Chilblains and Covid-19 (Covid Toes)

NewsBot · Apr 11, 2020

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Increasing number of reports of COVID-19 and foot skin lesions:
https://cgcop.es/2020/04/09/registro-de-casos-compatibles-covid-19/

NewsBot · Apr 11, 2020

Related:
Other covid-19 threads

NewsBot · Apr 12, 2020

Case report of foot skin lesion as first clinical sign in a 13 yr old boy with COVID-19
https://www.ejpd.com/images/acroischemia-ENG.pdf

NewsBot · Apr 13, 2020

How an early symptom of coronavirus could show up on your feet

NewsBot · Apr 13, 2020

Skin manifestations are emerging in the coronavirus pandemic

NewsBot · May 4, 2020

Chilblain‐like lesions during COVID‐19 epidemic: a preliminary study on 63 patients
Vincenzo Piccolo Iria Neri Cesare Filippeschi Teresa Oranges Giuseppe Argenziano Vincenzo Claudio Battarra Samantha Berti Francesca Manunza Anna Belloni Fortina … See all authors
24 April 2020

We have recently noticed an outbreak of chilblain‐like lesions in Italy contemporarily to COVID‐19 epidemic. Due to the well known lockdown‐related difficulties to visit the patients1 we created a Google form aimed to collect information about patients presenting with these singular clinical findings. An easy to access and quick tool was chosen by the investigators in order to permit the other colleagues to spend the least amount of time, given the severe health emergency.
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DaVinci · May 4, 2020

The only problem with this, is that in this part of the world we are heading into chilblain season. Need to be careful.

NewsBot · May 5, 2020

A case of COVID‐19 presenting in clinical picture resembling chilblains disease. First report from the Middle East
A. Alramthan W. Aldaraji
17 April 2020

Clinical characteristics of COVID‐19 disease were identified in a cohort study involving 1099 patients from China. COVID‐19 most commonly present with fever, cough, fatigue, and congestion. Two out of 1099 patients were reported to have skin rash, but time of onset and clinical description of rash were missing (Reference B). Another study focused primarily on cutaneous manifestations associated with COVID‐19 evaluated 88 patients from Italy. 18 out of the 88 patients developed cutaneous manifestations, but only 8 patients developed skin lesions at onset of disease.
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NewsBot · May 6, 2020

Document from the Australian College of Dermatologists

NewsBot · May 7, 2020

From the College of Podiatry (UK)
Statement on skin-related symptoms in COVID - 19

NewsBot · May 8, 2020

College of Podiatry plans to develop database on potential skin-related symptoms in COVID - 19

NewsBot · May 9, 2020

Comment on 'Two cases of COVID-19 presenting with a clinical picture resembling chilblains: first report from the Middle East': pernio unrelated to COVID-19.
Torres-Navarro I et al
Clin Exp Dermatol. 2020 May 1

Dear editor, we have read with interest Dr´s Alramthan and Aldaraji contribution to the spectrum of COVID-19 clinical manifestations.1 Since COVID-19 outbreak begin, new symptoms have been described.2 Some of them, were not initially highlighted and could be a distinguishing feature of COVID-19 infection, like anosmia or ageusia.3 Therefore, it is believed that a newly reported one, so-called acute acro-ischemia is another novel clinical manifestation of COVID-19 infection
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NewsBot · May 9, 2020

Covid-19 – The Big Crisis of our Lifetime? Considerations for Podiatry and Foot Health

NewsBot · May 9, 2020

Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations
Awadhesh KumarSingh et al
Diabetes & Metabolic Syndrome: Clinical Research & Reviews ; Volume 14, Issue 4, July–August 2020, Pages 303-310

Highlights
•High prevalence of diabetes is seen in patients with SARS-CoV-2 (COVID-19) and the presence of diabetes is a determinant of severity and mortality.
•Diabetes might facilitate infection by COVID-19 due to increased viral entry into cell and impaired immune response.
•Blood glucose control is important for all patients who have diabetes and COVID-19 infection.
•Telemedicine can be very useful for the management of patients with diabetes in present times with limited access to healthcare facilities.
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Background and aims
High prevalence of diabetes makes it an important comorbidity in patients with COVID-19. We sought to review and analyze the data regarding the association between diabetes and COVID-19, pathophysiology of the disease in diabetes and management of patients with diabetes who develop COVID-19 infection.

