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The aim of this manuscript is to investigate skin diseases associated with COVID-19 under three main headings: skin problems related to personal protective equipment and personal hygiene measures, skin findings observed in SARS-CoV-2 virus infections, and skin findings due to COVID-19 treatment agents. In PubMed and Google Scholar databases, publications on skin lesions related to personal protective equipment and personal hygiene measures, skin findings observed in SARS-CoV-2 virus infections and skin findings due to COVID-19 treatment agents subjects were searched in detail. Pressure injury, contact dermatitis, pruritus, pressure urticaria, exacerbation of preexisting skin diseases, and new skin lesion occurrence/new skin disease occurrence may be due to personal protective equipment. The incidence of skin lesions due to COVID-19 was reported to be between 0.2% and 29%. Many skin lesions including maculopapular, urticarial, vesicular, chilblain-like, thrombotic/ischemic, etc., are observed in COVID-19 patients. Some authors have stated that there is an absence of SARS-CoV-2 virus infection-specific skin rashes. Many skin lesions may appear as a result of COVID-19. Even in the absence of a COVID-19 diagnosis, skin findings should be evaluated carefully in the pandemic period.
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The Covid-19 pandemic has marked a paradigm shift in medical care, generating the need for the use of personal protective equipment (PPE) to safeguard health. This has caused secondary skin manifestations associated with their use. A descriptive cross-sectional investigation was carried out with the objective of characterizing the skin lesions associated with the use of PPE and Staphylococcus aureus infections in 283 nurses. The dermatological diagnosis was made by specialists;the bacteriological culture was performed using sterile cotton swabs or apposition smears on the skin lesion. For the isolation of the genus Staphylococcus, the samples were seeded in phenol red mannitol saline agar, incubating for 24 to 48 hours at 37°C. The identification of S. aureus was carried out by the fermentation of mannitol in the selective agar, the positive reaction of the coagulase test. S. aureus was differentiated from coagulase-negative Staphylococcus using the DNase test. LC-EPI was required in 75.618% of the nurses, of which 92.523% presented symptoms suggestive of secondary bacterial infection, fully confirmed by microbiological culture, identifying S. aureus. It was estimated that more than 60% of the LC-EPI were of a single presentation classified as grade I, mainly affecting the regions: orbital, temporal, nasal, infraorbital, and frontal, associated with the use of glasses/face protectors, hats, and masks as causes of the injuries. The definition of LC-EPI prevention protocols is recommended. © 2022 Instituto de Altos Estudios de Salud Publica. All rights reserved.
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BACKGROUND: In the 2022 mpox (monkeypox) outbreak, 79,000 global cases have been reported. Yet, limited dermatologic data have been published regarding lesion morphology and progression. OBJECTIVE: The objective of this study was to characterize skin lesion morphology, symptomatology, and outcomes of mpox infection over time. METHODS: The American Academy of Dermatology/International League of Dermatological Societies Dermatology COVID-19, Mpox, and Emerging Infections Registry captured deidentified patient cases of mpox entered by health care professionals. RESULTS: From August 4 to November 13, 2022, 101 cases from 13 countries were entered, primarily by dermatologists (92%). Thirty-nine percent had fewer than 5 lesions. In 54% of cases, skin lesions were the first sign of infection. In the first 1-5 days of infection, papules (36%), vesicles (17%), and pustules (20%) predominated. By days 6-10, pustules (36%) were most common, followed by erosions/ulcers (27%) and crusts/scabs (24%). Crusts/scabs were the predominant morphology after day 11. Ten cases of morbilliform rash were reported. Scarring occurred in 13% of the cases. LIMITATIONS: Registry-reported data cannot address incidence. There is a potential reporting bias from the predilection to report cases with greater clinical severity. DISCUSSION: These findings highlight differences in skin findings compared to historical outbreaks, notably the presence of skin lesions prior to systemic symptoms and low overall lesion counts. Scarring emerged as a major possible sequela.
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COVID-19 , Monkeypox , Skin Diseases , Humans , Cicatrix , COVID-19/epidemiology , Disease Outbreaks , Blister , Disease ProgressionABSTRACT
Nasal bridge is a common site suffering personal protective equipment-induced skin damages over face among first-line health care workers in this coronavirus disease 2019 pandemic. We hereby report folliculitis as a complication following regular use of N95 respirator and goggles, unreported in literature till now. Copyright © 2021 Neurological Surgeons' Society of India.
