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1.
J Pediatr ; 246: 271-273, 2022 07.
Article in English | MEDLINE | ID: covidwho-1859932

ABSTRACT

Reactive, nonsexually related acute genital ulceration, also known as Lipschütz ulcer, is a nonsexually related ulceration involving the vulva, most commonly affecting girls and adolescent women in response to infection. Herein, we describe 3 female patients with acute genital ulceration occurring after severe acute respiratory syndrome coronavirus 2 vaccination or natural infection.


Subject(s)
COVID-19 , Ulcer , Adolescent , COVID-19/prevention & control , Female , Humans , SARS-CoV-2 , Ulcer/etiology , Vaccination , Vulva
2.
Int J Environ Res Public Health ; 19(8)2022 04 12.
Article in English | MEDLINE | ID: covidwho-1809863

ABSTRACT

BACKGROUND: Although patients with venous leg ulcers are involved in ulcer management, little is known about why and how these patients self-treat their ulcers without direct supervision by health professionals. Yet patients' knowledge of ulcer management can be important for achieving ulcer closure and/or preventing recurrence. This study thus investigates the effects of an educational intervention on knowledge of self-care among patients with venous leg ulcers, mainly on wound dressing practice, compression therapy, physical activity and nutrition. METHODS AND PARTICIPANTS: This research was conducted in three outpatient hospitals in central Croatia. An educational brochure was made and distributed to patients; patients were surveyed about caring for venous leg ulcers before the brochure was distributed and after 3 months. RESULTS: In total, 208 patients were involved in the study: 112 in the experimental group and 96 in the control group. The educational intervention increased awareness of compression therapy, knowledge of recurrence prevention, appropriate lifestyle habits, and warning signs related to venous leg ulcers. CONCLUSIONS: Patient education on illness and self-care is necessary to achieve positive effects in self-care knowledge. In this study, patients learned how to change dressings, learned how to improve their lifestyle, and were empowered to deal with their illness.


Subject(s)
Self Care , Varicose Ulcer , Bandages , Humans , Ulcer , Varicose Ulcer/therapy , Wound Healing
3.
Dermatol Online J ; 27(12)2021 Dec 15.
Article in English | MEDLINE | ID: covidwho-1789590

ABSTRACT

Two weeks after her first dose of the SARS-CoV-2 mRNA-1273 (Moderna) vaccine, a 38-year-old woman developed acute-onset pain and ulceration within a tattoo on the distal left leg. Progressive ulceration was noted approximately one week following her second dose of the vaccine. A biopsy revealed sarcoidal granulomas and a dense neutrophilic infiltrate. Ultimately, the final diagnosis of what we have termed a "sarcoidal reaction with a Sweet-like phenomenon" was made; the patient experienced a reduction in pain and re-epithelialization of the ulcers with two weeks of the use of topical clobetasol 0.05% cream twice daily.


Subject(s)
COVID-19 , Sarcoidosis , Skin Diseases , Tattooing , Vaccines , Adult , COVID-19/diagnosis , Female , Humans , Pain , SARS-CoV-2 , Ulcer , Vaccination
4.
Int J STD AIDS ; 33(6): 622-624, 2022 05.
Article in English | MEDLINE | ID: covidwho-1765333

ABSTRACT

COVID-19 is a viral infection which can present with various clinical manifestations. While it primarily affects the respiratory tract, several other manifestations including skin involvements have been reported. Dermatologic manifestations are uncommon, and its prevalence is not well-known. In COVID-19, there have been two reports of acute genital ulceration to date, and both are female. Here, we report a male patient with COVID-19 complicated by acute genital ulceration in the course of the illness.