Methods
PubMed database and Google Scholar were searched using the key terms ‘COVID-19’, ‘SARS-CoV-2’, ‘diabetes’, ‘antidiabetic therapy’ up to April 2, 2020. Full texts of the retrieved articles were accessed.

Results
There is evidence of increased incidence and severity of COVID-19 in patients with diabetes. COVID-19 could have effect on the pathophysiology of diabetes. Blood glucose control is important not only for patients who are infected with COVID-19, but also for those without the disease. Innovations like telemedicine are useful to treat patients with diabetes in today’s times.
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NewsBot · May 11, 2020

Foot Manifestations in a COVID-19 Positive Patient A Case Study

NewsBot · May 24, 2020

Skin Involvement in SARS‐CoV‐2 Infection: Case Series
F. Diotallevi MD A. Campanati MD T. Bianchelli MD I. Bobyr MD M.M. Luchetti MD B. Marconi MD E. Martina MD G. Radi MD A. Offidani MD
Journal of Medical Virology 15 May 2020

since the beginning of the well‐known SARS CoV‐2 pandemic, skin involvement both in adults and children has been signaled (1,2). However, large‐scale studies describing skin manifestations and their etiopathogenic correlation with COVID‐19 in detail have not been reported yet. Through the analysis of emerging data from literature (3) and the direct observation of three patients with COVID‐19 (SARS‐CoV‐2 detection from nasopharyngeal swab samples through RNA extraction) and dermatological manifestations, we have hypothesized different mechanisms for their development.
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NewsBot · May 24, 2020

Clustered Cases of Acral Perniosis: Clinical Features, Histopathology and Relationship to COVID‐19
Kelly M. Cordoro Sean D. Reynolds Rachel Wattier Timothy H. McCalmont
12 May 2020 https://doi.org/10.1111/pde.14227

Background/Objectives
There has been a recent marked increase in pediatric and adult patients presenting with purpuric acral lesions concerning for ischemia, thrombosis and necrosis in COVID‐19 prevalent regions worldwide. The clinical and histopathological features and relationship to COVID‐19 have not been well described. The objective of this case series is to describe the clinical features and determine the histopathologic findings and clinical implications of the clusters of acral perniosis cases identified in pediatric patients.

Methods
We describe 6 otherwise healthy adolescents – 3 siblings per family from 2 unrelated families – presented within a 48‐hour period in April, 2020, with acral perniosis‐like lesions in the context of over 30 similar patients who were evaluated within the same week.

Results
Affected patients had mild symptoms of viral upper respiratory infection (URI) or contact with symptomatic persons 1‐2 weeks preceding the rash. They all presented with red to violaceous macules and dusky, purpuric plaques scattered on the mid and distal aspects of the toes. Skin biopsies performed on each of the 6 patients demonstrated near identical histopathologic findings to those of idiopathic perniosis, with a lymphocytic inflammatory infiltrate without evidence of thromboembolism or immune complex vasculitis. While SARS‐CoV‐2 polymerase chain reaction was negative, testing was performed 1‐2 weeks after URI symptoms or sick contact exposure.

Conclusion
We offer a clinical approach to evaluation of patients with this presentation and discuss the possibility that these skin findings represent a convalescent‐phase cutaneous reaction to SARS‐CoV‐2 infection.
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NewsBot · May 24, 2020

Viral Exanthem With "Pin and Needles Sensation" on Extremities of COVID-19 Patient
Bayushi Eka Putra et al
Int J Infect Dis. 2020 May 8;S1201-9712(20)30327-1

Cutaneous manifestation is a newly reported clinical manifestation of COVID-19 infection. The clinical description of cutaneous manifestation is still not fully described. Our patient, a medical personnel, had viral exanthem distributed in the extremities along with "pin and needles sensation" which differ from the previously published paper on cutaneous manifestation. The differential diagnosis of drug-induced skin rash and hand-foot-mouth disease have already been ruled out based on the patient's previous history and course of disease.
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NewsBot · May 27, 2020

Diversity of clinical appearance of cutaneous manifestations in the course of COVID-19.
Guarneri C et al
Journal of the European Academy of Dermatology and Venereology : JEADV, 22 May 2020,