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The article reviews published data on skin manifestations of COVID-19 infection, summarizing experiences of the Department of Dermatovenereology. University Hospital Hradec Kralove with monitoring skin involvement in SARS-CoV-2 in January-July 2021. Suspected association between COVID-19 and skin involvement was found in 41 out of 50 examined patients. Clinical follow-up was performed at 2-month intervals. The most frequent post-COVID-19 skin complication was telogen effluvium in 33 cases, the vast majority of them (32 patients) being females. The association of skin symptoms in COVID-19 patients with direct effect of SARS-CoV-2 is also discussed. As-signing all types of skin exanthems to direct cytopathic effects of the virus is not appropriate. Histopathological correlations should be crucial in lesion differentiation and in understanding the pathogenic mechanisms associated with COVID-19 infection. The differential diagnosis of skin exanthems also includes drug sensitivity reactions. In the literature, there have been reports of increasing heterogeneity of skin lesions associated with SARS-CoV-2 infection. Therefore, categorization will be necessary to distinguish pathognomonic symptoms from non-specific consequences of systemic involvement in COVID-19 infection and from drug side effects used in its management. Correlation of clinical presentations and pathology will be critical to differentiate coincidence and causative correlation with COVID-19 infection. Tools used for such causative correlation consist of improved immunohistochemical methods, detection of SARS-CoV-2 RNA with RT-PCR assays and the use of electron microscopy.
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Introduction: Pfizer/BioNTech (BNT162b2) and Oxford/AstraZeneca (chAdOx1-S) COVID-19 vaccines were approved for emergency use. Clinical trials of both vaccines reported no safety concerns other than a few local and systemic reactions that resolved in few days for both vaccines. Cutaneous reactions to COVID-19 vaccination are generally minor and self-limited. The most common cutaneous reaction reported was a local injection-site reaction. Objective: Here we present 3 cases of erythema multiform following COVID-19 vaccination with positive rechallenge in 2 cases. Methods: Not applicable. Results: Case 1: A 51 year old woman with no past medical history presented with a macular, erythematous, round-shaped itchy rash on the hands, knees and soles. She denied having a neither recent illness nor sick contact. However, she received the first dose of the mRNA Pfizer/BioNTech (BNT162b2), 3 days earlier. Lesions disappeared in 7 days with local corticosteroid treatment. One month later and two days after receiving the second shot of the same vaccine, lesions reappeared and extended to upper members. Skin biopsy was compatible with erythema polymorph. Case 2: A 55 year old man with a past medical history of hypertension, presented 6 days following the 2nd shot of the mRNA Pfizer/ BioNTech (BNT162b2), vesicular eruptions on the upper and lower members. The outcome was favorable within 2 weeks under local corticosteroid. The patient reported that he had the same skin lesions in ankles and soles few days following the 1st shot of the same vaccine. Histological findings revealed an erythema polymorph. Case 3: A 57 year old woman with a medical history of hypertension and anxiety disorder presented with a worsening rash and fever for 6 days. The patient reported that she experienced fever, polyarthralgia and that she had received the second shot of Oxford/AstraZeneca (chAdOx1-S), the day before these symptoms appeared. On the physical examination, she had targetoid skin lesions over the trunk, on the ear, upper and lower members. Otherwise she had oral and genital mucosal ulcerations. A thoracic CT scan was performed because of the persistent fever and showed multiple enlarged lymph nodes, a layer of pericardial and plural effusion. A favorable outcome was observed in 3 weeks. Conclusion: Erythema multiform remains an exceptional COVID 19 vaccine adverse effect. Health care workers must be aware of this potential adverse effect or its recurrence and advise patients accordingly. Benefits of receiving a COVID 19 vaccine remains more important.
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Background: Corona virus-19 disease (COVID-19) marked the beginning of a new pandemic COVID-19 after massive numbers of acute pneumonia with unknown origin. Some COVID-19 confirmed patients experienced some skin lesions that might be a clinical sign of COVID-19. Objective: This study aimed to determine the diversity of skin lesions caused by COVID-19 in Elbagour Hospital admitted COVID-19 positive cases. Methods: A prospective cohort study included patients from both sex who were COVID-19 confirmed and experienced skin lesions. 1020 patients having COVID-19 were examined. Out of them, 600 cases showed skin lesions. They were evaluated in El-Bagour General Hospital during the isolation period from March 2020 to March 2021. Dermatological examinations were done to assess skin lesions. The ABCD score was used to determine the severity of COVID-19 patients. Results: We reported eight types of skin lesions in the form of pityriasis rosea like lesions (387;63%), vesicular like exanthema (320;53.3%), erythema multiform (298;49.7%), petechiae (232;38.7%), urticarial lesions (231;38.5%), maculo-papules (220;36.7%), livedo reticularis (84;14%) and pseudo-chilblain (74;12.3%). Presence of skin lesions were significantly associated with moderate and severe cases (p < 0.05). Livedo reticularis was significantly linked to a high mortality rate (p < 0.001). Conclusion: Presence of skin lesions, as well as their number, onset and type were associated with COVID-19 prognosis. Presence of early (within the first 4 days) and more than 2 skin lesion types denoted disease severity. Moreover, livedo reticularis and maculo-papules warn against more disease severity, while presence of pseudo-chilblain points to moderate disease. © 2022, Ain Shams University Faculty of Medicine. All rights reserved.
