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1.
J Cosmet Dermatol ; 21(5): 1788-1795, 2022 May.
Article in English | MEDLINE | ID: covidwho-1861427

ABSTRACT

BACKGROUND: The new severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is the causative agent of coronavirus 2019 (COVID-2019) disease. A wide variety of symptoms of the disease has been frequently reported in the literature in recent years. However, information on the findings in keratinized tissues is still limited. Data on changes in keratinized tissues such as nails, teeth and hair, and oral mucousa due to drugs used in the treatment of this disease are also extremely insufficient. AIM: With this study, it was aimed to evaluate the changes in the keratinized tissues of our patients with COVID-19, who are frequently encountered in the Ear Nose and Throat outpatient clinic. MATERIALS AND METHOD: The study was carried out on patients who applied to Baskent University Ear Nose and Throat clinic. There were 3 groups. The first group consisted of patients diagnosed with COVID-19 and received relevant medical treatments, the second group included individuals who have never experienced COVID-19 infection but have been vaccinated against COVID-19, and the third group is the control group with normal healthy individuals who have never been diagnosed with COVID-19 infection and have not been vaccinated so far. With the Wood's lamp, fluorescent changes in nails, hair, tooth, and the oral mucousa were recorded. RESULTS: A total of 124(75 females, 49 males) patients were included in the study. Positive Wood's finding was significantly higher in COVID-19 group(Group 1) who received Favipravir when compared with individuals who did not receive Favipravir (p < 0.001). Wood's positivity was not detected in any of the individuals who did not use favipravir. The rate of determining Wood's positivity in favipravir users decreases after 58 days. DISCUSSION: Accordingly, Favipravir accumulation in the kretainized tissues manifest positive Wood's sign in our study. CONCLUSION: The adverse effects of the accumulation of the drugs-mainly Favipravir-used in the treatment of COVID-19 disease, have not yet been clearly demonstrated so far. Revealing the findings in these tissues with this study will pave the way for investigating changes or drug sequestrations in other organs in the long term.


Subject(s)
COVID-19 , Female , Fluorescence , Hair , Humans , Male , Nails , SARS-CoV-2 , Ultraviolet Rays
2.
Bol. micol. (Valparaiso En linea) ; 36(2): 5-11, dic. 2021. ilus
Article in Spanish | WHO COVID, LILACS (Americas) | ID: covidwho-1841786

ABSTRACT

El síndrome de la uña verde o cloroniquia corresponde a la infección por Pseudomonas aeruginosa de una lámina ungueal dañada en pacientes con algún factor de riesgo identificable, siendo los más frecuentes la inmunosupresión, el ambiente húmedo constante y la patología ungueal preexistente. Su diagnóstico es relativamente sencillo si se logra observar la tríada característica de coloración verdosa de la lámina ungueal, paroniquia proximal crónica y onicolisis distal; en casos de duda diagnóstica se puede enviar una muestra de la uña afectada para cultivos o estudio histopatológico. El pilar de su tratamiento corresponde al uso de antibióticos tópicos o sistémicos en conjunto con medidas generales que protejan de la humedad. Es muy importante enfatizar la prevención de esta patología en el personal de salud, especialmente en el contexto del lavado de manos frecuente y riguroso implementado durante la pandemia COVID-19, ya que existen reportes de transmisión nosocomial de P. aeruginosa por profesionales de la salud con infección ungueal.(AU)


Green nail syndrome or chloronychia is the infection of a damaged nail plate by Pseudomonas aeruginosa in a patient with an identifiable risk factor; the most frequently described are immunosuppression, a persistent moist environment and preexisting nail disease. Its diagnosis is relatively simple if the characteristic triad of green discoloration of the nail plate, chronic proximal paronychia and distal onycholysis can be observed, in cases of doubt a sample of the affected nail can be sent for cultures or histopathology. The cornerstone of treatment is the use of topical or systemic antibiotics along with measures to protect the nail from moisture. Prevention of this disease must be emphasized in health care personnel, especially in the context of frequent and rigorous handwashing practices implemented during the COVID-19 pandemic, since there are reports of nosocomial transmission of P. aeruginosaby health care professionals with nail infection.(AU)