The outbreak of COVID-19 has stricken more than 203,000 people in Italy up to 30th of April 2020, with over 27,000 died according to official estimates1 . While Italy was one of the most affected countries in Europe, the impact of the disease in the southern part of the state was less dramatic than in the north, due to some still not understood reasons. Particularly in Sicily, 'only' 3,140 cases have been recorded, of whom 533 encountered in the province of Messina.
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NewsBot · May 27, 2020

Teledermatology for COVID‐19 cutaneous lesions: substitute or supplement?
C Skayem C Cassius M Ben Kahla C Fiani L Frumholtz M Mrad A Petit E Zuelgaray M Bagot JD Bouaziz TA Duong
18 May 2020 https://doi.org/10.1111/jdv.16630

In the context of COVID‐19 pandemic, teledermatology is being favored over in‐person consultation in order to avoid the possibility of virus transmission1. In France, COVID‐19 wasn't known to cause cutaneous manifestations before April 6th 2020, when an alert about possible associated skin symptoms was raised to the general public and the professional social network2–4. We aimed to assess the impact of alerting about COVID‐associated lesions on the activity of urgent teledermatology (TD) and the activity of dermatologic emergencies unit (DEU) of two university hospitals during this pandemic.
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BEN-HUR · May 28, 2020

Chilblains a Common Finding During COVID-19 Pandemic:

- Thursday, May 28, 2020: https://www.medscape.com/viewarticle/930518

Skin lesions, and chilblains in particular, are a common cutaneous finding during the COVID-19 pandemic, according to results of a retrospective nationwide study from France.

While most patients in the cohort were not tested for SARS-CoV2, "the number of observed chilblain-like lesions, in patients without significant past medical history, is extremely unusual during the spring season in France, especially as people are staying inside, and may suggest a link with COVID-19," the study team writes in the Journal of the American Academy of Dermatology.

"This manifestation may be induced by an inflammatory endothelitis of small cutaneous vessels and/or and interferon-like cytokine production," corresponding author Dr. Martine Bagot of Saint-Louis Hospital and the University of Paris told Reuters Health by email.

The research team took a look back at skin lesions encountered in the outpatient setting during the COVID-19 pandemic in France from mid-March to mid-April. The cohort included 277 patients (median age, 27 years). About half were men.

Skin lesions were classified as acral (80%), vesicular (15%), urticarial (9%), morbilliform (9%), petechial (3%), livedo reticularis (1%) and other (15%). Some patients had skin lesions fitting in multiple categories.
Acral lesions were "unexpectedly" common and chilblain-like lesions were the most common of the acral lesions (75%), the authors report. Vesicular acral (dyshidrosis-like) lesions were reported in 14% of cases and acrodynia was present in 6%, sometimes isolated.

Thirty-four of the 277 patients had a SARS-Cov2 PCR test and 25 were positive (74%). Seven of these 25 (28%) had acral lesions. Among the patients without a positive PCR test, 115 patients had suggestive extracutaneous symptoms and/or reported a close contact with a COVID-19 patient.

In addition, 59 patients had isolated chilblains (no prior history of chilblains and in the absence of cold exposure), without associated extracutaneous symptoms. This "may suggest cutaneous symptoms of COVID-19, since this finding has been found in some patients with a positive SARS-Cov2 PCR test in our case series and in two recently published case reports," the researchers say...…
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NewsBot · May 29, 2020

Chilblain acral lesions in the COVID ‐19 era. Are they marker of infection in asymptomatic patients?
A. Ramondetta M. Panzone P. Dapavo M. Ortoncelli MT. Giura M. Licciardello G. Rozzo N. Siliquini MT. Fierro S. Ribero
18 May 2020

During these months in which the COVID‐19 emergency is waning, the activity of dermatologists has changes substantially. Since the beginning of March 2020, in the Dermatology Clinic at the University Hospital in Turin (Italy) the outpatient access has been significantly reduced and telemedicine has been useful whenever possible, by putting the patient in contact directly with dermatologists or mediated by the general practitioners.
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NewsBot · May 29, 2020

Novel outbreak of acral lesions in times of COVID‐19: A description of 74 cases from a tertiary university hospital in Spain
A. Saenz Aguirre F.J. De la Torre Gomar P. Rosés‐Gibert J. Gimeno Castillo Z. Martinez de Lagrán Alvarez de Arcaya R. Gonzalez‐Perez
18 May 2020

