tetano
Editor, Senior Moderator
Biology (Basel)
. 2020 Dec 5;9(12):E449.
doi: 10.3390/biology9120449.
Cutaneous Manifestations in Confirmed COVID-19 Patients: A Systematic Review
Claudio Conforti[SUP] 1 [/SUP], Caterina Dianzani[SUP] 2 [/SUP], Marina Agozzino[SUP] 1 [/SUP], Roberta Giuffrida[SUP] 3 [/SUP], Giovanni Francesco Marangi[SUP] 4 [/SUP], Nicola di Meo[SUP] 1 [/SUP], Silviu-Horia Morariu[SUP] 5 [/SUP], Paolo Persichetti[SUP] 4 [/SUP], Francesco Segreto[SUP] 4 [/SUP], Iris Zalaudek[SUP] 1 [/SUP], Nicoleta Neagu[SUP] 5 [/SUP]
Affiliations
Abstract
There have been increasing reports of skin manifestations in COVID-19 patients. We conducted a systematic review and included manuscripts describing patients with positive RT-PCR coronavirus testing from nasopharyngeal swabs who also developed cutaneous manifestations. A total of 655 patients were selected, with different types of skin rashes: Erythematous maculopapular (n = 250), vascular (n = 146), vesicular (n = 99), urticarial (n = 98), erythema multiforme/generalized pustular figurate erythema/Stevens-Johnson syndrome (n = 22), ocular/periocular (n = 14), polymorphic pattern (n = 9), generalized pruritus (n = 8), Kawasaki disease (n = 5), atypical erythema nodosum (n = 3), and atypical Sweet syndrome (n = 1). Chilblain-like lesions were more frequent in the younger population and were linked to a milder disease course, while fixed livedo racemosa and retiform purpura appeared in older patients and seemed to predict a more severe prognosis. For vesicular rashes, PCR determined the presence of herpesviruses in the vesicle fluid, which raised the possibility of herpesvirus co-infections. The erythema-multiforme-like pattern, generalized pustular figurate erythema and Stevens-Johnson syndrome were most frequently linked to hydroxychloroquine intake. A positive PCR determination of SARS-COV-2 from conjunctival swabs suggest that eye discharge can also be contagious. These cutaneous manifestations may aid in identifying otherwise asymptomatic COVID-19 carriers in some cases or predict a more severe evolution in others.
Keywords: COVID-19; cutaneous manifestations; histopathology; novel coronavirus; ocular; skin rash.
. 2020 Dec 5;9(12):E449.
doi: 10.3390/biology9120449.
Cutaneous Manifestations in Confirmed COVID-19 Patients: A Systematic Review
Claudio Conforti[SUP] 1 [/SUP], Caterina Dianzani[SUP] 2 [/SUP], Marina Agozzino[SUP] 1 [/SUP], Roberta Giuffrida[SUP] 3 [/SUP], Giovanni Francesco Marangi[SUP] 4 [/SUP], Nicola di Meo[SUP] 1 [/SUP], Silviu-Horia Morariu[SUP] 5 [/SUP], Paolo Persichetti[SUP] 4 [/SUP], Francesco Segreto[SUP] 4 [/SUP], Iris Zalaudek[SUP] 1 [/SUP], Nicoleta Neagu[SUP] 5 [/SUP]
Affiliations
- PMID: 33291502
- DOI: 10.3390/biology9120449
Abstract
There have been increasing reports of skin manifestations in COVID-19 patients. We conducted a systematic review and included manuscripts describing patients with positive RT-PCR coronavirus testing from nasopharyngeal swabs who also developed cutaneous manifestations. A total of 655 patients were selected, with different types of skin rashes: Erythematous maculopapular (n = 250), vascular (n = 146), vesicular (n = 99), urticarial (n = 98), erythema multiforme/generalized pustular figurate erythema/Stevens-Johnson syndrome (n = 22), ocular/periocular (n = 14), polymorphic pattern (n = 9), generalized pruritus (n = 8), Kawasaki disease (n = 5), atypical erythema nodosum (n = 3), and atypical Sweet syndrome (n = 1). Chilblain-like lesions were more frequent in the younger population and were linked to a milder disease course, while fixed livedo racemosa and retiform purpura appeared in older patients and seemed to predict a more severe prognosis. For vesicular rashes, PCR determined the presence of herpesviruses in the vesicle fluid, which raised the possibility of herpesvirus co-infections. The erythema-multiforme-like pattern, generalized pustular figurate erythema and Stevens-Johnson syndrome were most frequently linked to hydroxychloroquine intake. A positive PCR determination of SARS-COV-2 from conjunctival swabs suggest that eye discharge can also be contagious. These cutaneous manifestations may aid in identifying otherwise asymptomatic COVID-19 carriers in some cases or predict a more severe evolution in others.
Keywords: COVID-19; cutaneous manifestations; histopathology; novel coronavirus; ocular; skin rash.