1
|
Ivanova ZG, Aleksiev TI, Dobrev HP. Onychomadesis in a COVID-19 patient. Wien Med Wochenschr 2023; 173:272-275. [PMID: 36441360 PMCID: PMC9703413 DOI: 10.1007/s10354-022-00988-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/21/2022] [Indexed: 11/29/2022]
Abstract
We report the case of a 67-year-old woman who developed onychomadesis on 9 of her fingers 2 months after recovering from COVID-19, with subsequent full nail regrowth after 4 months. The development of onychomadesis in COVID-19 is probably related to inhibition of nail proliferation due to fever, direct viral damage, or an inflammatory process associated with endothelial damage and obliterative microangiopathy in the nail matrix area. Clinicians should be aware of nail changes and actively seek them out in patients with COVID-19.
Collapse
Affiliation(s)
- Zlatina Georgieva Ivanova
- Department of Dermatology and Venereology, Medical Faculty, Medical University, 15A V. Aprilov Blvd., 4002 Plovdiv, Bulgaria
| | - Teodor Ivanov Aleksiev
- Department of Dermatology and Venereology, Medical Faculty, Medical University, 15A V. Aprilov Blvd., 4002 Plovdiv, Bulgaria
| | - Hristo Petrov Dobrev
- Department of Dermatology and Venereology, Medical Faculty, Medical University, 15A V. Aprilov Blvd., 4002 Plovdiv, Bulgaria
| |
Collapse
|
2
|
Ică OM, Mitroi G, Ianoşi SL, Tutunaru CV, Leru PM, Matei D, Avramescu ET, Tănasie CA, Mitroi IB, Neagoe CD, Cazacu SM. Defining the short-term and long-term skin manifestations of COVID-19: insights after more than three years of the pandemic. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2023; 64:291-304. [PMID: 37867347 PMCID: PMC10720941 DOI: 10.47162/rjme.64.3.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/22/2023] [Indexed: 10/24/2023]
Abstract
AIM This review aimed to assess the impact of coronavirus disease 2019 (COVID-19) on skin health to establish a classification of the skin lesions that occur most frequently during the disease and whether a particular category of skin damage is more likely to occur both in the short term and in the long term. METHODS We conducted a literature search of the PubMed database. Ultimately, 109 articles were included in this review. The exact phrases∕syntax and connectors used for the database search∕query were as follows: "Coronavirus and skin", "COVID-19 and skin", "SARS-CoV-2 and skin", "Coronavirus cutaneous manifestations", "COVID-19 cutaneous manifestations", "SARS-CoV-2 cutaneous manifestations", "Coronavirus dermatology", "SARS-CoV-2 and dermatology", "COVID-19 and dermatology", "COVID-19 and skin eruption", "Coronavirus and skin rash", "COVID-19 and hair", "Coronavirus and hair", "Coronavirus and nails", "SARS-CoV-2 and hair", and "SARS-CoV-2 and nails". Only articles with abstracts referring strictly to cutaneous manifestations of COVID-19 were chosen. Articles without abstracts were not considered. RESULTS We established six of the most frequently reported clinical patterns associated with COVID-19 and their probability of occurring during COVID-19 disease evolution based on the current literature reports. We did not identify the particular types of skin lesions that are most prone to long-term persistence; most such cases are rare, and no conclusion can be drawn based on them. CONCLUSIONS Apart from classified COVID-19-related skin disorders, this pandemic has been a challenge for dermatologists and a wide range of cutaneous side effects related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) treatments have been reported. We are aware of other polymorphic clinical presentations, with novel data being reported periodically, but the pathophysiological mechanisms and evolution are largely unknown.
Collapse
Affiliation(s)
- Oana Maria Ică
- Department of Dermatology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - George Mitroi
- Department of Urology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Simona Laura Ianoşi
- Department of Dermatology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Cristina Violeta Tutunaru
- Department of Dermatology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Polliana Mihaela Leru
- Department of Family Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Daniela Matei
- Department of Medical Rehabilitation, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | | | - Cornelia Andreea Tănasie
- Department of Physiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Iulia Bianca Mitroi
- Medical Student, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Carmen Daniela Neagoe
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Sergiu Marian Cazacu
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| |
Collapse
|
3
|
Yang S, Han SB, Kang S, Lee J, Kim D, Kozlova A, Song M, Park SH, Lee J. The relationship of skin disorders, COVID-19, and the therapeutic potential of ginseng: a review. J Ginseng Res 2023; 47:33-43. [PMID: 36249949 PMCID: PMC9546782 DOI: 10.1016/j.jgr.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has made significant impacts on global public health, including the development of several skin diseases that have arisen primarily as a result of the pandemic. Owing to the widespread expansion of coronavirus disease 19 (COVID-19), the development of effective treatments for these skin diseases is drawing attention as an important social issue. For many centuries, ginseng and its major active ingredients, ginsenosides and saponins, have been widely regarded as herbal medicines. Further, the anti-viral action of ginseng suggests its potential effectiveness as a therapeutic agent against COVID-19. Thus, the aim of this review was to examine the association of skin lesions with COVID-19 and the effect of ginseng as a therapeutic agent to treat skin diseases induced by COVID-19 infection. We classified COVID-19-related skin disorders into three categories: caused by inflammatory, immune, and complex (both inflammatory and immune) responses and evaluated the evidence for ginseng as a treatment for each category. This review offers comprehensive evidence on the improvement of skin disorders induced by SARS-CoV-2 infection using ginseng and its active constituents.