Since the outbreak of novel Coronavirus Disease 2019 (COVID‐19), reports concerning suspicious COVID‐19 skin manifestations are progressively increasing. Morbilliform, varicelliform or urticarial rashes were firstly described1. Later, acral erythematous or purpuric lesions2‐4 were reported.
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NewsBot · May 29, 2020

Going viral: A brief history of Chilblain-like skin lesions (“COVID toes”) amidst the COVID-19 pandemic
Paul R.MasseyMD Krystal M.JonesMD
Seminars in Oncology 23 May 2020

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of the respiratory illness COVID-19, has led to a global pandemic. In a rapidly evolving medical literature its manifestations are expanding and now include coagulopathies renal dysfunction, cardiac arrests, multisystem inflammatory syndrome in children as well as cutaneous manifestations commonly observed with viral illnesses and chilblain-like skin lesions often referred to as “COVID toes”. Driven in large part by the internet-facilitated communication, dermatologists around the world now report a marked increase in the frequency of chilblain-like diagnoses, not infrequently in members of the same family, amidst the COVID-19 pandemic. While a mechanistic explanation has yet to be proven a robust antiviral immune response in young patients that simultaneously truncates the clinical course and induces the microangiopathic changes could lead to chilblain-like skin lesions. This or a similar explanation would then posit that chilblain-like lesions would be most likely to appear only after a successful viral response is mounted with lesions detected only when symptoms are likely to be subsiding. We review the rapid evolution of the chilblain-like presentation in patients with COVID 19 beginning with its first description in early March 2020 and summarize the evolving but rapidly self-confirming data.
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NewsBot · May 31, 2020

Are chilblain‐like acral skin lesions really indicative of COVID‐19? A prospective study and literature review
A. Docampo‐Simón M.J. Sánchez‐Pujol G. Juan‐Carpena J.C. Palazón‐Cabanes E. Vergara‐De Caso L. Berbegal I. Poveda‐Montoyo N. Pastor‐Tomás J. Mataix‐Díaz
26 May 2020

Recently, young COVID‐19 patients have presented with erythematous and purpuric acral lesions similar to chilblains1–3. Despite the scarcity of published cases, this topic has attracted significant mass media attention.4 Dermatologists have noted that more people than would be expected at this time of year are seeking medical attention for these chilblain‐like lesions. Some have suggested that people presenting with this manifestation should be tested and isolated2. Determining the accuracy of this association is therefore crucial.

To establish the real prevalence of COVID‐19 in patients with acral skin lesions, we firstly evaluated all the cases of acral lesions presented in dermatology and paediatrics departments and family doctors’ offices in an eastern Spanish region over a three‐week period. Then we prospectively performed a SARS‐CoV‐2 PCR on nasopharyngeal aspirates taken from all available patients to determine whether their cutaneous manifestations were predictive of a positive result.

To put our findings into context, we reviewed all the articles published before May 2020 concerning COVID‐19 patients with cutaneous lesions.

We evaluated 58 patients, whose characteristics are summarized in Table 1. In most cases, lesions were chilblain‐like. Fifteen patients had already been tested, and only one had a positive result: an 85‐year‐old man admitted for severe Covid‐19 pneumonia. He had an ulcer on a toe that was finally determined to be vascular in nature.

We performed prospective PCR testing in 24 patients. All test results were negative. In total, then, PCR was negative in 38 patients and positive in a single patient whose lesion was very unlikely to be due to COVID‐19.

Our bibliography search returned 97 articles and we found 2 more through cross‐references. Nine of these articles dealt with acral lesions specifically. Their results are summarized in Table 2.

Data published in the literature are heterogeneous, as are the methods employed to collect them. The first papers looked at cutaneous manifestations in patients with confirmed SARS‐CoV‐2 infection.5–8 This approach cannot reveal whether this dermatologic manifestation is a specific marker of SARS‐CoV‐2 infection, since patients without COVID‐19 are not included. The other approach, which we have followed, is to analyse all patients with acral lesions. This can be done retrospectively, reporting on patients in the sample who have already been tested, or prospectively, performing the test on all available patients, regardless of whether they have symptoms. The retrospective method has a significant risk of confounding bias: due to the scarcity of COVID‐19 tests8, they are usually reserved for patients with COVID‐19‐related symptoms, who are obviously more likely to test positive.

