ABSTRACT
RESUMEN Introducción: desde el inicio de la pandemia declarada en marzo del 2020 por la Organización Mundial de la Salud, la piel no se ve excluida de esta afectación, al inicio descripta como hallazgo poco frecuente, actualmente se estima que un 20 % de los pacientes con COVID-19 presentan algún tipo de manifestación dermatológica que se presenta durante la fase aguda de la enfermedad o durante la convalecencia. Las lesiones cutáneas son diversas, entre ellas llama la atención por su importancia y severidad las acroisquémicas. Objetivo: describir las características demográficas, clínicas, laboratoriales y evolutivas de 6 casos de COVID-19 con lesiones acroisquémicas severas. Metodología: estudio retrospectivo, descriptivo y observacional de casos de COVID-19 confirmados por pruebas laboratoriales con lesiones acroisquémicas severas interconsultados en el Servicio de Dermatología del Hospital Nacional o de la consulta privada en el periodo julio 2020 a julio 2021. Resultados: se analizaron 6 casos, 3 mujeres y 3 varones, con promedio de edad de 61.6 años, todos con diagnóstico confirmado de COVID-19. Los patrones clínicos de lesiones acroisquémicas observados fueron 2 isquemias microcirculatorias severas y 4 gangrenas secas. Todos los pacientes presentaron alguna comorbilidad y dímero D elevado. Uno recibió tratamiento ambulatorio, 4 en sala de internados y 1 en unidad de cuidados intensivos. Todos recibieron anticoagulación. La evolución fue satisfactoria en 2 de ellos, en 2 fue necesaria la amputación parcial o total de los miembros afectados y 1 obitó. Conclusión: las lesiones cutáneas acroisquémicas en pacientes que cursan o han cursado con COVID-19 son poco frecuentes, se presentan por lo general en personas mayores y están asociados a un peor pronóstico en cuanto a morbimortalidad.
ABSTRACT Introduction: since the beginning of the pandemic declared in March 2020 by the World Health Organization, the skin is not excluded from this affectation, initially described as a rare finding, currently it is estimated that 20% of patients with COVID-19 present some type of dermatological manifestation that manifests itself during the acute phase of the disease or during convalescence. Skin lesions are diverse, among them acroischemic ones are striking for their importance and severity. Objective: to describe the demographic, clinical, laboratory and evolutionary characteristics of 6 cases of COVID-19 with severe acroischemic lesions. Methodology: Retrospective, descriptive and observational study of COVID-19 cases confirmed by laboratory tests with severe acroischemic lesions consulted in the "Servicio de Dermatología" del "Hospital Nacional" or the private practice in the period July 2020 to July 2021. Results: 6 cases were analyzed, 3 women and 3 men, with an average age of 61.6 years, all with a confirmed diagnosis of COVID-19. The clinical patterns of acroischemic lesions observed were 2 severe microcirculatory ischemia and 4 dry gangrene. All patients had some comorbidity and elevated D-dimer. One received outpatient treatment, 4 in the inpatient ward and 1 in the intensive care unit. All received anticoagulation. The evolution was satisfactory in 2 of them, in 2 it was necessary the partial or total amputation of the affected limbs and 1 died. Conclusion: acroischemic skin lesions in patients with or who have had COVID-19 are rare, generally occur in older people, and are associated with a worse prognosis in terms of morbidity and mortality.
ABSTRACT
Abstract The cannabinoid chemistry is currently being addressed in preclinical approaches as a viable therapeutic alternative for the management of a wide range of signs, symptoms, and some biochemical hallmarks of many neurological pathologies (such as neuroinflammation and neurodegeneration). This clinical orientation is grounded on the consistent promissory profile that cannabinoid compounds have shown, and the great necessity of feasible options to undergo such disorders. Even though at early research stages, metabolic disorders are starting to rise as potential targets of cannabinoid alternatives; approaches in this term could, in turn, aim to modulate the endocannabinoid response for therapeutic purposes. This review recalls the pathologic scenarios endured in the course of neurological diseases of high occurrence and the most typical metabolic disorders, while discussing the neuroprotective mechanisms of cannabinoid agonists in the central nervous system, and the potential targets of the endocannabinoid system and metabolic disorders.