Collapse
Affiliation(s)
- Seoyoun Yang
- Molecular Dermatology Laboratory, Department of Integrative Biotechnology, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon, Republic of Korea
| | - Su Bin Han
- Molecular Dermatology Laboratory, Department of Integrative Biotechnology, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon, Republic of Korea
| | - Soohyun Kang
- Molecular Dermatology Laboratory, Department of Integrative Biotechnology, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon, Republic of Korea
| | - Junghyun Lee
- Molecular Dermatology Laboratory, Department of Integrative Biotechnology, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon, Republic of Korea
| | - Dongseon Kim
- Department of Integrative Biotechnology, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon, Republic of Korea
| | - Anastasiia Kozlova
- Department of Integrative Biotechnology, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon, Republic of Korea
| | - Minkyung Song
- T cell and Tumor Immunology Laboratory, Department of Integrative Biotechnology, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon, Republic of Korea,Corresponding author. T cell and Tumor Immunology Laboratory, Department of Integrative Biotechnology, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon City, 16419, Gyunggi Do, Republic of Korea
| | - See-Hyoung Park
- Department of Bio and Chemical Engineering, Hongik University, Sejong, Republic of Korea,Corresponding author. Department of Bio and Chemical Engineering, Hongik University, 30016, Sejong City, Republic of Korea
| | - Jongsung Lee
- Molecular Dermatology Laboratory, Department of Integrative Biotechnology, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon, Republic of Korea,Corresponding author. Molecular Dermatology Laboratory, Department of Integrative Biotechnology, College of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon City, 16419, Gyunggi Do, Republic of Korea
| |
Collapse
|
4
|
Sil A, Ghosh S, Das A, Chandra A. Transverse erythronychia: A unique nail manifestation of COVID-19 infection and brief review of COVID-19 associated nail changes. J R Coll Physicians Edinb 2022; 52:320-323. [PMID: 36476144 PMCID: PMC9742509 DOI: 10.1177/14782715221142559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Over the past 2 years, a plethora of mucocutaneous manifestations have been described to be associated with coronavirus 2019 (COVID-19) infection. Nail changes attributed to COVID-19 have rarely been documented in the literature. We describe here a unique nail finding 'transverse erythronychia' due to COVID-19 and review the literature on the diverse nail pathology attributed to the disease.
Collapse
Affiliation(s)
- Abheek Sil
- Department of Dermatology, Venereology,
and Leprosy, RG Kar Medical College and Hospital, Kolkata, India
| | - Shouvik Ghosh
- Department of Dermatology, Venereology,
and Leprosy, KPC Medical College and Hospital, Kolkata, India
| | - Anupam Das
- Department of Dermatology, Venereology,
and Leprosy, KPC Medical College and Hospital, Kolkata, India
| | - Atanu Chandra
- Department of Internal Medicine, RG Kar
Medical College and Hospital, Kolkata, India
| |
Collapse
|
5
|
Sivakumar A, Kumari R. When in doubt look up to the skies: A skywatchers perspective in dermatology. Indian J Dermatol Venereol Leprol 2022; 89:482-486. [DOI: 10.25259/ijdvl_824_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 02/01/2022] [Indexed: 11/04/2022]
|
6
|
Durmaz EÖ, Demircioğlu D. Fluorescence in the Sclera, Nails, and Teeth Secondary to Favipiravir Use for COVID-19 Infections. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2022; 15:35-37. [PMID: 35342504 PMCID: PMC8944284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Favipiravir, an antiviral agent originally used for influenza infections, has become popular due to its beneficial signals in coronavirus disease. It is currently used in some countries within COVID-19 treatment protocols. This is an initial report of favipiravir-related fluorescence observed in three healthcare providers working in the same ward in our hospital. All three individuals had been diagnosed with COVID-19 two months earlier and were treated with favipiravir. None of the three individuals received hydroxychloroquine or tetracyclines. Wood's light examination led to an incidental discovery of favipiravir-induced fluorescence involving the sclera, nails, and teeth. In all patients, white linear, square, and band-like specks of fluorescence were noticed on the sclera of both eyes, some teeth, and the proximal part of all fingernails and toenails. Exposure of the eyes to the Wood's light was for a brief duration of 3 to 5 seconds during examination and photodocumentation. Favipiravir might cause bright white fluorescence of nails, sclera, and teeth, detectable by Wood's light even two months after its cessation.
Collapse
Affiliation(s)
- Emel Öztürk Durmaz
- Drs. Durmaz and Demircioğlu are with the Acıbadem University School of Medicine in İstanbul, Turkey
| | - Deniz Demircioğlu
- Drs. Durmaz and Demircioğlu are with the Acıbadem University School of Medicine in İstanbul, Turkey
| |
Collapse
|
7
|
Çoban K, Durusoy Ç. The Nail and Hair Findings Developing In Patients Treated For COVID-19 Infection Flourescence of Keratinized Tissues on Wood's Lamp In COVID-19 Disease. J Cosmet Dermatol 2022; 21:1788-1795. [PMID: 35174612 DOI: 10.1111/jocd.14855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/11/2021] [Accepted: 01/28/2022] [Indexed: 11/28/2022]
Abstract
The new severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is the causative agent of coronavirus 2019 (COVID-2019) disease. A wide variety of symptoms of the disease have been frequently reported in the literature in recent years. However, information on the findings in keratinized tissues is stil limited. Data on changes in keratinized tissues such as nails, teeth and hair and oral mucousa due to drugs used in the treatment of this disease are also extremely insufficient. With this study, it was aimed to evaluate the changes in the keratinized tissues of our patients with COVID-19, who are frequently encountered in the Ear Nose and Throat outpatient clinic. The study was carried out on patients who applied to Başkent University Ear Nose and Throat clinic. There were 3 groups. The first group consisted of patients diagnosed with COVID-19 and received relevant medical treatments, the second group included individuals who have never experienced COVID-19 infection but have been vaccinated against COVID-19, and the third group is the control group with normal healthy individuals who have never been diagnosed with COVID-19 infection and have not been vaccinated so far. With the Wood's lamp, fluorescent changes in nails, hair, tooth and the oral mucousa were recorded. A total of 124(75 females, 49 males) patients were included in the study. Positive Wood's finding was significantly higher in COVID-19 group(Group 1) who received Favipravir when compared to individuals who did not receive Favipravir (p<0,001). Wood's positivity was not detected in any of the individuals who did not use favipravir. The rate of determining Wood's positivity in favipravir users decreases after 58 days. The adverse effects of the accumulation of the drugs- mainly Favipravir- used in the treatment of COVID-19 disease, have not yet been clearly demonstrated so far. Revealing the findings in these tissues with this study will pave the way for investigating changes or drug sequestrations in other organs in the long term.