Subject(s)
Pseudomonas aeruginosa/pathogenicity , Pseudomonas Infections , Nails/microbiology , Pseudomonas Infections/diagnosis , Pseudomonas Infections/drug therapy , Syndrome , Health Personnel , Onychomycosis , Onycholysis , COVID-19
3.
J Drugs Dermatol ; 21(5): 521-522, 2022 May 01.
Article in English | MEDLINE | ID: covidwho-1836609

ABSTRACT

With the onset of the SARS-CoV-2 pandemic, a number of nail unit changes have been associated with SARS-CoV-2 infection. We report a new unique nail finding within one month of infection and RT-PCR test positivity characterized by an abrupt proximal superficial nail plate change characteristic of shoreline nails. The possibility that this nail change may represent a Koebner phenomenon in patients prone to lichen planus is raised. J Drugs Dermatol. 2022;21(5):521-522. doi:10.36849/JDD.2105.


Subject(s)
COVID-19 , Lichen Planus , Nail Diseases , COVID-19/diagnosis , Humans , Lichen Planus/diagnosis , Nail Diseases/diagnosis , Nails , SARS-CoV-2
4.
Microvasc Res ; 142: 104361, 2022 07.
Article in English | MEDLINE | ID: covidwho-1829271

ABSTRACT

OBJECTIVE: COVID-19 is a multisystem disease that causes endothelial dysfunction and organ damage. Aim of the study was to evaluate the microvascular status in COVID-19 survivors with past different disease severity, in comparison with age and sex-matched primary Raynaud's phenomenon (PRP) patients and control subjects (CNT), including possible effects of concomitant therapies. METHODS: Sixty-one COVID-19 survivors (mean age 58 ± 13 years, mean days from disease onset 126 ± 53 and mean days from recovery 104 ± 53), thirty-one PRP patients (mean age 59 ± 15 years, mean disease duration 11 ± 10 years) and thirty CNT (mean age 58 ± 13 years) underwent nailfold videocapillaroscopy (NVC) examination. The following capillaroscopic parameters were searched and scored (0-3): dilated capillaries, giant capillaries, isolated microhemorrhages, capillary ramifications (angiogenesis) and capillary number, including absolute capillary number per linear millimeter at the nailfold bed. RESULTS: The mean nailfold capillary number per linear millimeter was significantly lower in COVID-19 survivors when compared with PRP patients and CNT (univariate and multivariate analysis p < 0.001). On the contrary, COVID-19 survivors showed significantly less isolated microhemorrhages than PRP patients and CNT (univariate and multivariate analysis, p = 0.005 and p = 0.012, respectively). No statistically significant difference was observed between COVID-19 survivors and control groups concerning the frequency of dilated capillaries and capillary ramifications. COVID-19 selective therapies showed a promising trend on preserving capillary loss and deserving further investigations. CONCLUSIONS: SARS-CoV-2 seems to mainly induce a significant loss of capillaries in COVID-19 survivors at detailed NVC analysis in comparison to controls. The presence of a significant reduced score for isolated microhaemorrhages in COVID-19 survivors deserves further analysis.


Subject(s)
COVID-19 , Nails , Adult , Aged , COVID-19/diagnosis , Capillaries , Humans , Microscopic Angioscopy , Middle Aged , Nails/blood supply , SARS-CoV-2 , Survivors
5.
J Coll Physicians Surg Pak ; 32(4): 455-460, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1766304