All previous studies including only patients with cutaneous acral lesions (summarized in table 2) have been retrospective, and we tested only a minority of patients. In total, 12 out of at least 49 tested patients were positive (24.5%). Combined with our results, they total 13 positives out of 88 tests (14.8%).

There are two possible explanations for the high proportion of negative results: I) A high number of false negatives. II) The lesions are not related to SARS‐CoV‐2 infection. The low prevalence of an infected contact in our sample, after three weeks of strict confinement in Spain, makes the possibility of being infected in our cohort less likely. The diffusion of this entity by the mass media may have caused patients who would not normally consult to do so.9 . Other possible explanations include a concomitant parvovirus B19 outbreak10 or trauma‐induced lesions.

Our study suggests that acral skin lesions are not a specific marker of SARS‐CoV‐2 infection. Although larger prospective studies are needed, current evidence indicates that acral skin lesions should not be regarded as a sign of COVID‐19 in otherwise asymptomatic patients.
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NewsBot · Jun 3, 2020

Late onset of acral necrosis after SARS‐CoV‐2 infection resolution
R. Balestri S. Termine G. Rech C.R. Girardelli
26 May 2020 https://doi.org/10.1111/jdv.16668

SARS‐CoV‐2 has been hypothesized as the aetiologic agent of CLL, on the basis of the temporal correlation between the “burst” of skin manifestations and the viral pandemic, even though we have scarce evidence of swab‐confirmed infections. Authors have therefore suggested some pathogenetic mechanisms such as a delayed immune‐mediated reaction to the virus in genetically‐predisposed patients1 or an early IFN‐I response in young patients, muting early viral replication but also inducing microangiopathic changes.
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NewsBot · Jun 3, 2020

Cutaneous manifestations of COVID‐19: A review of the published literature
Ömer Faruk Elmas MD Abdullah Demirbaş MD Kemal Özyurt MD Mustafa Atasoy Ümit Türsen
26 May 2020 https://doi.org/10.1111/dth.13696

COVID‐19 is a highly contagious respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2 (SARS‐Cov‐2). COVID‐19 outbreak, which caused thousands of deaths, has been declared a pandemic by the World Health Organization in March 2020. The infection has been reported to demonstrate different types of cutaneous manifestations including urticarial, maculopapular, papulovesicular, purpuric, livedoid, and thromboticischemic lesions. Given the high mortality rate of the infection, timely and accurate identification of relevant cutaneous manifestations may play a key role in the early diagnosis and management. In this study, we provide a review with a focus on the reported cutaneous manifestations of COVID‐19.
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NewsBot · Jun 3, 2020

Chilblains‐like lesions and COVID‐19
Beuy Joob Viroj Wiwanitkit
26 May 2020 https://doi.org/10.1111/pde.14238

The publication entitled “Chilblains‐like lesions in children following suspected Covid‐19 infection” is very interesting [1]. Colonna et al. reported four children with suspected COVID‐19 cases with “[h]istology from one case showed signs of vasculitis with evident fibrin thrombus [1].” While various skin findings have been reported with COVID‐19 infection, the chilblains lesions have been reported from Italy and Spain, and sporadically from China, the starting point of disease pandemic
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NewsBot · Jun 3, 2020

Further evidence that chilblains are a cutaneous manifestation of COVID‐19 infection
M. Hughes S. Rogers G. Lepri C. Bruni M. Matucci‐Cerinic
27 May 2020 https://doi.org/10.1111/bjd.19243

A range of cutaneous conditions including chilblain‐like lesions have been reported in patients with Coronavirus 2019 (COVID‐19) due to severe acute respiratory Syndrome coronavirus 2 (SARS‐Cov‐2). Using clinical data and images, the authors of a recent nationwide Spanish survey identified 5 clinical patterns which were associated with different patient demographics, onset (timing), and prognosis.
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NewsBot · Jun 4, 2020

NewsBot · Jun 4, 2020

NewsBot · Jun 6, 2020

Management of Diabetic Persons With Foot Ulceration During COVID-19 Health Care Emergency: Effectiveness of a New Triage Pathway
Meloni Marco et al
Diabetes Res Clin Pract. 2020 Jun 1

Aim: To define the outcomes of persons with diabetes and foot ulcers (DFUs) managed through a specific triage pathway during the COVID-19 crisis.