Collapse
Affiliation(s)
- Kübra Çoban
- Başkent University Medical Faculty, Otorhinolaryngology Department
| | - Çiçek Durusoy
- Başkent University Medical Faculty, Dermatology Department
| |
Collapse
|
8
|
Kammoun N, Kouki C, Hammami F, Sellami K, Rekik M, Bahloul E, Chtioui E, Amouri M, Masmoudi A, Turki H. The red half-moon nail sign: a new case report. J Cosmet Dermatol 2022; 21:5248-5249. [PMID: 35166013 DOI: 10.1111/jocd.14850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 11/29/2022]
Affiliation(s)
- N Kammoun
- Department of Dermatology, Hedi Chaker Hospital, Sfax, Tunisia
| | - C Kouki
- Department of Dermatology, Hedi Chaker Hospital, Sfax, Tunisia
| | - F Hammami
- Department of Dermatology, Hedi Chaker Hospital, Sfax, Tunisia
| | - K Sellami
- Department of Dermatology, Hedi Chaker Hospital, Sfax, Tunisia
| | - M Rekik
- Department of Dermatology, Hedi Chaker Hospital, Sfax, Tunisia
| | - E Bahloul
- Department of Dermatology, Hedi Chaker Hospital, Sfax, Tunisia
| | - E Chtioui
- Department of Dermatology, Hedi Chaker Hospital, Sfax, Tunisia
| | - M Amouri
- Department of Dermatology, Hedi Chaker Hospital, Sfax, Tunisia
| | - A Masmoudi
- Department of Dermatology, Hedi Chaker Hospital, Sfax, Tunisia
| | - H Turki
- Department of Dermatology, Hedi Chaker Hospital, Sfax, Tunisia
| |
Collapse
|
9
|
Toader M, Branisteanu D, Glod M, Esanu I, Branisteanu C, Capsa MS, Dimitriu A, Nicolescu A, Pinzariu A, Branisteanu D. Mucocutaneous lesions associated with SARS‑CoV‑2 infection (Review). Exp Ther Med 2022; 23:258. [PMID: 35251324 PMCID: PMC8892620 DOI: 10.3892/etm.2022.11183] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/10/2021] [Indexed: 01/08/2023] Open
Abstract
The ongoing COVID-19 pandemic, declared by the World Health Organisation in March 2020, with the emergence of new, possibly more contagious and more virulent strains, remains a research subject, with the complex systemic involvement better described and understood, but also with a variety of skin and mucosal lesions described in the literature. Mucocutaneous lesions associated with SARS-CoV-2 infection are still under investigation, due to their polymorphic clinical aspect and incompletely understood pathogenic mechanism. The cutaneous inflammatory, exanthematous and purpuric rashes, erythemato-purpuric enanthems, oral ulcers, lichenoid oral lesions, conjunctivitis, conjunctival pseudomembranes, or corneal lesions have been described in patients with COVID-19. Several classifications have been proposed based on the clinical pattern, histological findings, and possible pathogenic mechanisms. The pathogenic mechanism, the diagnostic criteria, the prognostic importance of these lesions are still being debated. The diverse clinical aspects of dermatological manifestations render the diagnosis difficult. However, several clinical patterns strongly associated with COVID-19, such as chilblains, papulovesicular exanthems, and febrile rash require increased awareness and changes to the investigation protocols for these conditions, to include testing for SARS-CoV-2. In the present review, the mucocutaneous findings associated with the novel coronavirus infection, reported thus far in the literature, was provided.
Collapse
Affiliation(s)
- Mihaela Toader
- Department of Oral Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Daniel Branisteanu
- Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihai Glod
- Department of Surgery, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Irina Esanu
- Department of Internal Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | | | - Maria-Stefana Capsa
- Department of Dermatology, ‘Railway Clinical Hospital’, 700506 Iasi, Romania
| | - Andreea Dimitriu
- Department of Dermatology, ‘Arcadia’ Hospitals and Medical Centers, 700620 Iasi, Romania
| | - Alin Nicolescu
- Department of Dermatology, Roma Medical Center for Diagnosis and Treatment, 011773 Bucharest, Romania
| | - Alin Pinzariu
- Department of Physiology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Daciana Branisteanu
- Department of Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| |
Collapse
|
10
|
Tammaro A, Adebanjo GAR, Parisella FR, Luzi F, Scarabello A. The hair and nail manifestations of COVID-19. J Cosmet Dermatol 2022; 21:1339-1346. [PMID: 35032337 DOI: 10.1111/jocd.14774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/12/2021] [Accepted: 01/10/2022] [Indexed: 11/29/2022]
Abstract
Emerging literature evidence shows that the manifestations of the coronavirus disease 2019 (COVID-19), which is the disease caused by SARS-CoV-2, encompass alterations of the pulmonary, cardiovascular, gastrointestinal and neurological system. Moreover, hematologic and dermatologic manifestations have been documented. The aim of this review is to summarize the dermatologic manifestations of COVID-19 involving the hair and nails in a narrative way. A total of 1136 patients have been reported to have de-novo hair loss following COVID-19. Notably, 958 patients experienced telogen effluvium (TE) (female/male ratio = 3,86:1), two female patients experienced anagen effluvium and 176 people had alopecia areata (female/male ratio of 19:3). Ten patients were reported to have ungual changes following the infection with the novel coronavirus: the individuals affected were 6 women and 4 men. COVID-19 can be associated to hair and ungual manifestations. This review summarizes the evidence regarding the hair and ungual manifestations of COVID-19, which could be harnessed to better understand the clinical implications and pathophysiology of this disease that has been burdening society globally since December 2019.
