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1.
Dermatol Clin ; 39(4): 505-519, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1252653

ABSTRACT

Children are a unique subset of patients in relation to the COVID-19 pandemic, often presenting asymptomatically, mildly, or atypically. Manifestations of the skin may be a primary (or the only) presenting sign. Recognizing cutaneous manifestations of COVID-19 in the pediatric population is important to guiding precautions, testing, and management for patients and close contacts. Whereas some dermatologic signs in children overlap with those in adults, other skin findings are reported with higher frequency in children and may be clues to multisystemic sequelae. This article describes presentation, pathophysiologic theories, and management strategies for cutaneous manifestations of COVID-19 in children.


Subject(s)
COVID-19/complications , COVID-19/diagnosis , Skin Diseases, Viral/etiology , Systemic Inflammatory Response Syndrome/complications , Systemic Inflammatory Response Syndrome/diagnosis , COVID-19 Testing/statistics & numerical data , Child , Humans , Skin Diseases, Viral/diagnosis
2.
Cutis ; 107(4): 209-215, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1239179

ABSTRACT

Cutaneous manifestations of COVID-19-SARS-CoV-2-are common and varied. Morbilliform, vesicular, and urticarial eruptions may be nonspecific initial features of the disease. Chilblainlike lesions on the fingers or toes typically occur as part of a resolution phase, signifying a milder course, whereas livedoid lesions and retiform purpura are associated with coaguloapthy and more severe disease. Additionally, a severe Kawasaki-like multisystem inflammatory syndrome rarely is seen in children. This diverse range of cutaneous manifestations in COVID-19 reflects a spectrum of host immunologic responses to SARS-CoV-2 and may inform disease pathophysiology.


Subject(s)
COVID-19/complications , Severity of Illness Index , Skin Diseases/diagnosis , Skin Diseases/etiology , COVID-19/epidemiology , COVID-19 Testing , Dermatology , Exanthema/diagnosis , Exanthema/etiology , Female , Humans , Male , Purpura/diagnosis , Purpura/etiology , Skin/pathology , Skin Diseases/virology , Skin Diseases, Viral/diagnosis , Skin Diseases, Viral/etiology , Urticaria/diagnosis , Urticaria/etiology
3.
J Am Acad Dermatol ; 84(5): 1356-1363, 2021 05.
Article in English | MEDLINE | ID: covidwho-1131418

ABSTRACT

BACKGROUND: COVID-19 is associated with a wide range of skin manifestations. OBJECTIVE: To describe the clinical characteristics of COVID-19-associated skin manifestations and explore the relationships among the 6 main cutaneous phenotypes and systemic findings. METHODS: Twenty-one Italian Dermatology Units were asked to collect the demographic, clinical, and histopathologic data of 200 patients with COVID-19-associated skin manifestations. The severity of COVID-19 was classified as asymptomatic, mild, moderate, or severe. RESULTS: A chilblain-like acral pattern was significantly associated with a younger age (P < .0001) and, after adjusting for age, significantly associated with less severe COVID-19 (P = .0009). However, the median duration of chilblain-like lesions was significantly longer than that of the other cutaneous manifestations taken together (P < .0001). Patients with moderate/severe COVID-19 were more represented than those with asymptomatic/mild COVID-19 among the patients with cutaneous manifestations other than chilblain-like lesions, but only the confluent erythematous/maculo-papular/morbilliform phenotype was significantly associated with more severe COVID-19 (P = .015), and this significance disappeared after adjustment for age. LIMITATIONS: Laboratory confirmation of COVID-19 was not possible in all cases. CONCLUSIONS: After adjustment for age, there was no clear-cut spectrum of COVID-19 severity in patients with COVID-19-related skin manifestations, although chilblain-like acral lesions were more frequent in younger patients with asymptomatic/pauci-symptomatic COVID-19.


