Background SARS-Cov-2 is a single-stranded RNA virus, a Betacoronavirus, composed of 16 non-structural proteins, with specific 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 different 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, diffuse 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 flexural exanthema (SDRIFE) and others. Conclusions This review describes the complexity of Covid-19, pathophysiological and clinical aspects, dermatological finding and other dermatological conditions associated with SARS-CoV-2 infection or COVID-19.

Chronic spontaneous urticaria exacerbation in a patient with COVID-19: rapid and excellent response to omalizumab Dear Editor, During the COVID-19 pandemic, physicians may not feel comfortable managing dermatological conditions with biological agents. No literature describing behavior of pre-existing chronic spontaneous urticaria (CSU) in COVID-19 patients has been reported up to June 20, 2020, in PubMed. We present a 54-year-old female with CSU and angioedema since September 2019. Her medical history was negative for use of nonsteroidal anti-inflammatory drugs or analgesics, and atopic diathesis (asthma, rhinitis, or dermatitis). Full urticaria work-up including C-reactive protein, serum IgE, complete blood count, D-dimer, thyroid, renal, and hepatic profile were within normal limits. At initial visit, uriticaria activity score (UAS) = 6 and urticaria control test (UCT) = 0, demonstrating severe CSU. She had previously failed levocetirizine 15 mg daily. After starting bilastine 80 mg daily, CSU activity decreased to UAS7 (UAS 7 days score = 06 and UCT = 12). In

This study presents a single center experience with livedoid vasculopathy (LV). A rare disease that can lead to severe quality of life impairment. Characterize clinical data of LV patients at the Dermatology Division at the University of São Paulo. A retrospective and transversal study was conducted, from 1 January 2005 to 31 December 2019. About 75 patients diagnosed as LV and confirmed by skin biopsy were included. Epidemiology, clinical appearance, histopathology data, and treatment history were observed. There were 78.66% Caucasian women, with a mean age of 39.9 years. Frequent cutaneous manifestations were ulcers, atrophic blanche-like scars, hyperpigmentation, purpuras, telangiectasias, and livedo racemosa. Pain, pruritus, and hypoesthesia were the main symptoms. After treatment, almost 40% of

Although the study involved a small number of patients, it has proved the technique to be feasible, easy to perform, and have the combined benefits of laparoscopic and open surgery. The results, shown by CT-scan, peri-operative, and QOL findings, were good.

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