Subject(s)
COVID-19 , Genital Diseases, Male , COVID-19/complications , Female , Genital Diseases, Male/etiology , Genitalia , Humans , Male , Ulcer/etiology
5.
Br J Nurs ; 31(4): S22-S32, 2022 Feb 24.
Article in English | MEDLINE | ID: covidwho-1716169

ABSTRACT

OBJECTIVE: Many patients with COVID-19 admitted to intensive care undergo prone positioning. These patients are at risk of developing facial pressure ulcers (PUs). This study aimed to identify evidence-based recommendations to prevent or reduce their incidence. METHOD: A multi-case study was undertaken using secondary data published between November 2020 and April 2021 discussing facial PUs in patients with COVID-19. CINAHL and MEDLINE electronic databases were analysed. Sixteen publications met the inclusion criteria. The overall quality of evidence was low. RESULT: Studies reported a high incidence of facial PUs. The evidence suggests key preventive areas are skin assessment, pressure-redistribution surfaces, eye coverings, education, medical devices and prophylactic dressings. Recommendations included skin cleaning and moisturising, eye coverings, replacing endotracheal tube holders and using hydrocolloid or film dressings. CONCLUSION: Considering the severe implications for patients and healthcare systems caused by facial PUs, ICUs should develop strategies to prevent and minimise them.


Subject(s)
COVID-19 , Pressure Ulcer , Humans , Intensive Care Units , Pressure Ulcer/epidemiology , Pressure Ulcer/prevention & control , SARS-CoV-2 , Ulcer
6.
Einstein (Sao Paulo) ; 20: eRC6541, 2022.
Article in English | MEDLINE | ID: covidwho-1687843

ABSTRACT

Acute vulvar ulcer (Lipschütz's ulcer) is a rare lesion with local hyperimmunoreactivity triggered by infection, which is characterized by acute, painful, and necrotic ulcerations. This condition is usually found in non-sexually active adolescents, and it resolves spontaneously. We report a case of a 35-year-old woman who was diagnosed with COVID-19 who did not have severe symptoms, but had high levels of D-dimer for 9 days. The COVID-19 diagnosis was followed by the appearance of an acute, necrotic, extremely painful vulvar ulcer, although symptoms caused by COVID-19 had improved. We emphasize the importance of the differential diagnosis to exclude diseases such as Behçet's syndrome, Sexually Transmitted Infections, as well as the presence of viruses that generally trigger Lipschütz's ulcer, such as Epstein-Barr virus and cytomegalovirus. No treatment is usually necessary, however, in the present report due to the pain experienced by the patient, we successfully used oral prednisone.


Subject(s)
Behcet Syndrome , COVID-19 , Epstein-Barr Virus Infections , Adolescent , Adult , Behcet Syndrome/complications , Behcet Syndrome/diagnosis , Behcet Syndrome/drug therapy , COVID-19 Testing , Female , Genitalia , Herpesvirus 4, Human , Humans , SARS-CoV-2 , Ulcer/drug therapy
7.
J Stomatol Oral Maxillofac Surg ; 123(3): 283-286, 2022 06.
Article in English | MEDLINE | ID: covidwho-1665216

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 has spread globally. Vaccination for coronavirus disease 2019 (COVID-19) is anticipated to reduce morbidity and mortality. However, the safety of vaccines against COVID-19 is a cause for concern and uncertainty, which leads to vaccine hesitancy. There have been some self-reported questionnaire studies regarding adverse effects after COVID-19 vaccination; however, adverse effects on the oral region are rare. In this report, we present one case of ulcers arising on the bilateral palate mucosa following COVID-19 vaccination, which was suspected to be an adverse effect of vaccination.


Subject(s)
COVID-19 Vaccines , COVID-19 , Palate , Ulcer , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Humans , Mucous Membrane/pathology , Palate/pathology , Ulcer/chemically induced , Vaccination/adverse effects
9.
Biomed Chromatogr ; 36(5): e5343, 2022 May.
Article in English | MEDLINE | ID: covidwho-1640672

ABSTRACT

Recently, prednisolone has been used in treating many medical conditions, such as autoimmune diseases and cancer. It is also prescribed to mitigate the respiratory complications caused by COVID-19 infection. It can cause some health complications, such as GIT ulcers, so it should be co-administered with proton-pump inhibitors, such as esomeprazole, to prevent the risk of ulcers. This work aims to develop an ecofriendly and sensitive TLC method for simultaneous determination of esomeprazole and prednisolone in their binary mixtures and spiked human plasma. Separation was performed using a mixture of ethyl acetate, methanol, and ammonia (9.5:0.5:0.1, v/v/v) as an eluting system with UV scanning at 245 nm. Dapoxetine was used as an internal standard to correct the variation during sampling. The resulting Rf values for plasma, esomeprazole, prednisolone, and dapoxetine were 0.03, 0.51, 0.72 and 0.85, respectively. Four greenness assessment tools-national environmental method index, eco-scale assessments, analytical greenness metric approach (AGREE), and green analytical procedure index (GAPI)-were used to evaluate the greenness characteristics of the proposed method to the environment, and the results were acceptable and satisfactory. Validation parameters were checked according to the US FDA guidelines to achieve the international requirements for bioanalytical method validation, and the results were within the accepted ranges.


