽  
A Rijal ◽  
SK Sharma ◽  
SS Dhakal
Keyword(s):  
Skin Lesion ◽  
Lupus Erythematosus ◽  
Skin Disease ◽  
Case Series ◽  
Skin Lesions ◽  
Cutaneous Manifestations ◽  
Malar Rash ◽  
Skin Changes ◽  
Nail Changes ◽  
Eye Involvement

Background: The cutaneous manifestations of lupus erythematosus (LE) specific skin disease consists of acute cutaneous LE (ACLE), Subacute cutaneous (SCLE) and Chronic cutaneous (CCLE). Objective: To evaluate the spectrum of cutaneous manifestation in patients of LE. Methods: A case series of 41 clinically diagnosed cases of LE attending the outpatient department of Dermatology, BPKIHS were evaluated for the specific and non-specific skin changes. Results: All the patients enrolled in the study were female,with the age ranging from 14-64 years. ACLE was detected in 22/41(78.04%). Malar rash was the frequent skin lesion. CCLE was seen in 6/41 (14.63%) patients with classical discoid lesions (localized and generalized) in 4/6(66.66%) and 2/6(33.33%) respectively. Non specific skin lesions were found in 30/ 41(73.17%) of patients. Mucosal ulcers were seen in 23/41(56.09%), Facial telangiectasias 20/41(48.78%), Raynaunds phenomena 22/41(53.65%), Chronic urticaria 9/41(21.95%), Nail changes 12/41(29.26%) and non scarring alopecia was seen in 6/41(14.63%) patients. Eye involvement was seen in 3/41(7.3%), cutaneous vasculitis in 5/41(12.19%) and scaring alopecia in 3/41(7.3%) patients. Conclusion: The cutaneous manifestations of patients with lupus erythematosus (LE) are very frequent, show a great variety and can occur at any stage of the disease. DOI: http://dx.doi.org/10.3126/hren.v10i1.5999 HREN 2012; 10(1): 8-11

scholarly journals Cutaneous manifestations caused by Simulium erythrocephalum bites in humans: A case series

2020 ◽  
Vol 73 (1-2) ◽  
pp. 59-62
Author(s):  
Ljuba Vujanovic ◽  
Marina Jovanovic ◽  
Zoran Golusin ◽  
Zorica Gajinov ◽  
Sanja Jakovljevic
Keyword(s):  
Veterinary Medicine ◽  
Local Reaction ◽  
Case Series ◽  
Skin Lesions ◽  
Symptomatic Therapy ◽  
Cutaneous Manifestations ◽  
Outdoor Activities ◽  
Systemic Corticosteroids ◽  
Wide Range ◽  
Insect Bites

Introduction. In contact with insects, people present a wide range of reactions, local or systemic, whether caused by insect bites or a venom injections, sucking blood or exposure to insect?s body and its secretions. Simulium erythrocephalum is an aggressive anthropophilic species, and following its bite humans may develop purpuric macules, edema and erythema surrounding the bite site. Our case series indicates frequent occurrence of Simulium erythrocephalum bites in Serbia. Case Series. We present a series of 30 cases reviewed between April and July 2006, who developed a local reaction at the site of this insect?s bite. In all patients, the skin lesions were located on the extremities, mainly the lower legs. The number of bites varied from two to more than ten. In all patients the bites occurred either during outdoor activities on the riverside or their residence was near the Danube. The therapy with antihistamines, local and/or systemic corticosteroids, as well as symptomatic therapy, with compression and limb elevation was recommended. The skin lesions regressed in one week in most patients, but in few they lasted for several weeks. Conclusion. In addition to its impact on human health, Simulium erythrocephalum also has a role in veterinary medicine. Insect bites in animals can cause significant livestock losses, occasionally resulting in animal mortality. Apart from this, Simulium erythrocephalum may also be a vector in the transmission of the parasite from the genus of Leucocytozoon that infests birds.

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.