ABSTRACT

OBJECTIVE: To compare patients with COVID-19 in intensive care units (ICUs) to healthy controls using nailfold videocapillaroscopy (NVC), offering standardised findings about micro-circulation. STUDY DESIGN: A descriptive, cross-sectional study. PLACE AND DURATION OF STUDY: Medical Intensive Care Unit, Kayseri City Education and Research Hospital, Kayseri, Turkey between January and May 2021. METHODOLOGY: The NVC parameters-capillary morphology, loop diameter, capillary density, dilated capillaries, giant capillaries, avascular areas, microaneurysms, and micro-hemorrhages of 32 patients with COVID-19 and 29 controls were recorded. RESULTS: The most common capillary morphology in the COVID-19 group (18/32, 56.2%) was serpentine, which also characterised some (6/29, 20.7%) patients in the non-COVID-19 group (p <0.001). The median capillary loop diameter was 77.78 ± 3.63 µm in the COVID-19 group and 71.67 ± 2.19 µm in the non-COVID-19 group (p=0.030). Mean capillary density was 6.41 ± 1.21/1 mm in the COVID-19 group and 8.55 ± 1.12/1 mm in the non-COVID-19 group (p <0.001). The COVID-19 group had significantly more enlarged capillaries (p = 0.001), giant capillaries (p = 0.025), avascular areas (p = 0.028), micro-aneurysms (p <0.001), and micro-hemorrhages (p = 0.011). Mean capillary density was 5.50 ± 0.19/1 mm among deceased patients with COVID-19, but 6.71 ± 0.25/1 mm among survivors (p = 0.011). CONCLUSION: NVC findings differed between patients with COVID-19 and controls, and capillary density was less among deceased patients with COVID-19 than survivors. KEY WORDS: Capillaries, COVID-19, Intensive care unit, Micro-circulation, Nailfold videocapillaroscopy.


Subject(s)
COVID-19 , Microscopic Angioscopy , Cross-Sectional Studies , Humans , Intensive Care Units , Nails
6.
J Cosmet Dermatol ; 21(4): 1339-1346, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1625816

ABSTRACT

Emerging literature evidence shows that the manifestations of the coronavirus disease 2019 (COVID-19), which is the disease caused by SARS-CoV-2, encompass alterations of the pulmonary, cardiovascular, gastrointestinal, and neurological system. Moreover, hematologic and dermatologic manifestations have been documented. The aim of this review is to summarize the dermatologic manifestations of COVID-19 involving the hair and nails in a narrative way. A total of 1136 patients have been reported to have de novo hair loss following COVID-19. Notably, 958 patients experienced telogen effluvium (TE) (female/male ratio = 3,86:1), two female patients experienced anagen effluvium, and 176 people had alopecia areata (female/male ratio of 19:3). Ten patients were reported to have ungual changes following the infection with the novel coronavirus: The individuals affected were 6 women and 4 men. COVID-19 can be associated with hair and ungual manifestations. This review summarizes the evidence regarding the hair and ungual manifestations of COVID-19, which could be harnessed to better understand the clinical implications and pathophysiology of this disease that has been burdening society globally since December 2019.


Subject(s)
Alopecia Areata , COVID-19 , Alopecia/complications , Alopecia Areata/epidemiology , Alopecia Areata/etiology , COVID-19/complications , Female , Hair , Humans , Male , Nails , SARS-CoV-2
9.
J Eur Acad Dermatol Venereol ; 36(2): e130-e132, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1434758
10.
Dermatol Ther ; 34(5): e15100, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1358575

ABSTRACT

The SARS-CoV-2 infection, responsible for COVID-19, has raised the interest for infection-associated muco-cutaneous symptoms. While dermatologic symptoms in general gained an increasing awareness, affection of the nail organ has been mentioned only recently. We provide a narrative review on COVID-19 manifestation on the nail organ and add symptoms induced by personal protective measures and SARS-CoV-2 vaccination. Available treatment options are discussed.


Subject(s)
COVID-19 , COVID-19 Vaccines , Humans , Nails , SARS-CoV-2 , Skin
11.
Biomed Res Int ; 2021: 5595016, 2021.
Article in English | MEDLINE | ID: covidwho-1286757

