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J Dermatol ; 48(10): 1588-1592, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1319212


In the worldwide coronavirus disease 2019 (COVID-19) outbreak, skin manifestations were seen in COVID-19 patients. We report a case in which a COVID-19 patient developed cutaneous lesions that were diagnosed as erythema nodosum-like lesions, which were associated with COVID-19. Nasopharyngeal swab polymerase chain reaction (PCR) confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Histopathologically, extensive inflammation was seen from the epidermis to the fat tissue. An organized thrombus and disrupted inner elastic lamina were seen in an intradermal vessel. These findings suggest septal panniculitis with cutaneous polyarteritis nodosa. The results of PCR using the specimen of skin lesion was negative. The patient took non-steroidal anti-inflammatory drugs and the skin lesion improved in 3 weeks. To characterize the skin eruption, we reviewed previous reports on COVID-19 (confirmed by the detection of SARS-CoV-2 infection) from Asian countries. The type of eruption and timing of its appearance in this case seemed rare. Differences in skin manifestations between Western and Asian countries were noted.

COVID-19 , Erythema Nodosum , Exanthema , Asia , Erythema Nodosum/diagnosis , Erythema Nodosum/drug therapy , Humans , SARS-CoV-2
Case Rep Infect Dis ; 2020: 8814249, 2020.
Article in English | MEDLINE | ID: covidwho-751446


Although a variety of existing drugs are being tested for patients with coronavirus disease 2019 (COVID-19), no efficacious treatment has been found so far, particularly for severe cases. We report successful recovery in an elderly patient with severe pneumonia requiring mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Despite administration of multiple antiviral drugs, including lopinavir/ritonavir, chloroquine, and favipiravir, the patient's condition did not improve. However, after administration of another antiviral drug, remdesivir, we were able to terminate invasive interventions, including ECMO, and subsequently obtained negative polymerase chain reaction results. Although further validation is needed, remdesivir might be effective in treating COVID-19.

The Journal of the Japanese Association for Infectious Diseases ; 94(4):568-572, 2020.
Article in Japanese | WHO COVID | ID: covidwho-722941


As no specific therapeutic agents have been established yet for coronavirus disease 2019 (COVID-19), the illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), symptomatic therapy is the mainstay of treatment. Although the “Concept of antiviral treatment for COVID-19, First edition” published by the Japanese Association for Infectious Diseases recommends the use of antiviral medication for infected individuals over the age of 50 years, we have documented the case of a 73-year-old woman with COVID-19 pneumonia who improved without antiviral medication. The patient became infected with SARS-CoV-2 on the cruise ship, Diamond Princess, and first tested positive for SARS-CoV-2, by the RT-PCR test, on February 15, 2020. She was admitted to another hospital with fever and pneumonia on February 16, and on February, the pneumonia worsened in severity, she was transferred to our hospital. However, her condition improved spontaneously within a few days, without any antiviral medication. This report is very valuable for documenting the natural history of COVID-19 pneumonia and can be considered as a reference case for formulating strategies for antiviral drug administration for COVID-19 patients in the future.