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>

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 Manifestações Cutâneas Associadas à COVID-19: Uma Revisão Narrativa

2020 ◽  
Vol 33 (13) ◽  
Author(s):  
Maria Relvas ◽  
Joana Calvão ◽  
Raquel Oliveira ◽  
José Carlos Cardoso ◽  
Margarida Gonçalo
Keyword(s):  
Case Reports ◽  
Clinical Manifestations ◽  
Case Series ◽  
Skin Lesions ◽  
Cutaneous Manifestations ◽  
Pubmed Database ◽  
The World ◽  
Confirmatory Tests ◽  
Substantial Heterogeneity ◽  
Pathophysiologic Mechanisms

Introduction: COVID-19 is an infectious disease caused by the new coronavirus, SARS-CoV-2, that has spread rapidly throughout the world. This has resulted in an urgent need to obtain information regarding its pathogenesis, diagnosis and clinical manifestations. More specifically, skin manifestations, seldom reported initially, have been increasingly described.Material and Methods: We performed a literature search in the PubMed database, regarding cutaneous manifestations associated with COVID-19. This article describes the clinical and histological findings of the main skin lesions observed in the context of SARS-CoV-2 infection.Discussion: Cutaneous manifestations associated with COVID-19 have been described in multiple retrospective and prospective studies, case series and case reports. The reported incidence reached 20.4%. Although there was substantial heterogeneity in terms of clinical patterns, the main ones include: erythematous/maculopapular, urticarial, papulovesicular, and purpuric/petechial eruptions, chilblain-like lesions and livedoid/acro-ischemic lesions. In the vast majority, the underlying pathophysiologic mechanisms are not fully understood, although histopathological findings and biomolecular studies can add relevant data.Conclusion: The recognition of cutaneous manifestations associated with COVID-19 is of utmost importance. They may help establishing an early diagnosis, namely in oligosymptomatic patients or when confirmatory tests are impossible to perform. Moreover, chilblain-like lesions and acro-ischemia, also seem to play an important role in terms of prognosis.

scholarly journals Cutaneous Manifestations of COVID-19: A Systematic Review

2020 ◽  
Author(s):  
Giulia Daneshgaran ◽  
Danielle P. Dubin ◽  
Daniel J. Gould
Keyword(s):  
Systematic Review ◽  
Health Care Professionals ◽  
Case Reports ◽  
Severe Disease ◽  
Case Series ◽  
Middle Aged ◽  
Cutaneous Manifestations ◽  
Pubmed Database ◽  
Maculopapular Rashes ◽  
Middle Aged Adults

Abstract Background: The COVID-19 pandemic has affected 4.5 million people and killed over 300,000 patients. Although this virus primarily causes respiratory symptoms, an increasing number of cutaneous manifestations associated with this disease have been reported.Objective: The aim of this review was to collate and categorize the dermatologic findings reported in COVID-19 patients and identify specific lesions that may facilitate diagnosis and prognostication.Methods: A systematic review of the PubMed database was conducted on May 14th, 2020 using the search terms “Covid-19 skin,” “Covid-19 rash,” “Covid-19 exanthem,” and “Covid-19 chilblains.” Peer-reviewed publications containing original COVID-19 patient cases and a discussion of the associated cutaneous findings were included in the analysis.Results: The literature search identified 115 records, of which 34 publications describing 996 dermatologic patients were included. Case reports (n=15), case series (n=10) and observational studies (n=7) were the most common publication types. Pseudo-chilblains (PC) was the most frequent lesion identified (40.4% of cases), appearing in young adults (mean age, MA, 23.2 years) after the onset of extracutaneous COVID-19 symptoms (55/100 patients). Erythematous maculopapular rashes (EMR) affected 21.3% of patients, most frequently impacting middle-aged adults (MA 53.2 years) and occurring at the same time as non-cutaneous symptoms (110/187 patients). Vesicular rashes (VR) affected 13.0% of patients, appearing in middle-aged adults (MA 48.3 years) after the onset of other symptoms (52/84 patients). Urticarial rashes (UR) affected 10.9% of patients, appearing in adults (MA 38.3 years) and occurring at the same time as non-cutaneous symptoms (46/78 patients). Vascular rashes resembling livedo/purpura/necrosis (LPN) were uncommon (4% of cases), appearing in elderly patients (MA 77.5 years) and occurring at the same time as non-cutaneous COVID-19 symptoms (18/29 patients). Erythema multiforme-like eruptions (EME), although infrequent (3.7% of cases), affected mostly children (MA 12.2 years).Conclusions: VR may suggest an initial diagnosis of COVID-19, PC may be most appropriate for epidemiological uses, and LPN may be a useful prognostic marker for severe disease. As a potential correlate to disease severity, prognosis, or infectibility, it is critical that all health care professionals be well-versed in these increasingly common cutaneous manifestations of COVID-19.

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