Subject(s)
COVID-19 , Esomeprazole , Chromatography, Thin Layer/methods , Humans , Prednisolone , Reproducibility of Results , Ulcer
10.
11.
Pediatr Dermatol ; 39(1): 153-154, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1566317

ABSTRACT

Vulvar aphthous ulcer, also known as acute genital ulceration or Lipschutz ulcers, is an uncommon, non-sexually acquired condition characterized by sudden onset ulcerations of the vulva in young girls and women. It is thought to represent an immunologic reaction to an infection or other source of inflammation and is commonly preceded by prodromal symptoms including fever, chills, fatigue, and malaise. During the COVID-19 pandemic, vulvar aphthous ulcer associated with COVID-19 infection has been reported. Here, we report a case of vulvar aphthous ulcer in response to COVID-19 vaccination.


Subject(s)
COVID-19 , Stomatitis, Aphthous , Vulvar Diseases , COVID-19 Vaccines , Female , Humans , Pandemics , SARS-CoV-2 , Stomatitis, Aphthous/etiology , Ulcer , Vaccination/adverse effects , Vulvar Diseases/etiology
12.
Inflamm Bowel Dis ; 27(Supplement_2): S25-S32, 2021 Nov 15.
Article in English | MEDLINE | ID: covidwho-1522203

ABSTRACT

BACKGROUND: Patients with Crohn's disease (CD) undergo frequent endoscopic procedures, with visualization of the gastrointestinal mucosa central to treatment decision-making. Subsequently, a noninvasive alternative to optical colonoscopy (OC) would be welcomed. One such technology is capsule endoscopy, including the PillCam COLON 2 (PCC2), though research validating its use in ileocolonic CD is limited. This study aims to compare PCC2 with ileocolonoscopy (OC) in assessing mucosal CD through use of a standardized scoring system. METHODS: At an Australian tertiary hospital, same-day PCC2 and ileocolonoscopy results of 47 CD patients, with known nonstricturing disease, were prospectively collected and analyzed for correlation and agreement. Deidentified recordings were reported by a single expert gastroenterologist. Mucosal disease was quantified using the Simple Endoscopic Score for Crohn's Disease (SES-CD). The SES-CD results of paired endoscopic modalities were compared in total per bowel segment and per SES-CD variable. RESULTS: Of 47 PCC2 recordings, 68% were complete, fully assessing terminal ileum to rectum, and OC was complete in 89%. Correlation (r) between total SES-CD scores was strongest in the terminal ileum (r = 0.77, P < .001), with the SES-CD variable of "ulcer detection" showing the strongest agreement. The PCC2 (vs OC) identified additional ulcers in the terminal ileum; ascending, transverse, and descending colon; and rectum; scores were 5 (1), 5 (3), 1 (1), 2 (1), and 2 (2), respectively. CONCLUSIONS: The PCC2 shows promise in assessing ileocolonic mucosa, especially in proximal bowel segments, with greater reach of visualization in the small bowel. Given the resource and safety considerations raised by the Coronavirus disease 2019 pandemic, capsule endoscopy has particular significance.This article aims to contribute to the limited body of research surrounding the validity of capsule endoscopy technology in assessing ileocolonic mucosa in Crohn's Disease patients. In doing so, an alternative option for patients enduring frequent endoscopies is given potential.