ABSTRACT

BACKGROUND: COVID-19 is a pandemic disease worldwide. Although cutaneous manifestations may present in affected patients, there have been limited studies on the cutaneous findings and hair and nail abnormalities after discharge. OBJECTIVE: To establish the cutaneous manifestations, hair and scalp disorders, and nail abnormalities in patients who recovered from COVID-19 infections. METHODS: A retrospective chart review and telephone interviews were conducted to determine the cutaneous manifestations, hair and scalp disorders, and nail abnormalities of patients aged over 18 years who were diagnosed with COVID-19 infections at Siriraj Hospital, Bangkok, Thailand, between January and June 2020. RESULTS: Ninety-three patients with prior COVID-19 infections participated in the study. The COVID-19 severity had been mild for most (71%). Cutaneous manifestations were reported in 8 patients (8.6%), with the common skin conditions being maculopapular rash and urticaria. The onsets of the skin conditions were before admission (1%), during admission (4.3%), and after discharge (3.2%). Increased hair shedding was also reported in 22 patients (23.7%), with a female predominance. Three patients were affected during admission, while the others were affected after discharge. The patients with moderate, severe, and critical COVID-19 infections experienced significantly more hair shedding than those with asymptomatic and mild diseases. Only 2 patients with mild COVID-19 disease reported nail abnormalities (chromonychia and brittle nails). CONCLUSIONS: Cutaneous manifestations, hair disorders, and nail abnormalities can occur in patients with COVID-19 after their discharge from hospital. Patients should therefore be followed up in anticipation of dermatological problems.


Subject(s)
COVID-19 , Hair Diseases , Nail Diseases , Pandemics , SARS-CoV-2/metabolism , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/metabolism , Female , Follow-Up Studies , Hair/metabolism , Hair/virology , Hair Diseases/epidemiology , Hair Diseases/metabolism , Hair Diseases/virology , Humans , Male , Middle Aged , Nail Diseases/epidemiology , Nail Diseases/metabolism , Nail Diseases/virology , Nails/metabolism , Nails/virology , Skin/metabolism , Skin/virology
12.
Transfus Apher Sci ; 60(5): 103200, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1284583

ABSTRACT

Psoriasis is a chronic inflammatory skin disease that is characterized by well-demarcated erythematous plaques with a silver scale. Although many new and emerging therapeutic agents are often sufficient to control the disease, there is still a need for alternative treatment options in challenging cases. Extracorporeal photopheresis (ECP) has been applied to many T-cell-mediated diseases to restore immune homeostasis and treat psoriasis effectively. In this paper, we present a psoriasis patient who did not respond to methotrexate, narrowband ultraviolet B, or acitretin. Because of a diagnosis of non-Hodgkin lymphoma, the patient had contraindications for cyclosporine, fumaric acid esters, and biologics but achieved remission with a total of 12 sessions of ECP in two and a half months. Although exacerbation was recorded after polymerase chain reaction (PCR) confirmed coronavirus 2019 (COVID-19) disease infection at the end of the first month, scores from the psoriasis area severity index (PASI) and dermatological life quality index (DLQI) were regressed significantly within two and a half months. ECP seems to provide an effective and rapid response for psoriasis and should be considered for psoriasis patients who fail to respond or have contraindications to existing treatments.


Subject(s)
COVID-19/complications , Lymphoma, Non-Hodgkin/complications , Pandemics , Photopheresis , Psoriasis/drug therapy , SARS-CoV-2 , Acitretin/therapeutic use , Chemical and Drug Induced Liver Injury/etiology , Combined Modality Therapy , Contraindications, Drug , Cyclosporine/adverse effects , Humans , Male , Methotrexate/adverse effects , Methotrexate/therapeutic use , Middle Aged , Nails/pathology , Psoriasis/complications , Psoriasis/pathology , Psoriasis/radiotherapy , Quality of Life , Severity of Illness Index , Ultraviolet Therapy
13.
J Eur Acad Dermatol Venereol ; 35(11): e699-e709, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1269750
14.
Microvasc Res ; 138: 104196, 2021 11.
Article in English | MEDLINE | ID: covidwho-1258467

