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1.
Ann Rheum Dis ; 81(5): 601-613, 2022 May.
Article in English | MEDLINE | ID: covidwho-1784782

ABSTRACT

OBJECTIVE: Autoinflammatory type I interferonopathies, chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature/proteasome-associated autoinflammatory syndrome (CANDLE/PRAAS), stimulator of interferon genes (STING)-associated vasculopathy with onset in infancy (SAVI) and Aicardi-Goutières syndrome (AGS) are rare and clinically complex immunodysregulatory diseases. With emerging knowledge of genetic causes and targeted treatments, a Task Force was charged with the development of 'points to consider' to improve diagnosis, treatment and long-term monitoring of patients with these rare diseases. METHODS: Members of a Task Force consisting of rheumatologists, neurologists, an immunologist, geneticists, patient advocates and an allied healthcare professional formulated research questions for a systematic literature review. Then, based on literature, Delphi questionnaires and consensus methodology, 'points to consider' to guide patient management were developed. RESULTS: The Task Force devised consensus and evidence-based guidance of 4 overarching principles and 17 points to consider regarding the diagnosis, treatment and long-term monitoring of patients with the autoinflammatory interferonopathies, CANDLE/PRAAS, SAVI and AGS. CONCLUSION: These points to consider represent state-of-the-art knowledge to guide diagnostic evaluation, treatment and management of patients with CANDLE/PRAAS, SAVI and AGS and aim to standardise and improve care, quality of life and disease outcomes.


Subject(s)
Autoimmune Diseases of the Nervous System , Nervous System Malformations , Rheumatology , Skin Diseases , Erythema Nodosum , Fingers/abnormalities , Humans , Quality of Life
3.
J Eur Acad Dermatol Venereol ; 36(3): e161-e162, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1470446
4.
J Formos Med Assoc ; 121(3): 723-724, 2022 03.
Article in English | MEDLINE | ID: covidwho-1458639
6.
J Dermatol ; 48(10): 1588-1592, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1319212

ABSTRACT

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.


Subject(s)
COVID-19 , Erythema Nodosum , Exanthema , Asia , Erythema Nodosum/diagnosis , Erythema Nodosum/drug therapy , Humans , SARS-CoV-2
7.
Int J Infect Dis ; 103: 549-551, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-974113

ABSTRACT

Type 2 leprosy reaction (T2LR), or Erythema Nodosum Leprosum (ENL), often poses a therapeutic challenge to clinicians and commonly requires long courses of steroids for control. While immunosuppressants are known to achieve control and lower steroid dependence in T2LR, the prospect of managing a severe T2LR in conjunction with COVID-19, with the concern of worsening COVID-19 with long-term immunosuppression has not previously been encountered. We report a case of severe T2LR treated with oral steroids and methotrexate, with COVID-19 infection acquired during hospital stay, and a favourable outcome achieved despite the continued use of immunosuppressants. We discuss the possible reasons for this both in terms of the drug pharmacodynamics and the immunological profile of T2LR.


Subject(s)
Adrenal Cortex Hormones/administration & dosage , COVID-19/drug therapy , Erythema Nodosum/drug therapy , Immunosuppressive Agents/therapeutic use , Leprosy, Lepromatous/drug therapy , Methotrexate/administration & dosage , SARS-CoV-2 , Adult , COVID-19/immunology , Erythema Nodosum/immunology , Humans , Leprosy, Lepromatous/immunology , Male
9.
Semin Respir Crit Care Med ; 41(5): 689-699, 2020 10.
Article in English | MEDLINE | ID: covidwho-766212

ABSTRACT

Sarcoidosis is a chronic, multisystem, inflammatory disorder of unknown etiology that is characterized by noncaseating granulomas that impair normal organ functioning. Sarcoidosis predominantly affects the lungs, but the skin is often cited as the second most frequently involved organ. Cutaneous manifestations of sarcoidosis are highly variable and ongoing research seeks to better understand the relationship between clinical morphology and disease prognosis. Skin findings in patients with sarcoidosis can be "specific," in which sarcoidal granulomas infiltrate the skin, or they can represent a "nonspecific" reactive inflammatory process, as is seen in calcinosis cutis and erythema nodosum. Cutaneous sarcoidosis can be the initial presenting sign or develop later in the course of the disease. In some patients, the skin will be the most involved and impactful organ system and will drive therapy. In other cases, the skin will be an incidental or minor finding, but may be easily accessible for biopsy to confirm the diagnosis. There are many potential therapies for sarcoidosis, though no one therapy is universally effective.


Subject(s)
Sarcoidosis/pathology , Skin Diseases/pathology , Chronic Disease , Erythema Nodosum/pathology , Granuloma/pathology , Humans , Lymphatic Diseases/pathology , Prognosis , Sarcoidosis/immunology , Skin Diseases/immunology
10.
Am J Emerg Med ; 40: 227.e1-227.e2, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-689078

ABSTRACT

Coronavirus 2019 (COVID-19) is a viral disease first described in Wuhan, China, which has quickly emerged as a global pandemic with a myriad of manifestations including dermatologic (Li My et al., n.d.; Gottlieb and Long, 2020 [1,2]). A variety of cutaneous symptoms have presented throughout various stages of the disease (Marzano, 2020; Recalcati, n.d.; Henry et al., n.d.; Fernandez-Nieto et al., n.d.; Quintana-Castanedo et al., n.d. [3-5,7,8]). We describe a case of a female patient who presented with an Erythema Nodosum-like exanthema likely secondary to COVID-19. The patient described tested positive for COVID-19 three days prior to presentation for the rash with minimal other symptoms of COVID-19. Given the high infectivity rate as well as multisystem presentation, it is important to continue to report on novel presentations of the virus for early identification and treatment of complications.


Subject(s)
COVID-19/complications , Erythema Nodosum/etiology , Exanthema/etiology , Female , Humans , Middle Aged
11.
BMJ Case Rep ; 13(7)2020 Jul 08.
Article in English | MEDLINE | ID: covidwho-639125

ABSTRACT

Erythema nodosum (EN) is a common dermatological manifestation with many different aetiologies. Often however, the aetiology remains unidentified. We present here a 42-year-old male patient with an EN that is due to an acute COVID-19 infection. Most of the usual aetiologies were excluded by laboratory testing and imaging studies. This case is, to our knowledge, the first report of this cutaneous manifestation in the context of a COVID-19 infection. The EN was successfully treated with the disappearance of the COVID-19 infection and topical corticosteroids.


Subject(s)
Analgesics/administration & dosage , Coronavirus Infections , Erythema Nodosum , Glucocorticoids/administration & dosage , Pandemics , Pneumonia, Viral , Tomography, X-Ray Computed/methods , Adult , Betacoronavirus/isolation & purification , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques/methods , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/physiopathology , Diagnosis, Differential , Erythema Nodosum/diagnosis , Erythema Nodosum/etiology , Erythema Nodosum/therapy , Humans , Male , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/physiopathology , Radiography, Thoracic/methods , SARS-CoV-2 , Skin Cream/administration & dosage , Treatment Outcome
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