Collapse
Affiliation(s)
- Antonella Tammaro
- NESMOS Dermatology Department, Sapienza University of Rome, Rome, Italy
| | | | | | - Fabiola Luzi
- NESMOS Dermatology Department, Sapienza University of Rome, Rome, Italy
| | | |
Collapse
|
11
|
Kumar A, Narayan RK, Prasoon P, Kumari C, Kaur G, Kumar S, Kulandhasamy M, Sesham K, Pareek V, Faiq MA, Pandey SN, Singh HN, Kant K, Shekhawat PS, Raza K, Kumar S. Mecanismos del COVID-19 en el cuerpo humano: Lo que sabemos hasta ahora. KOMPASS NEUMOLOGÍA 2022. [PMCID: PMC9059041 DOI: 10.1159/000521507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Ashutosh Kumar
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Departamento de Anatomía, (AIIMS), Patna, India
| | - Ravi K. Narayan
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Departamento de Anatomía, Instituto de Ciencias Médicas de las Islas Andamán y Nicobar, Port Blair, India
| | - Pranav Prasoon
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Centro de Investigación del Dolor de Pittsburgh, Facultad de Medicina, Universidad de Pittsburgh, Pittsburgh, Pennsylvania, Estados Unidos
| | - Chiman Kumari
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Departamento de Anatomía, Instituto de Posgrado de Educación e Investigación Médica (PGIMER), Chandigarh, India
| | - Gurjot Kaur
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Escuela de Ciencias Farmacéuticas, Universidad Shoolini, Solan, India
| | - Santosh Kumar
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Departamento de Anestesiología y Medicina Crítica, Escuela de Medicina, Universidad Johns Hopkins, Baltimore, Maryland, Estados Unidos
| | - Maheswari Kulandhasamy
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Departamento de Bioquímica, Colegio Médico Maulana Azad (MAMC), Nueva Delhi, India
| | - Kishore Sesham
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Departamento de Anatomía, Instituto de Ciencias Médicas de la India (AIIMS), Mangalagiri, Vijayawada, India
| | - Vikas Pareek
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Centro de Ciencias Cognitivas y del Cerebro, Instituto Indio de Tecnología Gandhinagar, Gandhinagar, Gujarat, India
| | - Muneeb A. Faiq
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Universidad de Nueva York (NYU) Langone Health Center, Escuela de Medicina Robert I. Grossman de la NYU, Nueva York, New York, Estados Unidos
| | - Sada N. Pandey
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Departamento de Zoología, Universidad Hindú de Banaras (BHU), Varanasi, India
| | - Himanshu N. Singh
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Departamento de Biología de Sistemas, Centro Médico Irving de la Universidad de Columbia, Nueva York, New York, Estados Unidos
| | - Kamla Kant
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Departamento de Microbiología, Instituto de Ciencias Médicas de la India (AIIMS), Bathinda, India
| | - Prakash S. Shekhawat
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Departamento de Hematología Clínica, Instituto Nacional de Ciencias Médicas, Jaipur, India
| | - Khursheed Raza
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Departamento de Anatomía, Instituto de Ciencias Médicas de la India (AIIMS), Deoghar, India
| | - Sujeet Kumar
- Red de Investigación de Trastornos Etiológicamente Elusivos (EEDRN), Nueva Delhi, India
- Centro de Proteómica y Desarrollo de Fármacos, Instituto de Biotecnología Amity, Universidad Amity, Maharashtra, India
| |
Collapse
|
12
|
Thakur V, Bisht YS, Sethi S, Jindal R. Red nail bands in conjunction with telogen effluvium as a post-COVID-19 phenomenon. Australas J Dermatol 2021; 63:141-142. [PMID: 34958136 DOI: 10.1111/ajd.13779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/17/2021] [Accepted: 12/07/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Vishal Thakur
- Department of Dermatology, Venereology, and Leprosy, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Yashwant Singh Bisht
- Department of Dermatology, Venereology, and Leprosy, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Sheenam Sethi
- Department of Dermatology, Venereology, and Leprosy, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Rashmi Jindal
- Department of Dermatology, Venereology, and Leprosy, Himalayan Institute of Medical Sciences, Dehradun, India
| |
Collapse
|
13
|
Seque CA, Enokihara MMSES, Porro AM, Tomimori J. Skin manifestations associated with COVID-19. An Bras Dermatol 2021; 97:75-88. [PMID: 34857407 PMCID: PMC8577992 DOI: 10.1016/j.abd.2021.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/20/2021] [Accepted: 08/22/2021] [Indexed: 01/08/2023] Open
Abstract
This article will address the main aspects of skin manifestations associated with COVID-19, based on a review of the literature published to date. Since the beginning of the pandemic, more than 1,500 articles have been published on the subject. Regarding the pathophysiology, it is believed that the same mechanisms responsible for the disease in the main target organs also act in the skin, although they are not yet fully elucidated. The actual frequency of dermatological manifestations remains uncertain – it can range from 0.2% to 45%, being close to 6% in systematic reviews. Pioneering studies of large case series conducted in European countries and the USA provide the first information on the main skin manifestations associated with COVID-19 and propose classifications regarding their clinical presentation, pathophysiology, as well as their frequencies. Although there is yet no consensus, maculopapular eruptions are considered the most frequent presentations, followed by erythema pernio-like (EPL) lesions. Manifestations such as urticaria, vesicular conditions and livedo/purpura/necrosis are rare. The time of onset, severity, need for specific treatment and prognosis vary according to the clinical presentation pattern. The increasing histopathological description of skin conditions can contribute to the diagnosis, as well as to the understanding of the pathophysiology. Also, in the dermatological field, the relationship between COVID-19 and androgens has been increasingly studied. Despite all the generated knowledge, the actual biological meaning of skin manifestations remains uncertain. Therefore, the exclusion of the main differential diagnoses is essential for the correlation between skin manifestation and COVID-19.
Collapse
Affiliation(s)
- Camila Arai Seque
- Department of Dermatology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | | | - Adriana Maria Porro
- Department of Dermatology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Jane Tomimori
- Department of Dermatology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
14
|
Kumar A, Narayan RK, Prasoon P, Kumari C, Kaur G, Kumar S, Kulandhasamy M, Sesham K, Pareek V, Faiq MA, Pandey SN, Singh HN, Kant K, Shekhawat PS, Raza K, Kumar S. COVID-19 Mechanisms in the Human Body-What We Know So Far. Front Immunol 2021; 12:693938. [PMID: 34790191 PMCID: PMC8592035 DOI: 10.3389/fimmu.2021.693938] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 10/11/2021] [Indexed: 01/08/2023] Open
Abstract
More than one and a half years have elapsed since the commencement of the coronavirus disease 2019 (COVID-19) pandemic, and the world is struggling to contain it. Being caused by a previously unknown virus, in the initial period, there had been an extreme paucity of knowledge about the disease mechanisms, which hampered preventive and therapeutic measures against COVID-19. In an endeavor to understand the pathogenic mechanisms, extensive experimental studies have been conducted across the globe involving cell culture-based experiments, human tissue organoids, and animal models, targeted to various aspects of the disease, viz., viral properties, tissue tropism and organ-specific pathogenesis, involvement of physiological systems, and the human immune response against the infection. The vastly accumulated scientific knowledge on all aspects of COVID-19 has currently changed the scenario from great despair to hope. Even though spectacular progress has been made in all of these aspects, multiple knowledge gaps are remaining that need to be addressed in future studies. Moreover, multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have emerged across the globe since the onset of the first COVID-19 wave, with seemingly greater transmissibility/virulence and immune escape capabilities than the wild-type strain. In this review, we narrate the progress made since the commencement of the pandemic regarding the knowledge on COVID-19 mechanisms in the human body, including virus-host interactions, pulmonary and other systemic manifestations, immunological dysregulations, complications, host-specific vulnerability, and long-term health consequences in the survivors. Additionally, we provide a brief review of the current evidence explaining molecular mechanisms imparting greater transmissibility and virulence and immune escape capabilities to the emerging SARS-CoV-2 variants.