Subject(s)
Capsule Endoscopy/methods , Colon/diagnostic imaging , Colonoscopy/methods , Crohn Disease/diagnostic imaging , Intestinal Mucosa/diagnostic imaging , Ulcer/diagnostic imaging , Wound Healing , Australia , COVID-19 , Capsule Endoscopes , Colon/drug effects , Humans , Immunosuppressive Agents/therapeutic use , Intestinal Mucosa/drug effects , SARS-CoV-2 , Severity of Illness Index , Treatment Outcome , Ulcer/drug therapy , Wound Healing/drug effects , Wound Healing/physiology
13.
J Pediatr Adolesc Gynecol ; 35(2): 165-166, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1487863

ABSTRACT

BACKGROUND: In this case report, we describe a potential association between the Pfizer-BioNTech COVID-19 vaccine and development of a vulvar aphthous ulcer in a virginal 14-year-old girl. CASE: A 14-year-old patient reported vulvar pain and visible lesion. Exam findings were consistent with vulvar aphthous ulcers. Two days prior to the onset of her symptoms she received her second Pfizer-BioNTech COVID-19 vaccine. The evening of vaccine administration, she experienced several hours duration of fatigue, muscle aching and insomnia but had otherwise been recently healthy and testing for common viral associations of vulvar ulcers was negative. SUMMARY AND CONCLUSION: Vaccination, in general, has been associated with mucosal side-effects and oral ulceration has been reported in subjects who received Pfizer-BioNTech COVID-19 vaccine. It is reasonable to hypothesize that vulvar ulceration may be caused by a similar mechanism and should be considered a rare side effect of this vaccine.


Subject(s)
COVID-19 , Ulcer , Vulvar Diseases , Vulvodynia , Adolescent , COVID-19 Vaccines/adverse effects , Female , Humans , Ulcer/etiology , Vulvar Diseases/etiology
14.
J Pediatr Adolesc Gynecol ; 35(2): 167-170, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1482738

ABSTRACT

BACKGROUND: Vulvar aphthous ulcers are a rare type of genital lesion most common in non-sexually active adolescents. Vulvar aphthous ulcers are typically associated with viral infections. To date, there have been several cases reported in patients infected with COVID-19. Vulvar aphthous ulcers following vaccination have not been previously reported in the literature. CASE: We present the case of a 16-year-old adolescent who developed vulvar aphthous ulceration following Pfizer-BioNTech (BNT162b2) vaccination. SUMMARY AND CONCLUSION: Through an extensive literature search, we found no previous reports of vulvar aphthous ulcer following vaccination. Our case highlights a potential novel side effect of Pfizer-BioNTech COVID-19 vaccination and a new etiology for vulvar aphthous ulcers. This case suggests that vulvar aphthous ulcers might be associated with COVID-19 vaccination through a yet undetermined mechanism that requires further investigation.


Subject(s)
COVID-19 , Ulcer , Vulvar Diseases , Adolescent , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Female , Humans , Vaccination
17.
J Eur Acad Dermatol Venereol ; 35(10): e647-e649, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1345980
18.
Front Immunol ; 12: 676828, 2021.
Article in English | MEDLINE | ID: covidwho-1320577

ABSTRACT

In coronavirus disease 2019 (COVID-19), ulcerative lesions have been episodically reported in various segments of the gastrointestinal (GI) tract, including the oral cavity, oropharynx, esophagus, stomach and bowel. In this report, we describe an autopsy case of a COVID-19 patient who showed two undiagnosed ulcers at the level of the anterior and posterior walls of the hypopharynx. Molecular testing of viruses involved in pharyngeal ulcers demonstrated the presence of severe acute respiratory syndrome - coronavirus type 2 (SARS-CoV-2) RNA, together with herpes simplex virus 1 DNA. Histopathologic analysis demonstrated full-thickness lympho-monocytic infiltration (mainly composed of CD68-positive cells), with hemorrhagic foci and necrosis of both the mucosal layer and deep skeletal muscle fibers. Fibrin and platelet microthrombi were also found. Cytological signs of HSV-1 induced damage were not found. Cells expressing SARS-CoV-2 spike subunit 1 were immunohistochemically identified in the inflammatory infiltrations. Immunohistochemistry for HSV1 showed general negativity for inflammatory infiltration, although in the presence of some positive cells. Thus, histopathological, immunohistochemical and molecular findings supported a direct role by SARS-CoV-2 in producing local ulcerative damage, although a possible contributory role by HSV-1 reactivation cannot be excluded. From a clinical perspective, this autopsy report of two undiagnosed lesions put the question if ulcers along the GI tract could be more common (but frequently neglected) in COVID-19 patients.


