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Dermatol Ther (Heidelb) ; 11(4): 1119-1126, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1230303


Herpes zoster (HZ) is associated with substantial morbidity. It is caused by reactivation of the latent varicella zoster virus (VZV) following decline in cell-mediated immunity, which is commonly age-related, but also occurs in individuals with immunosuppressive diseases and/or treatment. Since coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has been associated with T cell immune dysfunction and there have been reports of HZ in COVID-19 patients, we have performed a review of available literature on whether COVID-19 could trigger HZ. We identified 27 cases of HZ following COVID-19, which most frequently occurred within 1-2 weeks of COVID-19, and the majority of cases had typical presentation. Atypical presentations of HZ were noted especially in patients with lymphopenia. It has been hypothesized that VZV reactivation occurs as a consequence of T cell dysfunction (including lymphopenia and lymphocyte exhaustion) in COVID-19 patients. Based on current evidence, which is limited to case reports and case series, it is not possible to determine whether COVID-19 increases the risk of HZ. Practitioners should be aware of the possible increased risk of HZ during the pandemic period and consider timely therapeutic and preventive measures against it.

Dermatol Ther ; 33(4): e13804, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-679815


We aim to evaluate the change in the diagnostic spectrum in dermatology outpatient applications compared to before COVID-19. All patients were enrolled from the Department of Dermatology between February 12 and May 8, 2020, the duration of 4 weeks before COVID-19 and 8 weeks after were analyzed in three parts consisting of 4 weeks. Data obtained from the database such as age, gender, diagnoses were anonymized. Repeated applications with the same diagnosis in 10 days after the first presentation were ignored. Compared to the pre-outbreak, there was a 3.5-fold decrease in dermatology applications in the first month after COVID-19 and an 8.8-fold in the second month. We found a significant increase in the frequency of diagnoses such as generalized pruritus, pityriasis rosea, alopecia areata, bacterial skin/mucosa diseases, and zona zoster after COVID-19. The frequency declined in diseases such as verruca vulgaris, hyperpigmentation, skin tag, melanocytic nevus, and seborrheic keratosis/solar lentigo. It has been found that the frequencies of most diseases, including acne (⁓25% of patients), did not change. We think that many factors, such as affecting the quality of life, risk perception, increased stress burden may cause a change in the diagnostic distribution of the dermatology applications.

Betacoronavirus , Coronavirus Infections/epidemiology , Dermatology/methods , Pneumonia, Viral/epidemiology , Skin Diseases/diagnosis , Skin/pathology , Adult , COVID-19 , Comorbidity , Diagnosis, Differential , Female , Humans , Male , Pandemics , Quality of Life , Retrospective Studies , SARS-CoV-2 , Skin Diseases/epidemiology , Young Adult