Collapse
Affiliation(s)
- Ashutosh Kumar
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Patna, India
| | - Ravi K. Narayan
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- Department of Anatomy, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, India
| | - Pranav Prasoon
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- Pittsburgh Center for Pain Research, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Chiman Kumari
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- Department of Anatomy, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Gurjot Kaur
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- School of Pharmaceutical Sciences, Shoolini University, Solan, India
| | - Santosh Kumar
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- Department of Anesthesiology and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Maheswari Kulandhasamy
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- Department of Biochemistry, Maulana Azad Medical College (MAMC), New Delhi, India
| | - Kishore Sesham
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Vijayawada, India
| | - Vikas Pareek
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- Center for Cognitive and Brain Sciences, Indian Institute of Technology Gandhinagar, Gandhinagar, Gujarat, India
| | - Muneeb A. Faiq
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- New York University (NYU) Langone Health Center, NYU Robert I. Grossman School of Medicine, New York, NY, United States
| | - Sada N. Pandey
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- Department of Zoology, Banaras Hindu University (BHU), Varanasi, India
| | - Himanshu N. Singh
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- Department of Systems Biology, Columbia University Irving Medical Center, New York, NY, United States
| | - Kamla Kant
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bathinda, India
| | - Prakash S. Shekhawat
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- Department of Clinical Hematology, National Institute of Medical Sciences, Jaipur, India
| | - Khursheed Raza
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Deoghar, India
| | - Sujeet Kumar
- Etiologically Elusive Disorders Research Network (EEDRN), New Delhi, India
- Center for Proteomics and Drug Discovery, Amity Institute of Biotechnology, Amity University, Maharashtra, India
| |
Collapse
|
15
|
Yanatma I, Cenk H. Evaluation of Nail Findings in Patients with COVID-19 History and Wood's Lamp Examination. Skin Appendage Disord 2021; 38:1-6. [PMID: 34934766 PMCID: PMC8678237 DOI: 10.1159/000518983] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 08/06/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction Various skin findings due to coronavirus have been identified. There are a few case reports on nail findings after coronavirus (COVID-19) infection. We aimed to document the nail findings of the COVID-19 survivors and shed light on the interesting luminescence seen under the Wood's light. Methods One hundred and seventy-four patients diagnosed with COVID-19 infection in the last 100 days were grouped in terms of the agents used in the treatment. Fifty-seven volunteers without a history of infection were included. Results Patients treated with favipiravir had a significantly higher positivity of luminescence (p: 0.0001). The most common nail findings in patients were splinter hemorrhage (13%), followed by leukonychia (12%) and longitudinal ridges (7.9%). Discussion/Conclusions The luminescence may be seen due to the accumulation of favipiravir or its excipients (titanium dioxide and yellow ferric oxide) on the nails. Wood's lamp examination of the plasma taken from a patient after favipiravir's first dose revealed the same luminescence as we saw on the nails. Accordingly, this accumulation may be seen in the vital organs. Although our knowledge about the virus increases day by day, the potentially hazardous effects of the virus and long-term complications of the treatment options are still being investigated.
Collapse
Affiliation(s)
- Irem Yanatma
- Department of Dermatology, Seydisehir State Hospital, Konya, Turkey
| | - Hulya Cenk
- Department of Dermatology, Pamukkale University, Denizli, Turkey
| |
Collapse
|
16
|
Farajzadeh S, Khalili M, Dehghani S, Babaie S, Fattah M, Abtahi-Naeini B. Top 10 acral skin manifestations associated with COVID-19: A scoping review. Dermatol Ther 2021; 34:e15157. [PMID: 34628708 PMCID: PMC8646918 DOI: 10.1111/dth.15157] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 12/29/2022]
Abstract
COVID‐19‐associated cutaneous manifestations are one of the most important and relatively common extra‐respiratory presentations of SARS‐COV‐2 infection. The exact identification and classification of these lesions can facilitate the accurate diagnosis and treatment. There are several case reports and small case series which describe cutaneous lesions in hands and feet. Currently, there is no scoping review about acral skin manifestations associated with COVID‐19. This paper covers the COVID‐related acral skin manifestations in 10 entities including acral papulo‐vesicular eruption, acral urticarial lesion, acral non‐inflammatory purpura and necrosis, acro‐ischemia associated COVID‐19, acral vasculitis, chilblain‐like lesion (COVID Toe), acral erythema multiform (EM) like lesion, hand and foot skin lesions associated with multisystem inflammatory syndrome in children (MISC), acral peeling conditions and red half‐moon nail sign. Future studies should focus on exact investigation of etiologies of these lesions including role of immune senescence, environment, gender, immunogenetics and relation of these lesion with major organ involvements.
Collapse
Affiliation(s)
- Saeedeh Farajzadeh
- Pediatric Dermatology Department, Kerman university of Medical Science, Kerman, Iran
| | - Maryam Khalili
- Pediatric Dermatology Department, Kerman university of Medical Science, Kerman, Iran
| | - Shakiba Dehghani
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sharareh Babaie
- Department of Pediatric Intensive Care Unit, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Child Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahdi Fattah
- Department of Dermatology, Sulaimani Center for Skin Disease Treatment, Sulaimani, Iraq
| | - Bahareh Abtahi-Naeini
- Pediatric Dermatology Division of Department of Pediatrics, Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.,Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
17
|
Mohseni Afshar Z, Babazadeh A, Hasanpour A, Barary M, Sayad B, Janbakhsh A, Aryanian Z, Ebrahimpour S. Dermatological manifestations associated with COVID-19: A comprehensive review of the current knowledge. J Med Virol 2021; 93:5756-5767. [PMID: 34241899 PMCID: PMC8427109 DOI: 10.1002/jmv.27187] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023]
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a significant health problem globally. The virus has spread widely and become a global pandemic. The pathophysiology for SARS-CoV-2 has not been explained clearly. It has been associated with several multiorgan symptoms, among which its dermatological manifestations are of great interest. Primarily, there has been no report of skin features among COVID-19 patients. Nevertheless, recently there have been several reports regarding COVID-19 patients who presented with cutaneous manifestations. In the current review, we focus on the various cutaneous manifestations of COVID-19 infection.
