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1.
Hautarzt ; 73(4): 291-297, 2022 Apr.
Article in German | MEDLINE | ID: covidwho-1733959

ABSTRACT

BACKGROUND: The persistent global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can manifest on the skin in addition to the already known organ systems. Various clinical patterns of skin manifestations associated with coronavirus disease 2019 (COVID-19) have been described. In view of the associated morbidity and mortality, knowledge of cutaneous manifestations in the setting of COVID-19 may be helpful in early detection, risk stratification, diagnosis and treatment. Thus, we provide a summary of the various dermatologic findings associated with COVID-19, including clinical presentation, current pathophysiological concepts, and management, to support early diagnosis and treatment. GOAL: The current literature regarding skin lesions associated with COVID-19 and the most important aspects are analyzed. MATERIALS AND METHODS: A literature search was performed in PubMed and Medline databases until February 28, 2021. RESULTS AND CONCLUSION: The classification of skin manifestations in the context of SARS-CoV­2 infection according to clinical dermatological patterns can help to identify patients with increased risk at an early stage and to treat them adequately to counteract a possibly more severe course of the disease as it occurs, e.g., in livedo. Thus, knowledge of the pathophysiological mechanisms can improve management of the disease and support possible countermeasures in coping with the disease.


Subject(s)
COVID-19 , Skin Diseases , Humans , Pandemics , SARS-CoV-2 , Skin/pathology , Skin Diseases/diagnosis , Skin Diseases/etiology , Skin Diseases/therapy
2.
Der Hautarzt|Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete ; : 1-7, 2022.
Article in German | EuropePMC | ID: covidwho-1728279

ABSTRACT

Hintergrund Die durch das Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) ausgelöste anhaltende globale Pandemie manifestiert sich neben bekannten Organsystemen auch an der Haut. In der Literatur wurden verschiedene klinische Muster von Hauterscheinungen mit COVID-19 in Verbindung gebracht. Die Kenntnis der kutanen Manifestationen kann bei der Früherkennung, Risikostratifizierung von Patienten, Diagnose und den therapeutischen Strategien hilfreich sein. In dem vorliegenden Artikel wird der aktuelle Kenntnisstand zu dermatologischen Befunden im Zusammenhang mit COVID-19 unter Berücksichtigung der klinischen Präsentation, aktuellen pathophysiologischen Konzepten und Management zusammengefasst. Zukünftig sollen auch Erkenntnisse aus einem aktuell geführten Register der Universität Harvard gezogen werden können. Derzeit werden hier Hautveränderungen in Assoziation mit COVID-19 gesammelt (https://ilds.org/covid-19/international-dermatology-covid19-registry/). Ziel der Arbeit Ziel dieses Übersichtsartikels ist es, die aktuell verfügbare Literatur mit Hinweisen auf Hautveränderungen im Zusammenhang mit COVID-19 zu analysieren, zu strukturieren und die wichtigsten Aspekte zusammenzufassen. Material und Methoden Es wurde eine systematische Literaturrecherche in der medizin-wissenschaftlichen Datenbank PubMed und Medline für englischsprachige Originalartikel, Fallserien und -berichte sowie Übersichtsarbeiten unter Verwendung der Suchbegriffe „Covid“, „COVID-19“ oder „SARS-CoV-2“ in Kombination mit „skin“ oder „dermatol“ durchgeführt, welche bis Februar 2021 (Einträge bis zum 28.02.2021) veröffentlicht wurden. Untersucht wurde der Zusammenhang zwischen bestätigten oder vermuteten SARS-CoV-2-Infektionen in Assoziation mit Hautmanifestationen. Eingeschlossen wurden vorwiegend Arbeiten, welche ein möglichst großes Patientenkollektiv, das Erwachsenenalter und einen positiven Corona-Nachweis beinhalteten. Ziel der Arbeit ist es, einen Überblick der am häufigsten beobachteten Hautmanifestationen bei Infektionen mit SARS-CoV‑2 zu geben. Ergebnisse und Diskussion Die Zuordnung der Hautmanifestationen im Rahmen einer SARS-CoV-2-Infektion nach klinisch dermatologischen Mustern kann dazu beitragen, Patienten mit erhöhtem Risiko frühzeitig zu identifizieren und adäquat zu behandeln, um einem möglicherweise schwereren Krankheitsverlauf wie er beispielsweise bei der Livedo auftritt, entgegenzuwirken. Die erworbenen Kenntnisse der pathophysiologischen Mechanismen können zu einem verbesserten Management der Erkrankung und Hilfestellung möglicher Gegenmaßnahmen in der Bewältigung der Erkrankung beitragen.