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COVID-19 is an infection caused by the SARS-CoV2 virus, which has debuted with mild disease or severe acute respiratory syndrome that has caused hospitalizations in the Intensive Care Unit (ICU). This article aims to describe skin lesions in patients in the ICU caused by prolonged hospitalization through updated information for better management and approach to future sequelae. The research approach is qualitative, the scope is descriptive, and the external purpose will be of the applied type, the method used is the analysis of documents such as scientific articles, books, and updated theses. The results were favorable since the cutaneous lesions were described according to the anatomical location, analyzing that these lesions predominate in the face, trunk and extremities, characterized by changes in coloration up to more worrisome compli-cations such as gangrene and vasculopathy. © 2022, University of Cienfuegos, Carlos Rafael Rodriguez. All rights reserved.
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The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enforced the use of hand sanitation and of personal protective equipment, such as masks and visors, especially by health-care professionals, but also by the general public. However, frequent hand sanitation and the prolonged and continuous use of personal protective equipment are responsible for constant frictional and pressure forces on skin causing lesions, the most reported being acne, facial itching, dryness, and rash. Thus, it is important to find measures to prevent skin lesions, in order to improve the quality of life of health-care professionals and of the general public. This article gathers the current information regarding measures to prevent human to human transmission of COVID-19, reviews the most common skin lesions caused by the use of hand sanitizers and different types of personal protective equipment, and the possible preventive measures that can be used on a daily basis to minimize the risk of developing skin-related pathologies. Daily skin care routines and the incorporation of a dressing between the skin and the personal protective equipment to serve as a protective barrier are some of the applied measures. Moisturizers and dressings improve the skin's ability to respond to constant aggressions. Lastly, the need for additional studies to evaluate the lubrication properties of different types of dressings is discussed. The understanding of what kind of dressing is more suitable to prevent pressure injuries is crucial to promote healthy skin and wellbeing during pandemic times.
Subject(s)
COVID-19 , Skin Diseases , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Personal Protective Equipment/adverse effects , Quality of Life , SARS-CoV-2 , Sanitation , Skin Diseases/etiologyABSTRACT
Reduced CD73 was found to protect HIV-infected people against multiple sclerosis, and the researchers want to identify ways to manipulate the CD73 gene to turn it on in patients with HIV and off in those with multiple sclerosis. mAb neutralises hantaviruses The first human antibody to effectively neutralise two types of hantaviruses in animal models has been discovered. RSV vaccine in pregnancy reduces prescribing in infants A blinded, multicountry trial found that infants of mothers assigned a respiratory syncytial virus (RSV) fusion vaccine during pregnancy had fewer antimicrobial prescription courses over the first 90 days of life than infants of mothers assigned placebo. Unlike the unvaccinated control group, vaccinated mice remained clear of skin lesions, the number of parasites at the infection site was held at bay, and protection was sustained over 10 weeks.
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AIM: To explore the mediating role of fear and resilience on the relationship between clinical nurses' reporting of skin lesions and their anxiety and depression during the coronavirus disease 2019 (COVID-19) pandemic. BACKGROUND: Prolonged personal protective equipment wearing may cause severe skin lesions among clinical nurses. The possible relationship between clinical nurses' reporting of skin lesions and their anxiety and depression remains unknown. Moreover, little is known about what factors could mediate such a relationship. METHODS: This is a cross-sectional online survey. CHERRIES was used to report results. RESULTS: Of 2014 participants, 94.8% (n = 1910) reported skin lesions. Skin lesions were positively related to anxiety (p < .001, ß = .228, SE = .099) and depression (p < .001, ß = .187, SE = .093). Fear activated while resilience buffered the relationship between clinical nurses' reporting of skin lesions and anxiety and between skin lesions and depression. CONCLUSION: Reduced fear and enhanced resilience level were related to decreased levels of anxiety and depression among clinical nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should evaluate the occurrence and severity of clinical nurses' skin lesions, arrange reasonable working duration to relieve skin lesions, provide appropriate psychological support to reduce clinical nurses' fear and implement various strategies to enhance their resilience, thereby decreasing their anxiety and depression. CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR2000030290.