Collapse
Affiliation(s)
- Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
| | | | - Mohammad Barary
- Student Research CommitteeBabol University of Medical SciencesBabolIran
| | - Babak Sayad
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Alireza Janbakhsh
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
- Department of Dermatology, School of MedicineBabol University of Medical SciencesBabolIran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
| |
Collapse
|
18
|
Fernández-Lázaro D, Garrosa M. Identification, Mechanism, and Treatment of Skin Lesions in COVID-19: A Review. Viruses 2021; 13:1916. [PMID: 34696346 PMCID: PMC8540564 DOI: 10.3390/v13101916] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/12/2021] [Accepted: 09/20/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a multisystem disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), that primarily causes respiratory symptoms. However, an increasing number of cutaneous manifestations associated with this disease have been reported. The aim of this study is to analyze the scientific literature on cutaneous manifestations associated with SARS-CoV-2 by means of a narrative literature review until June 2021. The search was conducted in the following electronic databases: Medline (PubMed), SciELO, and Cochrane Library Plus. The most common cutaneous manifestations in patients with COVID-19 are vesicular eruptions, petechial/purpuric rashes, acral lesions, liveoid lesions, urticarial rash, and maculopapular-erythematous rash. These manifestations may be the first presenting symptoms of SARS-CoV-2 infection, as is the case with acral lesions, vesicular eruptions, and urticaria. In relation to severity, the presence of liveoid lesions may be associated with a more severe course of the disease. Treatment used for dermatological lesions includes therapy with anticoagulants, corticosteroids, and antihistamines. Knowledge of the dermatologic manifestations associated with SARS-CoV-2 contributes to the diagnosis of COVID-19 in patients with skin lesions associated with respiratory symptoms or in asymptomatic patients. In addition, understanding the dermatologic lesions associated with COVID-19 could be useful to establish a personalized care plan.
Collapse
Affiliation(s)
- Diego Fernández-Lázaro
- Department of Cellular Biology, Histology and Pharmacology, Faculty of Health Sciences, University of Valladolid, Campus of Soria, 42004 Soria, Spain
- Neurobiology Research Group, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain;
| | - Manuel Garrosa
- Neurobiology Research Group, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain;
- Area of Histology, Faculty of Medicine, Institute of Neurosciences of Castile and Leon (INCYL), University of Valladolid, 47005 Valladolid, Spain
| |
Collapse
|
19
|
Yin H, Wang S, Yu Y, Chen S, Lu L. Moving nail bands in systemic lupus erythematosus. J Eur Acad Dermatol Venereol 2021; 36:e130-e132. [PMID: 34553792 DOI: 10.1111/jdv.17695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/15/2021] [Indexed: 11/29/2022]
Affiliation(s)
- H Yin
- Department of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - S Wang
- Department of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y Yu
- Department of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - S Chen
- Department of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - L Lu
- Department of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
20
|
Preda-Naumescu A, Penney K, Pearlman RL, Brodell RT, Daniel CR, Nahar VK. Nail Manifestations in COVID-19: Insight into a Systemic Viral Disease. Skin Appendage Disord 2021; 183:1-6. [PMID: 34580633 PMCID: PMC8450840 DOI: 10.1159/000518087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/21/2021] [Indexed: 11/21/2022] Open
Abstract
Nail manifestations are 1 of the several extrapulmonary findings associated with COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Nail changes, however, have been largely ignored and not yet summarized. This article is intended to increase awareness of nail manifestations of SARS-CoV-2, which occur weeks to months after acute infection and the periungual pernio-like changes may occur concomitantly with infection. An electronic search was carried out in PubMed (Medline), Science Direct, and Scopus databases. The following keywords and all of their possible combinations were used to identify studies: “SARS-CoV-2,” “COVID-19,” “Coronavirus,” “2019-ncov,” “nail,” and “nails.” Six case reports were included in this study. Manifestations identified included red half-moon sign, transverse orange nail lesions, Mees' lines, and Beau's lines. Though largely nonspecific, these findings can be recognized with the onset of symptom onset or as late as 16 weeks following the disease. Some of these findings are shared with other conditions associated with a proinflammatory state. Nail changes offer unique insight into the pathophysiologic basis for SARS-CoV-2 and they may serve as diagnostic clues.
Collapse
Affiliation(s)
- Ana Preda-Naumescu
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Kayla Penney
- LSU Health Shreveport School of Medicine, Shreveport, Louisiana, USA
| | - Ross L Pearlman
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Robert T Brodell
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Carlton Ralph Daniel
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Vinayak K Nahar
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.,Department of Preventive Medicine, School of Medicine/John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA
| |
Collapse
|
21
|
Wollina U, Kanitakis J, Baran R. Nails and COVID-19 - A comprehensive review of clinical findings and treatment. Dermatol Ther 2021; 34:e15100. [PMID: 34398500 PMCID: PMC8420555 DOI: 10.1111/dth.15100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/01/2021] [Accepted: 08/13/2021] [Indexed: 12/19/2022]
Abstract
The SARS‐CoV‐2 infection, responsible for COVID‐19, has raised the interest for infection‐associated muco‐cutaneous symptoms. While dermatologic symptoms in general gained an increasing awareness, affection of the nail organ has been mentioned only recently. We provide a narrative review on COVID‐19 manifestation on the nail organ and add symptoms induced by personal protective measures and SARS‐CoV‐2 vaccination. Available treatment options are discussed.
Collapse
Affiliation(s)
- Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Dresden, Germany
| | - Jean Kanitakis
- Dermatology Department, Edouard Herriot Hospital Group, (Pav. R), Hospices Civils de Lyon, Lyon, France
| | - Robert Baran
- Dermatology, Nail Disease Center, Cannes, France
| |
Collapse
|
22
|
Ceccarelli MA, Nakamura RC, Canella C. Multiple retronychia following COVID-19 infection. VISUAL JOURNAL OF EMERGENCY MEDICINE 2021; 24:101087. [PMID: 34307903 PMCID: PMC8279508 DOI: 10.1016/j.visj.2021.101087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/01/2021] [Accepted: 06/29/2021] [Indexed: 11/26/2022]
|
23
|
Patient Recovery from COVID-19 Infections: Follow-Up of Hair, Nail, and Cutaneous Manifestations. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5595016. [PMID: 34258268 PMCID: PMC8238562 DOI: 10.1155/2021/5595016] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 06/09/2021] [Indexed: 11/17/2022]
Abstract
Background COVID-19 is a pandemic disease worldwide. Although cutaneous manifestations may present in affected patients, there have been limited studies on the cutaneous findings and hair and nail abnormalities after discharge. Objective To establish the cutaneous manifestations, hair and scalp disorders, and nail abnormalities in patients who recovered from COVID-19 infections. Methods A retrospective chart review and telephone interviews were conducted to determine the cutaneous manifestations, hair and scalp disorders, and nail abnormalities of patients aged over 18 years who were diagnosed with COVID-19 infections at Siriraj Hospital, Bangkok, Thailand, between January and June 2020. Results Ninety-three patients with prior COVID-19 infections participated in the study. The COVID-19 severity had been mild for most (71%). Cutaneous manifestations were reported in 8 patients (8.6%), with the common skin conditions being maculopapular rash and urticaria. The onsets of the skin conditions were before admission (1%), during admission (4.3%), and after discharge (3.2%). Increased hair shedding was also reported in 22 patients (23.7%), with a female predominance. Three patients were affected during admission, while the others were affected after discharge. The patients with moderate, severe, and critical COVID-19 infections experienced significantly more hair shedding than those with asymptomatic and mild diseases. Only 2 patients with mild COVID-19 disease reported nail abnormalities (chromonychia and brittle nails). Conclusions Cutaneous manifestations, hair disorders, and nail abnormalities can occur in patients with COVID-19 after their discharge from hospital. Patients should therefore be followed up in anticipation of dermatological problems.