ABSTRACT

OBJECTIVES: The hyperinflammatory state and the viral invasion may result in endothelial dysfunction in SARS-CoV-2 infection. Although a method foreseeing microvascular dysfunction has not been defined yet, studies conducted in patients diagnosed with COVID-19 have demonstrated the presence of endotheliitis. With this study, we aimed to investigate the microvascular circulation in patients diagnosed with COVID-19 and multisystem inflammatory syndrome in children (MIS-C) by nailfold videocapillaroscopy (NVC). METHODS: Thirty-one patients with SARS-CoV-2 infection, 25 of whom were diagnosed with COVID-19 and 6 with MIS-C and 58 healthy peers were included in the study. NVC was performed in eight fingers with 2 images per finger and 16 images were examined for the morphology of capillaries, presence of pericapillary edema, microhemorrhage, avascular area, and neoangiogenesis. Capillary length, capillary width, apical loop, arterial and venous width, and intercapillary distance were measured from three consecutive capillaries from the ring finger of the non-dominant hand. RESULTS: COVID-19 patients showed significantly more capillary ramification (p < 0.001), capillary meandering (p = 0.04), microhemorrhage (p < 0.001), neoangiogenesis (p < 0.001), capillary tortuosity (p = 0.003). Capillary density (p = 0.002) and capillary length (p = 0.002) were significantly lower in the patient group while intercapillary distance (p = 0.01) was significantly longer compared with healthy volunteers. Morphologically, patients with MIS-C had a higher frequency of capillary ramification and neoangiogenesis compared with COVID-19 patients (p = 0.04). CONCLUSION: Abnormal capillary alterations seen in COVID-19 and MIS-C patients indicate both similar and different aspects of these two spectra of SARS-CoV-2 infection and NVC appears to be a simple and non-invasive method for evaluation of microvascular involvement.


Subject(s)
COVID-19/pathology , Capillaries/pathology , Microscopic Angioscopy , Nails/blood supply , Systemic Inflammatory Response Syndrome/pathology , Adolescent , Age Factors , Biomarkers/blood , C-Reactive Protein/analysis , COVID-19/physiopathology , COVID-19/virology , Capillaries/physiopathology , Case-Control Studies , Child , Child, Preschool , Female , Fibrin Fibrinogen Degradation Products/analysis , Humans , Male , Microcirculation , Predictive Value of Tests , Regional Blood Flow , Systemic Inflammatory Response Syndrome/physiopathology , Systemic Inflammatory Response Syndrome/virology
16.
J Cosmet Dermatol ; 20(8): 2392-2393, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1225676
17.
J Cosmet Dermatol ; 21(3): 1199-1207, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1207451

ABSTRACT

BACKGROUND: We detected yellow-green fluorescence in the face, hair and lunulae of patients using favipiravir. AIM: We evaluated the frequency and intensity of favipiravir-associated fluorescence. PATIENTS/METHODS: The participants comprised patients who had taken at least a single dose of favipiravir and been examined no later than 30 days after the last dose. The gender, age, body mass index (BMI), Fitzpatrick's skin-type, hair color, N-acetylcysteine use, presence and the intensity of fluorescent reflection under Wood's light in the lunulae of the fingernails, hair, and the face were recorded. RESULTS: There were 275 patients, 144 (52.4%) of whom were women. 165 (57.9%) had used treatment for a maximum of 5 days, 99 (34.7%) for 6-10 days, and 21 (7.4%) for more than ten days. Using more than 22 tablets of favipiravir increased the probability of detecting fluorescence in the lunulae by 6.72 (2.61-17.23) times. Using more than 28 tablets increased the risk of fluorescence in hair and the T-zone by 5.92 (2.43-14.71) and 2.88 (1.11-7.47) times, respectively. No relationship was found between the fluorescence intensity in any localization and the total dose. However, we determined a negative correlation between the elapsed time after the last dose and the fluorescence intensity in the lunulae and the T-zone (p=0.036; p=0.031; respectively). It was noted that BMI negatively correlated with the fluorescence intensity in the lunulae (p=0.001). Skin type was related to intensity for all localizations (p<0.001). Fluorescence was found in the lunulae with significantly less frequency in patients using N-acetylcysteine (p=0.040). CONCLUSIONS: We must be aware of favipiravir-induced phototoxicity.


Subject(s)
COVID-19 , Nails , Amides , Antiviral Agents/therapeutic use , Female , Fluorescence , Humans , Pyrazines , SARS-CoV-2
18.
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