Subject(s)
COVID-19/complications , Hypopharynx/pathology , SARS-CoV-2/isolation & purification , Ulcer/pathology , Aged , Antigens, CD/metabolism , Antigens, Differentiation, Myelomonocytic/metabolism , Autopsy , Blood Platelets/metabolism , Blood Platelets/pathology , COVID-19/mortality , COVID-19/pathology , COVID-19/physiopathology , Gastrointestinal Tract/pathology , Herpesvirus 1, Human/genetics , Herpesvirus 1, Human/isolation & purification , Humans , Hypopharynx/virology , Immunohistochemistry , Inflammation/immunology , Inflammation/metabolism , Inflammation/virology , Lymphocytes/metabolism , Monocytes/metabolism , Mucous Membrane/pathology , Muscle, Skeletal/pathology , Necrosis/pathology , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/metabolism , Thrombosis/pathology , Ulcer/virology
19.
J Tissue Viability ; 30(3): 462-464, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1253297

ABSTRACT

Hydroxyurea is a chemotherapeutic agent used for myeloproliferative disorders and sickle cell anemia that is well known to cause painful mucocutaneous ulcers, typically involving the legs or mouth. However, genital ulcerations due to hydroxyurea therapy are a rare, and likely underrecognized, adverse effect with only a few cases reported in the literature to date. Ulcers of the lower legs caused by hydroxyurea are associated with a diagnostic delay, and this is likely exacerbated in cases of genital ulceration due to a lack of awareness. Herein we present two cases of painful genital ulceration in patients on hydroxyurea therapy. In the first Case, an 87 year-old male with polycythemia vera developed an ulcer on the scrotum, which was assessed initially through virtual visits during the COVID-19 pandemic, and was refractory to topical and oral antibiotic treatments. The second case was a 79 year-old male with essential thrombocythemia and a history of persistent leg ulcers who developed erosions of the glans penis. Both patients experienced complete resolution within weeks of discontinuing hydroxyurea therapy. In conclusion, genital ulcers and erosions induced by hydroxyrea may be underrecognized in clinical practice, but if identified, withdrawal of hydroxyurea leads to quick resolution of these lesions and the associated pain.


Subject(s)
Hydroxyurea/adverse effects , Leg Ulcer/chemically induced , Ulcer/chemically induced , Aged, 80 and over , Humans , Hydroxyurea/administration & dosage , Male , Myeloproliferative Disorders/drug therapy , Polycythemia Vera/drug therapy , Scrotum
20.
BMC Oral Health ; 21(1): 273, 2021 05 20.
Article in English | MEDLINE | ID: covidwho-1238718

ABSTRACT

BACKGROUND: The emergence of COVID-19 has devastated many parts of the world. From asymptomatic to symptomatic, the virus causes a wide spectrum of presentations. COVID-19 patients may present with oral manifestations. In Afghanistan, where COVID-19 has severely strained the health care system, much of the population lacks proper oral hygiene. This makes the oral cavity a perfect site for SARS-CoV-2 to manifest clinical signs. CASE PRESENTATION: A 62-year-old male was evaluated in the Dentistry Teaching Clinic of Kabul University of Medical Sciences for a painful erosive lesion on dorsal surface of his tongue. He also complained of fever, cough, and taste alteration. He was referred to Afghan Japan Hospital for COVID-19 testing and tested positive. He was followed on for the treatment of SARS-CoV2. After 2 weeks, the patient tested negative and returned to the dentistry clinic for follow-up. Although there were no other signs of COVID-19, the painful erosive lesion on his tongue persisted. Oral evaluation were performed and the patient was advised to practice good hygiene. After 10 days, we observed an asymptomatic geographic tongue without fever and myalgias and the lesion of dorsal surface of tongue improved from severe condition to moderate. CONCLUSION: In conclusion, patients with suspected or confirmed SARS-CoV-2 should be screened for symptoms and physical findings in the oral mucosa To prevent such an outcome, awareness programs need to be implemented for the diagnosis and management of clinical symptoms among patients.


Subject(s)
COVID-19 , COVID-19 Testing , Humans , Japan , Male , Middle Aged , RNA, Viral , SARS-CoV-2 , Tongue , Ulcer
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