Collapse
|
24
|
Hadeler E, Morrison BW, Tosti A. A review of nail findings associated with COVID-19 infection. J Eur Acad Dermatol Venereol 2021; 35:e699-e709. [PMID: 34131957 PMCID: PMC8447455 DOI: 10.1111/jdv.17448] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/20/2021] [Accepted: 06/10/2021] [Indexed: 01/08/2023]
Affiliation(s)
- E Hadeler
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - B W Morrison
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - A Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
25
|
Akl J, El-Kehdy J, Salloum A, Benedetto A, Karam P. Skin disorders associated with the COVID-19 pandemic: A review. J Cosmet Dermatol 2021; 20:3105-3115. [PMID: 34077629 PMCID: PMC8242622 DOI: 10.1111/jocd.14266] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/26/2021] [Indexed: 12/16/2022]
Abstract
Introduction In December 2019, a new coronavirus has emerged out of China, the SARS‐CoV‐2 virus, causing a disease known as COVID‐19, which steadily has progressed into a pandemic. This coronavirus affects many organs, including the skin, whose manifestations are a consequence of the disease itself, as well as the preventative measures taken to avoid the infection. This paper reviews the cutaneous manifestations which currently have been encountered during this pandemic. Methods A search was conducted on PubMed, and all relevant articles were included. Results The results show the occurrence of many cutaneous findings, ranging from those related to the infection itself and to various dermatitides related to the use of personal protective equipment (PPE) utilized by healthcare workers while attending to infected patients. Discussion Recognizing these findings is important for the accurate diagnosis of those infected with COVID‐19 as well as the prompt treatment of the side effects caused by PPE that might further impair the effectiveness of healthcare workers.
Collapse
Affiliation(s)
- Jennifer Akl
- Department of Dermatology, Saint George Hospital University Medical Center, Beirut, Lebanon.,Faculty of Medicine, University of Balamand, Beirut, Lebanon
| | - Jessica El-Kehdy
- Department of Dermatology, Saint George Hospital University Medical Center, Beirut, Lebanon.,Faculty of Medicine, University of Balamand, Beirut, Lebanon
| | - Antoine Salloum
- Department of Dermatology, Saint George Hospital University Medical Center, Beirut, Lebanon.,Faculty of Medicine, University of Balamand, Beirut, Lebanon.,Dermatologic SurgiCenter, Philadelphia, PA, USA
| | - Anthony Benedetto
- Dermatologic SurgiCenter, Philadelphia, PA, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Paula Karam
- Department of Dermatology, Saint George Hospital University Medical Center, Beirut, Lebanon.,Faculty of Medicine, University of Balamand, Beirut, Lebanon
| |
Collapse
|
26
|
Gülseren D, Yalıcı-Armagan B. Yellow-white fluorescence on the nails: A novel finding of Favipiravir used for the treatment of COVID-19. J Cosmet Dermatol 2021; 20:2392-2393. [PMID: 33978291 PMCID: PMC8242614 DOI: 10.1111/jocd.14214] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/21/2021] [Accepted: 04/28/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Duygu Gülseren
- Department of Dermatology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Başak Yalıcı-Armagan
- Department of Dermatology, School of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
27
|
Demir B, Yuksel EI, Cicek D, Turkoglu S. Heterogeneous red-white discoloration of the nail bed and distal onycholysis in a patient with COVID-19. J Eur Acad Dermatol Venereol 2021; 35:e551-e553. [PMID: 33987893 PMCID: PMC8242612 DOI: 10.1111/jdv.17347] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- B Demir
- Department of Dermatology, Firat University Hospital, Elazig, Turkey
| | - E I Yuksel
- Department of Dermatology, Firat University Hospital, Elazig, Turkey
| | - D Cicek
- Department of Dermatology, Firat University Hospital, Elazig, Turkey
| | - S Turkoglu
- Department of Dermatology, Firat University Hospital, Elazig, Turkey
| |
Collapse
|
28
|
Panda M, Dash S, Behera B, Sil A. Dermatological Manifestations Associated with COVID-19 Infection. Indian J Dermatol 2021; 66:237-245. [PMID: 34446946 PMCID: PMC8375538 DOI: 10.4103/ijd.ijd_464_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) causing the 2019 coronavirus disease (COVID-19) has infected millions in recent years and is a major public health concern. Various cutaneous manifestations of the COVID-19 disease have been identified. Skin is a mirror to internal disease and can be the presenting sign of COVID-19 disease. Several cutaneous manifestations can indicate severe COVID-19 disease. In the present scenario, physicians should know the various cutaneous manifestations of COVID-19 disease for early diagnosis and proper management of the disease.