3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-318089

ABSTRACT

The coronavirus disease 2019 (COVID‐19) is associated with a wide clinical spectrum of skin manifestations, including chilblain‐like, urticarial, vesicular and vasculitic lesions. Recently, delayed skin reactions following mRNA vaccination against SARS-CoV-2 have been reported. The exact pathomechanisms underlying these skin lesions remain unknown. Here, we describe eleven cases of delayed skin reactions after SARS-CoV-2 vaccination with the mRNA-1273 vaccine, discuss their transient and benign clinical courses and consider their potential pathomechanisms based on histopathological analyses. We conclude that further investigations to characterize the precise molecular and cellular mechanisms underlying this rare phenomenon are warranted.

4.
Eur J Med Res ; 26(1): 98, 2021 Aug 25.
Article in English | MEDLINE | ID: covidwho-1371980

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) is associated with a wide clinical spectrum of skin manifestations, including urticarial, vesicular, vasculitic and chilblain-like lesions. Recently, delayed skin reactions have been reported in 1% individuals following mRNA vaccination against SARS-CoV-2. The exact pathophysiology and the risk factors still remain unclear. PATIENTS AND METHODS: 6821 employees and patients were vaccinated at our institutions between February and June 2021. Every patient received two doses of the mRNA-1273 vaccine in our hospitals, and reported back in case of any side effects which were collected in our hospital managed database. RESULTS: Eleven of 6821 vaccinated patients (0.16%) developed delayed skin reactions after either the first or second dose of the mRNA-1273 vaccine against SARS-CoV-2. Eight of 11 patients (73%) developed a rash after the first dose, while in 3/11 (27%), the rash occurred after the second dose. More females (9/11) were affected. Four of 11 patients required antihistamines, with two needing additional topical steroids. All the cutaneous manifestations resolved within 14 days. None of the skin reactions after the first dose of the vaccine prevented the administration of the second dose. There were no long-term cutaneous sequelae in any of the affected individuals. CONCLUSION: Our data suggests that skin reactions after the use of mRNA-1273 vaccine against SARS-CoV-2 are possible, but rare. Further studies need to be done to understand the pathophysiology of these lesions.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , Dermatitis/etiology , Erythema/etiology , Adult , Aged , Dermatitis/drug therapy , Dermatitis/epidemiology , Erythema/drug therapy , Erythema/epidemiology , Female , Histamine Antagonists/therapeutic use , Humans , Male , Middle Aged , Steroids/therapeutic use , Vaccination/adverse effects
5.
Allergo J Int ; 29(8): 257-261, 2020.
Article in English | MEDLINE | ID: covidwho-1086715

ABSTRACT

The population prevalence of insect venom allergy ranges between 3-5%, and it can lead to potentially life-threatening allergic reactions. Patients who have experienced a systemic allergic reaction following an insect sting should be referred to an allergy specialist for diagnosis and treatment. Due to the widespread reduction in outpatient and inpatient care capacities in recent months as a result of the COVID-19 pandemic, the various allergy specialized centers in Germany, Austria, and Switzerland have taken different measures to ensure that patients with insect venom allergy will continue to receive optimal allergy care. A recent data analysis from the various centers revealed that there has been a major reduction in newly initiated insect venom immunotherapy (a 48.5% decline from March-June 2019 compared to March-June 2020: data from various centers in Germany, Austria, and Switzerland). The present article proposes defined organizational measures (e.g., telephone and video appointments, rearranging waiting areas and implementing hygiene measures and social distancing rules at stable patient numbers) and medical measures (collaboration with practice-based physicians with regard to primary diagnostics, rapid COVID-19 testing, continuing already-initiated insect venom immunotherapy in the outpatient setting by making use of the maximal permitted injection intervals, prompt initiation of insect venom immunotherapy during the summer season, and, where necessary, using outpatient regimens particularly out of season) for the care of insect venom allergy patients during the COVID-19 pandemic.

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