Methods: Patients who had an active DFU during the COVID-19 emergency were included. All participants were managed using a specific triage system driven both by ulcer'severity and concomitant co-diseases. Subjects with severely complicated DFUs were urgently referred to hospital regardless of the concomitant comorbidities. Subjects with complicated DFUs received outpatient evaluation (within 48-72 hours) and were admitted to hospital if required (revascularization, surgical intervention, intravenous antibiotic therapy); after the first outpatient visit or hospitalization, patients were followed according to the number of comorbidities (in the case of 3 or more comorbidities patiente were followed up by telemedicine). Patients with uncomplicated DFUs were managed by telemedicine after outpatient evaluation. Healing, major amputation, death and rate of COVID-19 infection were evaluated. The minimum follow-up was 1 month.

Results: The study group included 151 patients. The mean age was 69.9±14.2 years, 58.9% were male and 91.4% had type 2 diabetes; 58.7% had severely complicated, 21% complicated and 20.3% uncomplicated DFUs. Among those, 78.8% presented with 3 or more comorbidities. One hundred and six patients had regular clinical follow-ups, while 45 were managed through telemedicine. Forty-one (27.1%) patients healed, 3 (1.9%) had major amputations and 3 (1.9%) died. One patient (0.6%) reported COVID-19 positivity due to infection aquired at home.

Conclusion: The triage pathway adopted during the COVID-19 pandemic showed adequate management of DFUs and no cases of hospital virus exposure.
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NewsBot · Jun 6, 2020

Full text available:
Standing on your Foot and Ankle during COVID-19: Perspectives from a Singaporean Orthopaedic Foot and Ankle surgery unit

NewsBot · Jun 7, 2020

Recommendations for management of diabetic foot ulcers during COVID ‐19 outbreak
Osman Kelahmetoglu Mehmet Fatih Camlı Ahmet Kirazoglu Yusuf Erbayat Susan Asgarzade Ufuk Durgun Turan Mehdizade Ali Yeniocak Kemalettin Yildiz Selma Sonmez Ergun Ethem Guneren
05 June 2020

COVID‐19 pandemia began in Wuhan, China, in December 2019. A total of 1 878 489 people were infected and 119 044 people were lost because of the disease and its complications by 15 April. Severe morbidity and mortality complications are mostly seen in elderly and patients having comorbidities. Diabetic foot ulcers (DFUs) are one of severe complications of diabetes mellitus and it may require urgent surgical interventions. In this paper, we aimed to create a management algorithm to prevent the unexpected complications that may occur in the patients and health care workers during the evaluation of COVID‐19 in DFU patients who require urgent surgical intervention. We advise the use of thorax computerised tomography for preoperative screening in all DFU patients with severe signs of infection and especially those requiring urgent surgery for both the detection of the possible undiagnosed COVID‐19 in the patient for the need for close follow‐up and protection of the surgical and anaesthesiology team.
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NewsBot · Jun 7, 2020

Classification and pathophysiology of cutaneous
manifestations of COVID-19
Surinder Gupta et al
Int J Res Dermatol. 2020 Jul

Cutaneous manifestation of in COVID-19 patients are varied and needs proper categorization and classification.
Various morphological manifestation on skin are seen. The pathophysiology of this virus is not well understood
because of it being a novel virus. This disease involves all organs of the body, primarily the respiratory system, heart,
kidneys, liver, spleen and the skin as well. In addition to pneumonia which is a hall mark feature of this virus,
multiorgan failure occurs as a result of its cascading pathological pathways. Another fatal feature of this virus is
hyperimmune response (because of IL-6), known as, ‘cytokine storm’. The pathophysiological changes in skin
leading to different kinds of rashes range from vasculitis changes to formation of microthrombi obliterating the
dermal vessels. After reviewing current literature, we have proposed a simplified classification of cutaneous
manifestations of COVID-19 is proposed based on morphological features, relation with severity of disease and
histopathological changes. Pathophysiology of cutaneous changes is also being described.
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NewsBot · Jun 7, 2020

Are the cutaneous manifestations during or due to SARS‑CoV‑2
infection/COVID‑19 frequent or not? Revision of possible
pathophysiologic mechanisms
Paulo Ricardo Criado et al
Infammation Research