Collapse
Affiliation(s)
- Maitreyee Panda
- Department of Skin and VD, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Siddhartha Dash
- Department of Skin and VD, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, Odisha, India
| | - Biswanath Behera
- Department of Skin and VD, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, Odisha, India
| | - Abheek Sil
- Department of Dermatology, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
| |
Collapse
|
29
|
Ocampo-Garza SS, Ocampo-Candiani J, Camela E, Vastarella M, Fabbrocini G, Scalvenzi M, Villani A. Nail changes as manifestation of systemic disease in COVID-19 infection. J Eur Acad Dermatol Venereol 2021; 35:e474-e475. [PMID: 33830556 PMCID: PMC8251398 DOI: 10.1111/jdv.17273] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/22/2021] [Indexed: 12/17/2022]
Affiliation(s)
- S S Ocampo-Garza
- Departamento de Dermatología, Universidad Autónoma de Nuevo León, Hospital Universitario ¨Dr. José Eleuterio González¨, Monterrey, Nuevo León, México.,Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - J Ocampo-Candiani
- Departamento de Dermatología, Universidad Autónoma de Nuevo León, Hospital Universitario ¨Dr. José Eleuterio González¨, Monterrey, Nuevo León, México
| | - E Camela
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - M Vastarella
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - G Fabbrocini
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - M Scalvenzi
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - A Villani
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| |
Collapse
|
30
|
Tammaro A, Adebanjo GAR, Erasmus HP, Chello C, Pezzuto A, Ramirez-Estrada S, Rello J. Transverse orange nail lesions following SARS-CoV-2 infection. Dermatol Ther 2020; 34:e14688. [PMID: 33340203 PMCID: PMC7883228 DOI: 10.1111/dth.14688] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/10/2020] [Accepted: 12/16/2020] [Indexed: 01/10/2023]
Affiliation(s)
- Antonella Tammaro
- NESMOS, Dermatology Department, Sapienza University of Rome, Rome, Italy
| | | | - Hans-Peter Erasmus
- Department of Internal Medicine, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Camilla Chello
- NESMOS, Dermatology Department, Sapienza University of Rome, Rome, Italy
| | - Aldo Pezzuto
- Department of Cardiovascular-Respiratory Science, Sant'Andrea Hospital-Sapienza University of Rome, Rome, Italy
| | | | - Jordi Rello
- Centro de Investigación Biomedica en Red de Enfermedades Respirorias (CIBERES), Instituto Salud Carlos III, Madrid, Spain.,Clinical Research/Epidemiology in Pneumonia and Sepsis (CRIPS), Vall d'Hebron Institut of Research (VHIR), Barcelona, Spain.,Clinical Research, CHU Nîmes, Université Montpellier-Nimes, Nîmes, France
| |
Collapse
|
31
|
Lavery MJ, Bouvier CA, Thompson B. Cutaneous manifestations of COVID-19 in children (and adults): A virus that does not discriminate. Clin Dermatol 2020; 39:323-328. [PMID: 34272030 PMCID: PMC7604214 DOI: 10.1016/j.clindermatol.2020.10.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a beta coronavirus with a characteristic S-glycoprotein spike on the cell surface. Initial reports did not include cutaneous manifestations as a feature of COVID-19; however, there is a growing repertoire of reports demonstrating an array of dermatologic manifestations on the skin in children and adults. Dermatologic afflictions have been summarized into different categories several times, with the most recent analysis identifying six clinical patterns: urticaria, maculopapular-morbilliform eruption, papulovesicular exanthem, chilblain-like acral pattern, livedo reticularis-livedo racemosa pattern, and purpuric vasculitic pattern. In children, the dermatologic features appear to occur before or concomitantly with other COVID-19 manifestations. Dermatologists play a key role in diagnosing patients with COVID-19 who may present for the first time unwittingly exhibiting early signs of COVID-19. We have reviewed the current evidence on the dermatologic impact of COVID-19 in both the adult and pediatric populations.
Collapse
Affiliation(s)
- Michael Joseph Lavery
- Department of Dermatology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom; Department of Dermatology, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, United Kingdom.
| | - Charles Alexis Bouvier
- Department of Pediatrics, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Ben Thompson
- Department of Dermatology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom; Department of Dermatology, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, United Kingdom
| |
Collapse
|
32
|
Méndez-Flores S, Zaladonis A, Valdes-Rodriguez R. COVID-19 and nail manifestation: be on the lookout for the red half-moon nail sign. Int J Dermatol 2020; 59:1414. [PMID: 32860426 DOI: 10.1111/ijd.15167] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 02/03/2023]
Affiliation(s)
- Silvia Méndez-Flores
- Department of Dermatology, Instituto Nacional de Ciencias Médicas y Nutrición, Mexico City, Mexico
| | - Angela Zaladonis
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | | |
Collapse
|
33
|
Kaya G, Kaya A, Saurat JH. Clinical and Histopathological Features and Potential Pathological Mechanisms of Skin Lesions in COVID-19: Review of the Literature. Dermatopathology (Basel) 2020; 7:3-16. [PMID: 32608380 PMCID: PMC7583593 DOI: 10.3390/dermatopathology7010002] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 06/28/2020] [Accepted: 06/29/2020] [Indexed: 02/07/2023] Open
Abstract
In recent weeks, several reports have emerged of skin lesions with different clinical presentations in COVID-19 cases. All dermatologists should be aware of these cutaneous lesions, which may be early clinical symptoms of infection. We reviewed the literature on cutaneous manifestations in the PubMed database from December 2019 and June 2020. From the cases described as case reports or series in 57 recent articles, it appears that skin lesions (i) are highly varied, (ii) may not be related to the severity of the condition and (iii) resolve spontaneously in a few days. The frequency of these lesions in COVID-19 patients varies between 1.8% and 20.4%. The major clinical forms described were maculopapular eruptions, acral areas of erythema with vesicles or pustules (pseudochilblain), urticarial lesions, other vesicular eruptions and livedo or necrosis. The lesions were mainly localized in the trunk and extremities. The majority of patients were male, aged between 4.5 and 89 years. A minority of the patients were children presenting with acral, chilblain-like lesions, papulo-vesicular eruptions or Kawasaki disease-like pediatric inflammatory multisystem syndrome. The mean duration of the lesions was a few days, but some lasting as little as 20 min and others as long as four weeks have been reported. The mean latency time in the majority of cases was between 1 and 14 days; however, in some patients, lesions appeared 2 to 5 days before the onset of COVID-19 symptoms. The histopathological features of these lesions also vary, corresponding to the diversity of clinical manifestations. These features underline the nature of epidermal and dermal vascular lesions-and in severe cases, microvascular injury and thrombosis-associated with COVID-19, and provide important clues to their pathological mechanisms.
Collapse
Affiliation(s)
- Gürkan Kaya
- Departments of Dermatology and Clinical Pathology, University Hospital of Geneva, 1205 Geneva, Switzerland
| | - Aysin Kaya
- Department of Clinical Pharmacology and Toxicology, University of Geneva, 1205 Geneva, Switzerland; (A.K.); (J.-H.S.)
| | - Jean-Hilaire Saurat
- Department of Clinical Pharmacology and Toxicology, University of Geneva, 1205 Geneva, Switzerland; (A.K.); (J.-H.S.)
| |
Collapse
|