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COVID-19 , Nurses , Anxiety/psychology , COVID-19/epidemiology , Cross-Sectional Studies , Depression/complications , Depression/epidemiology , Fear , Humans , PandemicsABSTRACT
The emergence of the novel SARS-CoV-2 coronavirus and rapid spread of the COVID-19 disease it causes in late 2019 and early 2020 has since led to a global pandemic announced by the World Health Organization (WHO). The pandemic is a steadily growing social, economic, psychological, and health burden. The infection rates worldwide are climbing. COVID-19 is considered a systemic disease, potentially resulting in acute respiratory distress and cardiovascular failure leading to death. Yet, SARS-CoV-2, a novel and still under-studied virus, has been documented to cause a large variety of symptoms, in many cases including cutaneous manifestations. This paper is a review of medical literature available to date regarding the cutaneous manifestations in the course of SARS-CoV-2 infection. It is also aimed at discussing the significance of dermatological findings for improved diagnosis and treatment of COVID-19 patients. Considering the gravity of the novel coronavirus pandemic, an improved dermatological approach would aid timely diagnosis and effective management of COVID-19, and would facilitate classification of the cutaneous abnormalities observed.
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COVID-19 manifests itself in patients with damage to many organs and systems of the body, primarily the respiratory and cardiovascular sys-tems. At the same time, there are reports of various manifestations of skin lesions in COVID-19. We present a clinical case of skin lesions in a patient with a severe coronavirus infection. Patient G., 56 years old, was admitted to the «COVID» hospital 10 days after disease on-set. The examination revealed severe respiratory failure with a decrease in blood oxygen saturation to 80% and a specific lesion of the lungs (80%) according to computed tomography. The patient received high doses of oxygen intra-nasally, but later due to low oxygen saturation she was transferred to the intensive care unit where she underwent non-invasive ventilation. The skin lesion developed 1 month after admis-sion to the hospital and manifested itself as small grouped papular rashes on an erythematous background localized on the left thigh and pop-liteal fossa. The appearance of exanthema coincided with the 3rd episode of an increase in the level of C-reactive protein in the blood. When the patient was discharged from the hospital (on the 40th day of hospitalization) with positive dynamics of the general condition a significant decrease in skin rashes was observed. © 2021, Media Sphera Publishing Group. All rights reserved.
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Objective: Increased anxiety among individuals following the declaration of the coronavirus disease (COVID-19) pandemic, changes in social life, and dermatological eruptions caused or triggered by the COVID-19 infection have altered the incidence of dermatological diseases. To determine the impact of the pandemic, this study evaluated changes in the frequency, profile, and diagnostic spectrum of dermatology patients during the pandemic compared to the previous year. Materials and Methods: This study compared a 6-month period from March 2020, when the first COVID-19 case was reported in Turkey, to September 2020, with the same period in 2019. Age, sex, diagnosis groups, and diagnoses were recorded and compared with the previous year.
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The novel coronavirus (SARS-CoV-2), the cause of coronavirus 2019 disease (COVID-19) pandemic, is associated with some cutaneous manifestations. This novel disease is associated mostly with significant morbidity and mortality. While the cutaneous presentations of COVID-19 are infrequent, it is of great importance for all clinicians to be aware of these manifestations, as it may contribute to sooner and better diagnosis and management of the disease, even in asymptomatic or paucisymptomatic patients. Although known to primarily cause interstitial pneumonia and respiratory failure, there are several important dermatologic components in adults that clinicians must be aware of. The reported cutaneous manifestations of COVID-19 are various, dispersed, and sometimes confusing. The aim of this review was to collate and categorize the dermatologic findings reported in adult patients with COVID-19 and identify specific lesions that may facilitate diagnosis and prognostication.
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The role of children in the distribution of COVID-19 and the variety of clinical manifestations among the pediatric population are not yet fully understood. Recently, there are increasing data of coronavirus infection in children with a new syndrome with high fever and a clinical picture of multisystem damage, defined as Multisystem Inflammatory Syndrome in Children (MIS-C). We present a 12-year-old boy with PCR-proven SARS-CoV-2 infection and severe multisystem inflammatory syndrome manifested with fever, rash, polyserositis and acute abdomen. The diagnostic process, the clinical course and the positive outcome of the applied therapeutic plan are described in details. MIS-C is a severe complication of COVID-19 in children, which sets a diagnostic and therapeutic challenge to pediatricians and GPs. The description of all cases observed in Bulgarian children during the first year of the pandemic would contribute to MIS-C's timely recognition in daily clinical practice.
