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1.
J Med Case Rep ; 16(1): 208, 2022 May 28.
Article in English | MEDLINE | ID: covidwho-1869099

ABSTRACT

BACKGROUND: Chronic cough, with a duration of coughing of more than 8 weeks in adults, affects 5-10% of the general population. One of the most common causes of chronic cough is cough-variant asthma, which accounts for approximately one-third of cases. This phenotype of asthma is characterized by extreme sensitivity of the neuronal pathways mediating cough to environmental irritants, which results in an urge to cough. This case is an example of cough-variant asthma presenting with allergic shiners due to her severe cough. CASE PRESENTATION: A 38-year-old Iranian woman, who was well before the start of the coronavirus disease 2019 pandemic, presented with a nonproductive hacking cough that had begun after excessive use of antiseptic solutions. The only positive finding on physical examination was a reddish-purple rash on and around the eyelids mimicking a heliotrope rash, which had probably evolved due to the severity of the cough. The results of the pulmonary function test were within normal limits. Methacholine challenge test and chest x-ray were both normal. Chest high-resolution computed tomography revealed hyperinflation and tree-in-bud opacities. All other laboratory tests were normal. Because of the reversibility in her pulmonary function test, despite normal baseline parameters, asthma treatment was initiated, resulting in disappearance of the cough and the eye discoloration, being indicative of the correct diagnosis and proper treatment. CONCLUSION: Patients with cough-variant asthma may often have no other classic symptoms of asthma other than cough.


Subject(s)
Asthma , COVID-19 , Cyprinidae , Exanthema , Animals , Asthma/complications , COVID-19/complications , Chronic Disease , Cough/etiology , Exanthema/complications , Female , Humans , Iran
2.
Indian Pediatr ; 59(5): 393-399, 2022 05 15.
Article in English | MEDLINE | ID: covidwho-1843039

ABSTRACT

CONTEXT: The clinical picture of pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection differs from adults as do the cutaneous manifestations. In this review, we summarize the varied morphological manifestations of SARS-CoV-2 infection in the pediatric population. EVIDENCE ACQUISITION: A comprehensive literature search was conducted (23 September, 2021) across multiple databases (PubMed, EMBASE, MEDLINE and Cochrane) with the relevant keywords. An additional filter of age group between 0-18 years was kept in each of the searches. RESULTS: Chilblains constitute the most common cutaneous manifestation of pediatric coronavirus disease (covid-19). Other commonly reported manifestations include maculopapular rash, urticaria, erythema multiforme, and papulovesicular eruptions. Majority of children with these manifestations are asymptomatic, highlighting the need to clinically suspect and appropriately manage such patients. A subset of pediatric patients develop severe multisystem involvement termed as multi-system inflammatory syndrome in children (MIS-C) that has varied mucocutaneous manifestations. CONCLUSION: A wide variety of dermatological manifestation of SARS-CoV-2 infection is reported, and both the pediatrician and dermatologist need to be aware of the same to suspect and diagnose COVID-19 infection in children.


Subject(s)
COVID-19 , Exanthema , Adolescent , Adult , COVID-19/complications , COVID-19/diagnosis , Child , Child, Preschool , Exanthema/etiology , Humans , Infant , Infant, Newborn , SARS-CoV-2 , Systemic Inflammatory Response Syndrome/diagnosis
3.
Intern Med ; 61(7): 1113-1114, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1834088
6.
Am J Emerg Med ; 54: 324.e5-324.e7, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1748330

ABSTRACT

Mycoplasma pneumoniae-induced rash and mucositis (MIRM) is a recently defined clinical entity characterized by pneumonia caused by M. pneumoniae with associated mucositis and frequent cutaneous lesions of a characteristic pattern. Although often similar in presentation, MIRM has distinct clinical and histologic features that are different from erythema multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis. We report a case of MIRM in a nine-year-old boy.