Subject(s)
COVID-19/diagnosis , Skin Diseases, Viral/diagnosis , Adult , Age of Onset , Aged , Chilblains/virology , Humans , Italy , Male , Middle Aged , SARS-CoV-2 , Severity of Illness Index , Skin Diseases, Viral/pathology
4.
Eur J Dermatol ; 31(1): 55-59, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-1112539

ABSTRACT

BACKGROUND: Since December 2019, the global population has been experiencing an unprecedented challenge due to Corona virus disease (COVID-19). A pandemic was declared by the World Health Organization on March 11th 2020, with an escalation of new cases worldwide. Dermatology units experienced a reorganization of regular activity, also providing clinical diagnosis and medical assistance to COVID-19-positive patients who developed cutaneous manifestations. OBJECTIVE: To evaluate the impact of the COVID-19 pandemic on Italian dermatologic clinical practice. MATERIALS & METHODS: This was a prospective online survey, consisting of a questionnaire with 35 multiple-choice questions uploaded on the website of the Italian Society of Dermatology and Venereology - SIDeMaST. RESULTS: A total of 136 dermatologists, 78 women (57%) and 58 men (43%), participated in the survey. The mean age was 58 ± 14 years. In total, 60% of participants reported an impact of the pandemic on their practice, in most cases consisting of a remarkable reduction in routine clinical activity (58%). Concern regarding possible infection was evaluated with a score ranging from 0 (no concern) to 5 (extremely concerned): the fear of becoming infected was high (≥3 in 40%), as was the fear of infecting families, colleagues or patients (≥3 points in 45%). CONCLUSION: The COVID-19 pandemic is having a strong impact on dermatology practice in Italy. The identification of critical points may help scientific societies to improve the clinical scenario and create specific strategies to overcome the emergency.


Subject(s)
COVID-19/epidemiology , Dermatology/organization & administration , Practice Patterns, Physicians' , COVID-19/transmission , Dermatologists/psychology , Fear , Female , Health Care Surveys , Humans , Infectious Disease Transmission, Patient-to-Professional , Italy/epidemiology , Male , Middle Aged , Pandemics , Prospective Studies , Risk Factors , SARS-CoV-2 , Skin Diseases, Viral/diagnosis , Skin Diseases, Viral/therapy
5.
Cutis ; 106(6): 309-310, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1068030

ABSTRACT

Recently, several cutaneous manifestations of coronavirus disease 2019 (COVID-19) have been reported. However, there is a paucity of published images. Those that have been published so far tend to fall under distinct morphologic categories. We present a 52-year-old patient with an ill-defined skin eruption that preceded mild gastrointestinal (GI) symptoms and without respiratory symptoms who tested positive for COVID-19. With this case report, we widen the spectrum of the cutaneous manifestations of COVID-19 infection. Consequently, we propose an expansion of the criteria for COVID-19 testing when skin findings are associated with relatively mild GI symptoms.


Subject(s)
COVID-19 Testing , COVID-19/diagnosis , Gastrointestinal Diseases/diagnosis , Skin Diseases, Viral/diagnosis , COVID-19/complications , Gastrointestinal Diseases/virology , Humans , Male , Middle Aged , Skin Diseases, Viral/pathology
9.
BMJ Case Rep ; 13(10)2020 Oct 29.
Article in English | MEDLINE | ID: covidwho-894842

ABSTRACT

A 50-year-old man presented to our dermatology clinic with itchy skin rash. The rash began 5 days after systemic symptoms appeared such as mild fever and mild dyspnoea. The rashes were a characteristic of follicular eruption, which started on his stomach and spread all over his body. After a thorough evaluation, he was diagnosed with COVID-19 and was started on COVID-19 regimens. Skin lesions disappeared on the ninth day of treatment. Our findings contribute to the growing awareness of dermatological manifestations in patients with COVID-19.


Subject(s)
Coronavirus Infections/diagnosis , Exanthema/diagnosis , Pneumonia, Viral/diagnosis , Skin Diseases, Viral/diagnosis , Anti-Bacterial Agents/therapeutic use , Antiviral Agents/therapeutic use , COVID-19 , Coronavirus Infections/drug therapy , Diagnosis, Differential , Drug Therapy, Combination , Dyspnea/diagnosis , Dyspnea/etiology , Exanthema/drug therapy , Fever/diagnosis , Fever/etiology , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/drug therapy , Skin Diseases, Viral/drug therapy , Treatment Outcome
14.
Australas J Dermatol ; 62(1): e98-e101, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-751860

ABSTRACT

An increasing number of publications have brought attention to COVID-19-associated cutaneous lesions. Histopathological descriptions and clinical correlation of the histopathological findings of COVID-19 skin lesions are lacking. In this manuscript, we reviewed and described the histopathological characteristics of COVID-19 infection cutaneous patterns reported in the literature.


