Dermatological Manifestations in COVID-19 Disease

Authors : Öner ÖZDEMİR, Ayşegül PALA, Elif ŞEKER

Pages : 218-220

Doi:10.31832/smj.805026

View : 20 | Download : 8

Publication Date : 2021-03-22

Article Type : Other Papers

Abstract :Although the etio-pathogenesis of skin lesions in COVID-19 is yet not clear, several theories have been proposed. One of them is cytokine storm causing thrombophilic arteritis in COVID-19 patients due to activation of endothelial cells and macrophages. Furthermore, involvement of activated keratinocytes and/or Langerhans cells of the skin may cause various clinical spectrum According to another theory, livedo reticularis-like lesions may be result of decreased blood flow to cutaneous micro-vascular system by accumulation of micro-thromboses derived from other organs. From SARS-CoV-2 infected 148 patients, hospital records of 18 patients clinically showed skin involvement. 8 out of 18 patients showed the symptoms at the onset of COVID-19 and remained after hospitalization. Erythematous rash was observed in 14 patients, widespread urticaria in 3 patients, and chickenpox-like vesicles in 1 patient. Generally, affected area was trunk with low itching, but skin lesions healed in a few days. The authors emphasized skin manifestations are similar to cutaneous involvement occurring during common viral infections.1 Castelnovo et al reported skin involvement of two young COVID-19 patients. First patient presented widespread urticaria in the thigh and peri-malleolar area spontaneously improving in a few days.2 Second patient had vasculitic purpura, then evolving to erythematous rash. The patient was recovered after a short time with corticosteroid. In another study, a woman with COVID-19 was admitted with odynophagia. She later developed arthralgia and pruritic disseminated erythematous plaques involving face and acral areas. The authors suggested skin symptoms as an indicator for SARS-CoV-2 infection. 3 The skin manifestations in 130 COVID-19 patients of two hospitals from Rome and Barcelona were examined. Vesicles surrounded by erythematous halos with mild pruritus were observed in only 2 patients of Rome. In Barcelona, only 1 patient had numerous isolated vesicular lesions in the back. The authors stated that skin lesions seen in COVID-19 are similar to dermatological manifestations seen in typical viral infection of Herpesviridae family.4 Fernandez-Nieto et al conducted a retrospective analysis of 132 patients with SARS-CoV-2 infection. The mean duration of skin lesions was 8.7 days.5 In 95 patients, there were acute acro-ischemic insert ignore into journalissuearticles values(chilblain-like pattern); lesions in the form of red to violet macules, plaques, and nodules, usually at the distal aspects of toes and fingers. Rounded erythematous macules and vesicles in erythema multiforme-like pattern tending to coalesce were observed in 37 patients. In conclusion; as of today, there are limited studies and reports available on dermatological manifestations in COVID-19 patients. Dermatological symptoms can start before or after SARS-CoV-2 infection. The region of involvement and healing time of symptoms varies. Some symptoms are the same as occurring during classical viral infections.
Keywords : covid 19, dermatology, skin, lesion