Subject(s)
Erythema Multiforme , Exanthema , Mucositis , Pneumonia, Mycoplasma , Stevens-Johnson Syndrome , Child , Erythema Multiforme/diagnosis , Exanthema/etiology , Humans , Male , Mucositis/complications , Mycoplasma pneumoniae , Pneumonia, Mycoplasma/complications , Pneumonia, Mycoplasma/diagnosis , Stevens-Johnson Syndrome/etiology
7.
J Investig Med High Impact Case Rep ; 10: 23247096211066283, 2022.
Article in English | MEDLINE | ID: covidwho-1745526

ABSTRACT

The immunization against coronavirus disease (COVID-19) via vaccination serves as a significant milestone in the fight against the pandemic. Rapid introduction of various COVID-19 vaccines to stem the spread of virus has researchers scrambling to document the adverse effects left in its wake. Thus far, there have been singular examples of cutaneous vasculitis associated with COVID-19. A history of vasculitis leaves little error to miss its inclusion in diagnostic differentials. It also invokes the physiologic possibility that afflicted patients possess a more susceptible landscape for recurrence that was then triggered by the vaccine when compared with those who lack similar history. In our case report, we build on those findings with one of the first documented examples of vaccination-induced vasculitic rash in a previously asymptomatic patient.


Subject(s)
COVID-19 , Exanthema , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Exanthema/etiology , Humans , Vaccination
8.
Australas J Dermatol ; 63(2): 228-234, 2022 May.
Article in English | MEDLINE | ID: covidwho-1744140

ABSTRACT

BACKGROUND: Little is known about mucocutaneous involvement in critically ill patients with the multisystem inflammatory syndrome in children (MIS-C). The aim of our study was to describe the localisation and variety of rash and to investigate whether presenting with rash at admission alters the clinical course of MIS-C. METHODS: This prospective, observational cohort study was conducted amongst children under 18 years of age who were admitted to our paediatric intensive care unit (PICU) between May 2020 and May 2021 with a possible diagnosis of MIS-C. RESULTS: A total of 33 children with MIS-C, 21 boys (64%), with a median age of 9.4 years (3.4-11.5) were enrolled. Twenty-four children presented with mucocutaneous symptoms (72%). Age, male gender, PICU length of stay, presenting symptoms, inotrope requirement, the existence of myocarditis or respiratory failure were higher but not significantly different in patients with rash compared to those without rash (P > 0.05). The median duration of symptoms before admission and presence of cervical lymphadenopathy were significantly higher in patients than those without rash (P < 0.05). Children with a rash had a significantly higher neutrophil count, CRP, procalcitonin, troponin levels and lower lymphocyte counts and albumin levels than those without rash (P < 0.05). Twelve children with rash (50%) had symmetrical intertriginous distribution. Two children had erythematous lesions on the areola and the surroundings. In conclusion, intertriginous involvement, periareolar erythema and other mucocutaneous manifestations might be the first alarming symptoms of moderate to severe MIS-C. Therefore, close monitoring with a multidisciplinary approach should be considered for these patients to assess potential disease progression.


Subject(s)
COVID-19 , Exanthema , Adolescent , COVID-19/complications , Child , Disease Progression , Humans , Male , Prospective Studies , Systemic Inflammatory Response Syndrome
9.
J Eur Acad Dermatol Venereol ; 36(7): e520-e522, 2022 07.
Article in English | MEDLINE | ID: covidwho-1741444
12.
Am J Clin Dermatol ; 23(3): 277-286, 2022 May.
Article in English | MEDLINE | ID: covidwho-1729434

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the coronavirus disease 2019 (COVID-19) pandemic, affecting people worldwide. SARS-CoV-2 infection is a multisystem disease with potential for detrimental effects on various systemic organs. It affects people of all ages with varying degrees of disease severity. Patients with SARS-CoV-2 infection commonly present with dry cough, fever, and fatigue. A clinical spectrum of skin findings secondary to SARS-CoV-2 has also been reported. The most common cutaneous patterns associated with COVID-19 are chilblain-like lesions (CBLL), maculopapular lesions, urticarial lesions, vesicular lesions, and livedoid lesions. Other skin findings secondary to SARS-COV-2 infection are erythema multiforme (EM)-like lesions and skin findings associated with multisystem inflammatory syndrome in children (MIS-C) and rarely multisystem inflammatory syndrome in adults (MIS-A). Physician awareness of skin manifestations of SARS-CoV-2 infection can help with early identification and treatment. This narrative review provides an update of various skin manifestations reported with SARS-CoV-2 infection, including clinical presentation, proposed pathogenesis, histopathology, prognosis, and treatment options.


Subject(s)
COVID-19 , Exanthema , Adult , COVID-19/complications , Child , Exanthema/pathology , Humans , SARS-CoV-2 , Systemic Inflammatory Response Syndrome
13.
Cleve Clin J Med ; 89(3): 161-167, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1726177

ABSTRACT

Cutaneous findings can be clues to diagnosis and infection severity in viral illnesses, including COVID-19. The authors provide an update on the diagnostic and prognostic value of the 5 most common cutaneous abnormalities associated with COVID-19 in adult patients: morbilliform rash, urticaria, vesicles, pseudo-chilblains, and vaso-occlusive lesions.


