ABSTRACT
Nail manifestations are 1 of the several extrapulmonary findings associated with COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Nail changes, however, have been largely ignored and not yet summarized. This article is intended to increase awareness of nail manifestations of SARS-CoV-2, which occur weeks to months after acute infection and the periungual pernio-like changes may occur concomitantly with infection. An electronic search was carried out in PubMed (Medline), Science Direct, and Scopus databases. The following keywords and all of their possible combinations were used to identify studies: "SARS-CoV-2," "COVID-19," "Coronavirus," "2019-ncov," "nail," and "nails." Six case reports were included in this study. Manifestations identified included red half-moon sign, transverse orange nail lesions, Mees' lines, and Beau's lines. Though largely nonspecific, these findings can be recognized with the onset of symptom onset or as late as 16 weeks following the disease. Some of these findings are shared with other conditions associated with a proinflammatory state. Nail changes offer unique insight into the pathophysiologic basis for SARS-CoV-2 and they may serve as diagnostic clues.
ABSTRACT
Teledermatology has become critical for maintaining patient access to dermatologic services since the eruption of the COVID-19 pandemic. This survey of first-time synchronous teledermatology patients (n = 100) seen by providers of the University of Mississippi Medical Center during Spring 2020 was designed to learn more about patient experiences associated with the technical challenges of synchronous teledermatology. Our patient population had considerable experience with various social media including Facebook (82%) and hardware platforms, such as Apple devices (66%). We found that the majority of patients were satisfied (88.9%) with their synchronous teledermatology encounter and 81.8% of patients did not experience a technical difficulty with their consult. About 15% of patients lost connection with their provider during their consultation. Furthermore, about 30% of patients rated "showing their skin" to their provider as "hardest" on a ten scale. However, about 34% of patients sent "store-and-forward"-type images to supplement their encounter. Despite overwhelming satisfaction with synchronous teledermatology, a majority prefer an in-person consultation for their next visit (68.7%). Synchronous teledermatology offers a critical service to patients to expand access to specialty consultation. It is well-received by patients despite technical barriers, especially during a global health crisis.