Introduction Because of the increasing emergence of skin manifestations of the coronavirus disease 2019 (COVID-19) worldwide, we investigated the published reports of these lesions. Methods We conducted a literature search for original and review articles published from November 11, 2019, to September 30, 2020. Results We determined five skin lesions common in patients with COVID-19: pseudo-chilblains, maculopapular, urticarial, vesicular, and vaso-occlusive lesions. These lesions manifest at various times in relation to COVID-19 symptoms, which may indicate whether the lesions are virus-induced or are delayed immunological responses to the infection. Skin lesions are more prevalent among Europeans and US residents than among Asians, as is pseudo-chilblain, and the morphology of the skin lesions varies between continents. Pseudo-chilblains are the most common COVID-19 skin manifestation in Europe and the United States, but there is only one reported case from Asian populations. Additionally, patients with vaso-occlusive lesions are more likely than those with pseudo-chilblains to be admitted to the intensive care unit and to die. Conclusion Different cutaneous manifestations in patients with COVID-19 could reflect a wide spectrum of viral interactions with the skin, though reporting bias may play a role as well.
Background Teledermatology (TD) has emerged as a critical way of delivering care remotely in the COVID-19 pandemic. Objective We conducted a systematic review to assess how TD has been implemented worldwide. Methods We searched PubMed, SCOPUS, EMBASE, Web of Science and Google Scholar for articles on the use of TD for patient care, written in English and published from December 1 st 2019 to October 15 th 2020. Results 27 studies were included, involving 16,981 patients. There was significant uptake of TD during the pandemic. Synchronous TD appeared to be more commonly implemented than asynchronous TD. Common ambulatory dermatoses such as acne or eczema were reported to be more amenable to TD assessment and management. TD also appeared to be useful for the diagnosis of cutaneous involvement of COVID-19 infection and follow-up of stable onco-dermatology cases. Limitations Pooled analysis of all relevant outcomes was not always possible due to the heterogeneity in methodologies of included studies. Conclusions TD is a useful and convenient tool for the management of common ambulatory dermatoses in the COVID-19 pandemic.
Erysipelas and uncomplicated cellulitis are common infections that tend to recur in a substantial proportion of affected patients following an initial episode, especially if the predisposing condition is chronic lymphedema. All patients who suffer an episode of cellulitis should be carefully evaluated to establish the risk of recurrence. Several predisposing conditions (such as lymphedema and skin conditions that serve as a portal of entry for bacteria) can be effectively treated in order to reduce the risk of relapse. The medical literature provides convincing evidence that antimicrobial prophylaxis can markedly reduce the frequency of relapse of erysipelas. Two recent studies performed by the 'Prophylactic Antibiotics for the Treatment of Cellulitis at Home' (PATCH) group have clearly confirmed the efficacy of antimicrobial prophylaxis. Penicillin remains the drug of choice. Treatment options in patients with penicillin allergy are limited by the rising prevalence of macrolide resistance among group A streptococci. Further research is required to clarify the optimal penicillin regimen as well as to develop new therapies for patients with allergy to penicillin.
Background: Previous analysis showed that the incidence rates of skin cancer in Singapore increased from 1968 to 2006, especially among older Chinese, and particularly for basal cell carcinoma (BCC).Objective: We updated the skin cancer incidence rates and time trends among the Chinese, Malays, and Indians in Singapore.Methods: We analyzed the skin cancer incidence from the nationwide Singapore Cancer Registry from 1968 to 2016.Results: Among 12,692 cases diagnosed from 1968 to 2016, there were 8367 (65.9%) cases of BCC, 3598 (28.3%) of squamous cell carcinoma (SCC), and 727 (5.8%) of melanoma. The mean ages at skin cancer diagnosis were 72.7 years for SCC, 66.9 years for BCC, and 59.8 years for melanoma. Sun-exposed areas accounted for 81.3% of BCCs, 61.6% of SCCs, and 26.7% of melanomas. The age-standardized incidence rate of cutaneous BCC was highest in the Chinese and increased by 2.5 fold over the study period, followed by a lower rate and slower increase in the Malays, and the lowest rate among the Indians. The SCC and melanoma incidences remained low in all 3 ethnicities during this study period. The Chinese had the highest relative risk for developing any skin cancer (P \ .0001) compared with those of the Malays and Indians. Most cases of skin cancer were diagnosed at age $60, with men showing a higher incidence of SCC compared with that of women. Conclusion:Incidence rates of BCC have increased in Singapore, especially among the Chinese, in the past 5 decades. The SCC and melanoma incidence rates remained low and stable.
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