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We are in the midst of a pandemic caused by novel virus SARS-Cov-2 with no sign of abating. The clinical features have been ranging from asymptomatic to severe respiratory distress leading to death. Fortunately, children have been less affected in terms of both morbidity and mortality. Although the signs and symptoms are similar to adults, a smaller number of children tend to be symptomatic. Some children however have been reported with unusual skin lesions or vasculitis like syndrome and also recently an overlap of Kawasaki and toxic shock like syndrome named as Pediatric inflammatory multisystem syndrome, temporally associated with SARS-CoV-2. The common presentations in children and their difference from adults are discussed.
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BACKGROUND: The spectrum of clinical manifestations and differential diagnosis associated with coronavirus disease 2019 is broad, ranging from fever and cutaneous eruptions to respiratory distress or even neurological disorders. Coexisting multipathogen infections significantly increase the complexity of the proper diagnostic and therapeutic approach and correlate with the rate of intensive care unit admissions and in-hospital mortality. CASE PRESENTATION: We present a case of multipathogen respiratory infection with severe acute respiratory syndrome coronavirus 2, varicella zoster virus, and polymicrobial tracheobronchitis in a 48-year-old Caucasian male hospitalized after traumatic brain injury. The patient tested positive for severe acute respiratory syndrome coronavirus 2 infection upon admission. During his stay in the intensive care unit, the patient developed a vesicular exanthema along with respiratory failure and signs of septic shock. CONCLUSION: This case of an adult presenting with severe acute respiratory syndrome coronavirus 2 infection and simultaneous primary varicella zoster virus infection illustrates the importance of considering coinfections in patients with coronavirus disease 2019 with unusual clinical manifestations.
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COVID-19 , Coinfection , Herpes Zoster , Adult , Herpesvirus 3, Human , Humans , Male , Middle Aged , SARS-CoV-2 , Ventilators, MechanicalABSTRACT
Relevance. The Coronavirus pandemic, which has changed the lives of people and the medical community around the world, was announced by WHO in March 2020. The reason was the rapidly spreading new coronavirus infection SARS - CoV-2. It is important to know that in the future outbreaks of infections, crown-like or any other infections are not excluded and medical workers should be prepared to work in special conditions. The pandemic has not revealed a more severe course of the disease in pregnant women compared to the general population of adults, but medical workers need to be prepared for any development of the situation in case of changes in the epidemiological situation in the regions, the country and the world. The purpose of the study: analysis of the management of pregnancy and childbirth in patients infected with the COVID-19 virus in the mode of the infectious hospital of the Multidisciplinary City Hospital No. 3. Materials and methods research: A retrospective study was conducted based on the analysis of statistical data of 1541 medical records histories for the period from May to August 2021 in dynamics in the obstetric unit of the Multidisciplinary City Hospital No. 3 in Nur-Sultan. The inclusion criteria are pregnant patients with confirmed analysis of SARS - CoV-2 coronavirus infection. Clinical manifestations of COVID-19 coronavirus infection, laboratory, X-ray and CT data, timing and methods of delivery, severity and complications caused by this disease were taken for analysis in medical records. Quantitative data and percentage ratio are presented. Research results: 1501 (97.4%) hospitalized pregnant women had an average degree of CVI and a severe degree - 40 (2.6%). The following symptoms were most often noted: fever, cough, shortness of breath, diarrhea, sore throat, myalgia, chills. Less common: rash, headache, malaise and loss of appetite. Radiographs and CT data showed both typical bilateral signs of lung damage in 357 (30%) and unilateral signs in 618 (51.9%). Changes in laboratory parameters in these women included: an increase in the level of D-dimer, an increase in C-reactive protein, lymphocytopenia, a moderate increase in liver enzymes (aspartate aminotransferase, alanine aminotransferase), thrombocytopenia. Maternal mortality was not recorded during the study period. Conclusions: The management and treatment of pregnant women with coronavirus infection in MGB No. 3 in an infectious mode according to clinical protocols approved by the Joint Commission on the Quality of Medical Services of the Ministry of Health of the Republic of Kazakhstan allowed to improve pregnancy outcomes and prevent cases of maternal mortality. Further studies of the course of pregnancy and its outcomes in pregnant women with coronavirus infection are needed.