Background SARS-Cov-2 is a single-stranded RNA virus, a Betacoronavirus, composed of 16 non-structural proteins, with
specifc roles in replication of coronaviruses. The pathogenesis of COVID-19 is not yet fully understood. The virus and host
factors interplay among distinct outcomes of infected patients.
Methods Using MeSH (Medical Subject Headings) in PubMed, authors searched for articles cotaining information on
COVID-19 and the skin.
Results The pathophysiology of the disease is multifactorial: association with innate immune response, hypercoagulability
state, lung tissue damage, neurological and/or gastrointestinal tract involvement, monocytic/macrophage activation syndrome,
culminating in exaggerated cytokine secretion, called “cytokine storm”, which leads to worsening and death. These systemic
conditions may be associated with cutaneous lesions, that have polymorphic aspects, where at histopathological level show
involvement in diferent skin changes. These lesions may be associated with multisystemic manifestations that could occur
due to angiotensin-converting enzyme 2 receptor and transmembrane serine protease action, allowing the pulmonary infection
and possibly skin manifestation. Several reports in literature show cutaneous lesions similar to chilblain, urticarial eruptions,
difuse or disseminated erythema, livedo racemosa, blue toe syndrome, retiform purpura, vesicle trunk, purpuric exanthema
or exanthema with clinical aspects of symmetrical drug-related intertriginous and fexural exanthema (SDRIFE) and others.
Conclusions This review describes the complexity of Covid-19, pathophysiological and clinical aspects, dermatological
fnding and other dermatological conditions associated with SARS-CoV-2 infection or COVID-19.
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NewsBot · Jun 12, 2020

Eosinophilic granulomatosis with polyangiitis mimicking COVID‐19: a case report
H. Hashizume Y. Sano S. Furukawa S. Imokawa
04 June 2020

Coronavirus disease 2019 (COVID‐19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection, is currently spreading worldwide, causing the worst pandemic experienced this century. During the present outbreak, reports have been accumulating that various types of cutaneous manifestations were observed in COVID‐19 patients. We read with interest the recent article by Amatore et al. describing a COVID‐19 case who presented with a febrile rash consisting of annular, polycyclic, and circinate erythema, presumably specific to COVID‐19.
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NewsBot · Jun 14, 2020

Cutaneous Manifestations in Children with COVID-19
Ranjit Kumar Gunda, Nalinikanta Panigrahy, Vijayanand Jamalpuri
RAINBOW PEDIATRIC JOURNAL

Infection with SARS CoV 2 (COVID-19) initially presents with symptoms similar to other respiratory
viral infections, most commonly with fever, cough, fatigue, and myalgia. Cutaneous and mucosal
involvements were seen in many recent COVID 19 reports across globe among all age groups including
children and young adults. We reviewed here reported common skin manifestations of novel corona virus infection and how few of those can mimic other childhood viral illness
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NewsBot · Jun 14, 2020

COVID Toes: Digital Vascular Changes in Patients with a COVID19 Infection
Justin Chin et al
Frontiers in Medical Case Reports | June 2020 | Volume 01| Issue 05 | PAGE 1-08

COVID-19 is a highly infectious disease caused by the SARS-CoV2 virus and has resulted in a global pandemic.
Primarily understood as a respiratory disease, ongoing studies have observed the effects of COVID-19 on other body
systems. COVID toes, also known as pseudo-chilblains, is an increasingly common dermatological condition in
which pruritic, erythematous rashes appear on the toes. Generally benign in adults, COVID toes have also been
observed in Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19. Here we present a
case of a 9-year-old Hispanic asymptomatic COVID-19 male and a 53-year-old African American female with
symptomatic, confirmed COVID-19, with a comparison of the prognostic differences between children and adults of
COVID toes and a review of the current literature.
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NewsBot · Jun 16, 2020

The broad spectrum of dermatological manifestations in COVID‐19. Clinical and histopathological features learned from a series of 34 cases
C.A. Rubio‐Muniz M. Puerta‐Peña D. Falkenhain‐López J. Arroyo‐Andrés M. Agud‐Dios J.L. Rodriguez‐Peralto P.L. Ortiz‐Romero R. Rivera‐Díaz
11 June 2020 https://doi.org/10.1111/jdv.16734

Since the outbreak of Coronavirus Disease (COVID‐19) pandemic began in Europe, a plethora of cutaneous manifestations have been related to this infection1,2. However, their underlying mechanism and prognostic relevance remain unclear. Thus, we collected data from all COVID‐19 cases presenting with skin manifestations in our hospital in Madrid during one month.
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NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

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