tetano
Editor, Senior Moderator
Hum Pathol
. 2020 Nov 5;S0046-8177(20)30217-3.
doi: 10.1016/j.humpath.2020.10.011. Online ahead of print.
Cutaneous manifestations in patients with COVID-19: clinical and histological findings
Antonin Fattori[SUP] 1 [/SUP], Bernard Cribier[SUP] 2 [/SUP], Marie-Pierre Chenard[SUP] 3 [/SUP], Mona Mitcov[SUP] 2 [/SUP], Sylvain Mayeur[SUP] 3 [/SUP], No?lle Weingertner[SUP] 3 [/SUP]
Affiliations
Abstract
The clinical spectrum of COronaVIrus Disease-19 (COVID-19) is getting wider with the exponential increase of patients worldwide. Initially described with flu-like symptoms, variable cutaneous manifestations have been reported, with only few histopathological descriptions. Detection of the virus in cutaneous samples has been assessed in very few cases until now and the causative role of SARS-CoV-2 has not been proven for every type of cutaneous manifestations yet. We aimed to describe histological features of cutaneous eruptions occurring concomitantly to SARS-CoV-2 infection and assess by immunochemistry and in situ hybridization using RNA scope validated technics the presence of the virus in skin lesions. We retrieved all skin biopsies received in the departments of Pathology and Dermatopathology, University Hospital of Strasbourg, performed in hospitalized SARS-CoV-2 infected patients presenting concomitant cutaneous manifestations since March 2020. In situ hybridization and immunostaining using a polyclonal Sars nucleocapsid protein antibody were performed on each sample. Skin biopsies from six patients presenting morbilliform eruption concomitant to SARS-CoV-2 infection were available for evaluation. All six samples showed varying degrees of spongiosis, perivascular inflammatory infiltrates of the dermis, and for some of them, discrete interface dermatitis. In situ hybridization and immunohistochemistry were negative in all cutaneous samples. Morbilliform rash concomitant to SARS-CoV-2 infection is characterized by mild and unspecific histopathological features with no detectable viral RNA and protein and appears then not to be directly caused by the virus. Even if, at least for a few cases, the differential diagnosis with drug hypersensitivity reaction can be difficult, these cutaneous eruptions seem to rather correspond to paraviral rashes.
Keywords: COVID-19; SARS-CoV-2; cutaneous manifestations; in situ hybridation; skin.
. 2020 Nov 5;S0046-8177(20)30217-3.
doi: 10.1016/j.humpath.2020.10.011. Online ahead of print.
Cutaneous manifestations in patients with COVID-19: clinical and histological findings
Antonin Fattori[SUP] 1 [/SUP], Bernard Cribier[SUP] 2 [/SUP], Marie-Pierre Chenard[SUP] 3 [/SUP], Mona Mitcov[SUP] 2 [/SUP], Sylvain Mayeur[SUP] 3 [/SUP], No?lle Weingertner[SUP] 3 [/SUP]
Affiliations
- PMID: 33161030
- DOI: 10.1016/j.humpath.2020.10.011
Abstract
The clinical spectrum of COronaVIrus Disease-19 (COVID-19) is getting wider with the exponential increase of patients worldwide. Initially described with flu-like symptoms, variable cutaneous manifestations have been reported, with only few histopathological descriptions. Detection of the virus in cutaneous samples has been assessed in very few cases until now and the causative role of SARS-CoV-2 has not been proven for every type of cutaneous manifestations yet. We aimed to describe histological features of cutaneous eruptions occurring concomitantly to SARS-CoV-2 infection and assess by immunochemistry and in situ hybridization using RNA scope validated technics the presence of the virus in skin lesions. We retrieved all skin biopsies received in the departments of Pathology and Dermatopathology, University Hospital of Strasbourg, performed in hospitalized SARS-CoV-2 infected patients presenting concomitant cutaneous manifestations since March 2020. In situ hybridization and immunostaining using a polyclonal Sars nucleocapsid protein antibody were performed on each sample. Skin biopsies from six patients presenting morbilliform eruption concomitant to SARS-CoV-2 infection were available for evaluation. All six samples showed varying degrees of spongiosis, perivascular inflammatory infiltrates of the dermis, and for some of them, discrete interface dermatitis. In situ hybridization and immunohistochemistry were negative in all cutaneous samples. Morbilliform rash concomitant to SARS-CoV-2 infection is characterized by mild and unspecific histopathological features with no detectable viral RNA and protein and appears then not to be directly caused by the virus. Even if, at least for a few cases, the differential diagnosis with drug hypersensitivity reaction can be difficult, these cutaneous eruptions seem to rather correspond to paraviral rashes.
Keywords: COVID-19; SARS-CoV-2; cutaneous manifestations; in situ hybridation; skin.