Subject(s)
COVID-19 Testing , COVID-19/complications , SARS-CoV-2/isolation & purification , Skin Diseases, Viral/pathology , Biopsy , COVID-19/diagnosis , COVID-19/pathology , Humans , Skin Diseases, Viral/diagnosis
15.
Australas J Dermatol ; 62(1): 27-36, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-748609

ABSTRACT

As the world tries to grapple with the COVID-19 pandemic, dermatologists are left in a lurch as there is a lacuna in dermatologic literature as well as training regarding the cutaneous manifestations of varied viral agents capable of causing epidemics/pandemics or the potential to be bio-weaponised. Such outbreaks have the potential to become a pandemic given this age of globalisation. The quote by George Santayana stands true 'Those who cannot remember the past are condemned to repeat it'. Thus, this article lends a perspective to the recent viral outbreaks and is aimed at summarising these agents and their clinical features to serve as a quick reference for dermatologists.


Subject(s)
COVID-19 Testing , COVID-19/complications , SARS-CoV-2/isolation & purification , Skin Diseases, Viral/pathology , Biopsy , COVID-19/diagnosis , COVID-19/pathology , Dermatology/standards , Diagnosis, Differential , Disease Management , Early Diagnosis , Humans , Skin Diseases, Viral/diagnosis
19.
Dermatol Ther ; 33(6): e14181, 2020 11.
Article in English | MEDLINE | ID: covidwho-721122

ABSTRACT

The medical community in the past months has seen a flourishing of information related to the SARS-CoV-2 virus responsible for the COVID-19 pandemic. From the early days of the pandemic, the SARS-CoV-2 virus has been linked to multiple different types of skin involvement. To the best of our knowledge, we are the first to report on a case of familial clustering of a maculopapular COVID-19 rash. Eight persons presented COVID-19 symptoms, six were confirmed via SAR-CoV-2 chemoluminescent immunoassays, and the four related by blood presented skin manifestations. Although, it has not been fully established if the SARS-CoV-2 can in fact cause viral exanthems, our observations regarding the familial clustering and the temporal evolution seen in this family seem to present strong evidence of a viral exanthema related to SARS-CoV-2 infection.


Subject(s)
COVID-19 Testing , COVID-19/complications , Skin Diseases, Viral/diagnosis , Adult , Aged, 80 and over , COVID-19/diagnosis , Family Health , Female , Humans , Infant , Luminescent Measurements , Male , Middle Aged , SARS-CoV-2/isolation & purification , Skin Diseases, Viral/physiopathology
20.
Dermatol Ther ; 33(6): e14170, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-709683

ABSTRACT

A previous study has defined the maculopapular subtype of manifestations of COVID-19. The objective of our study was to describe and classify maculopapular eruptions associated with COVI-19. We carried out a subanalysis of the maculopapular cases found in the previous cross-sectional study. Using a consensus, we defined seven clinical patterns. We described patient demographics, the therapy received by the patient and the characteristics of each pattern. Consensus lead to the description of seven major maculopapular patterns: morbilliform (45.5%), other maculopapular (20.0%), purpuric (14.2%), erythema multiforme-like (9.7%), pytiriasis rosea-like (5.7%), erythema elevatum diutinum-like (2.3%), and perifollicular (2.3%). In most cases, maculopapular eruptions were coincident (61.9%) or subsequent (34.1%) to the onset of other COVID-19 manifestations. The most frequent were cough (76%), dyspnea (72%), fever (88%), and astenia (62%). Hospital admission due to pneumonia was frequent (61%). Drug intake was frequent (78%). Laboratory alterations associated with maculo-papular eruptions were high C-reactive protein, high D-Dimer, lymphopenia, high ferritin, high LDH, and high IL-6. The main limitation of our study was the impossibility to define the cause-effect relationship of each pattern. In conclusion, we provide a description of the cutaneous maculopapular manifestations associated with COVID-19. The cutaneous manifestations of COVID-19 are wide-ranging and can mimic other dermatoses.


Subject(s)
COVID-19/virology , SARS-CoV-2/pathogenicity , Skin Diseases, Viral/virology , Skin/virology , Adolescent , Adult , Aged , Aged, 80 and over , Antiviral Agents/therapeutic use , COVID-19/complications , COVID-19/diagnosis , Cross-Sectional Studies , Female , Host-Pathogen Interactions , Humans , Male , Middle Aged , Risk Factors , SARS-CoV-2/drug effects , Skin/pathology , Skin Diseases, Viral/diagnosis , Spain , Young Adult
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