Subject(s)
COVID-19 , Exanthema , Skin Diseases , Adult , COVID-19/diagnosis , Exanthema/etiology , Exanthema/pathology , Humans , SARS-CoV-2 , Skin/pathology , Skin Diseases/diagnosis , Skin Diseases/etiology
16.
Clin Rheumatol ; 41(5): 1577-1582, 2022 May.
Article in English | MEDLINE | ID: covidwho-1709352

ABSTRACT

Coronavirus disease-19 (COVID-19) is a global pandemic that is caused by COVID-19 virus, which was initially identified in December 2019 in Wuhan, China. Vaccination is one of the most effective public health interventions, and soon after the Pfizer/BioNTech (BNT162b2) vaccine became available late in 2020, it began to be actively used to fight against COVID-19. Since then, cases of vaccine-associated immune-mediated diseases (IMDs) have been reported. There have been few cases of IMD flare-ups or onset after COVID-19 vaccine administration, and emerging IMDs may be identified over next few years after high use of this vaccine. To this day, few cases of newly diagnosed systemic lupus erythematosus (SLE) following COVID-19 vaccine exposure were reported. Herein, we present the case of a patient diagnosed with SLE, acute pancreatitis, and vasculitic skin rash on the extremities 1 week after the first dose of the Pfizer-BioNTech COVID-19 vaccine. Key Point • COVID-19 Vaccine induced Systemic Lupus Erythematosus.


Subject(s)
COVID-19 , Exanthema , Lupus Erythematosus, Systemic , Pancreatitis , Acute Disease , COVID-19 Vaccines/adverse effects , Exanthema/etiology , Humans , Lupus Erythematosus, Systemic/complications , Pancreatitis/etiology
17.
Braz J Infect Dis ; 26(2): 102337, 2022.
Article in English | MEDLINE | ID: covidwho-1707607

ABSTRACT

The diagnosis of coronavirus disease (COVID-19) has been a great challenge since the infection affects not only the respiratory system, but also different organs, given the intense inflammatory and autoimmune reaction triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Herein we present a case of a 36-year-old male patient, with some comorbidities and previous use of carbamazepine, who developed a severe condition triggered by COVID-19, including extensive exfoliative erythroderma and severe impairment of liver function, which lasted approximately 80 days.


Subject(s)
COVID-19 , Drug Hypersensitivity Syndrome , Eosinophilia , Exanthema , Adult , Antigen-Antibody Complex , COVID-19/complications , Drug Hypersensitivity Syndrome/diagnosis , Drug Hypersensitivity Syndrome/etiology , Humans , Male , SARS-CoV-2
18.
J Am Acad Dermatol ; 86(3): 530-531, 2022 03.
Article in English | MEDLINE | ID: covidwho-1700944
19.
Am J Dermatopathol ; 44(6): e61-e63, 2022 Jun 01.
Article in English | MEDLINE | ID: covidwho-1691773

ABSTRACT

ABSTRACT: Acantholytic dyskeratosis mimicking Grover disease as a cutaneous manifestation of a side effect to the Moderna (mRNA-1273) COVID vaccine is rare with only one documented case in the literature to date. Herein, we present a case of an eruptive, erythematous, vesiculopapular rash developing in a patient after the Moderna vaccine. Histopathology of a representative biopsy [x2, done 8 weeks apart] of the rash revealed similar histopathologic findings of patchy suprabasal acantholysis with dyskeratotic keratinocytes and an underlying inflammatory infiltrate of lymphocytes and neutrophils. Direct immunofluorescence was negative. In contrast to the only case previously reported in the literature, a confounding feature in our case, was that patient had a medical history significant for Grover disease, which had been successfully treated with complete resolution and seemed to be in remission. Given the temporal relationship of the onset of the rash to vaccine administration, the changes were likely vaccine-related with the caveat that, in light of the medical history, the differential diagnosis includes reactivation of Grover disease by the vaccine as a trigger factor.


Subject(s)
COVID-19 , Carcinoma in Situ , Exanthema , Acantholysis/etiology , Acantholysis/pathology , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Ichthyosis , Vaccination
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