Figure 1 Acro-ischaemic lesions in a patient infected with COVID-19. Lesions were mainly purpuric, haemorrhagic bullae and necrotic, affecting fingers (a) and toes (b).

No abstract

Introduction: COVID-19 is an infectious disease caused by the new coronavirus, SARS-CoV-2, that has spread rapidly throughout the world. This has resulted in an urgent need to obtain information regarding its pathogenesis, diagnosis and clinical manifestations. More specifically, skin manifestations, seldom reported initially, have been increasingly described.Material and Methods: We performed a literature search in the PubMed database, regarding cutaneous manifestations associated with COVID-19. This article describes the clinical and histological findings of the main skin lesions observed in the context of SARS-CoV-2 infection.Discussion: Cutaneous manifestations associated with COVID-19 have been described in multiple retrospective and prospective studies, case series and case reports. The reported incidence reached 20.4%. Although there was substantial heterogeneity in terms of clinical patterns, the main ones include: erythematous/maculopapular, urticarial, papulovesicular, and purpuric/petechial eruptions, chilblain-like lesions and livedoid/acro-ischemic lesions. In the vast majority, the underlying pathophysiologic mechanisms are not fully understood, although histopathological findings and biomolecular studies can add relevant data.Conclusion: The recognition of cutaneous manifestations associated with COVID-19 is of utmost importance. They may help establishing an early diagnosis, namely in oligosymptomatic patients or when confirmatory tests are impossible to perform. Moreover, chilblain-like lesions and acro-ischemia, also seem to play an important role in terms of prognosis.

No abstract

Generalized eruptive keratoacanthoma of Grzybowski is a rare variant of multiple keratoacanthomas counting with about 40 cases reported. It is a chronic and progressive disease for which none of the described therapeutic options has been entirely satisfactory. We report a case of an 83-year-old female who presented with a 3-month history of extremely pruritic, multiple, skin-coloured to erythematous to brownish, millimetric papules, with a keratotic centre. Histological examination of an incisional biopsy was consistent with the diagnosis of keratoacanthoma. The patient started acitretin 25 milligrams daily with a complete resolution of pruritus and regression of numerous lesions.

A dermatomiosite é uma miopatia inflamatória idiopática, rara, com manifestações cutâneas e sistémicas variadas. Mais de 70% dos doentes apresentam autoanticorpos específicos da doença, que se correlacionam com manifestações clínicas distintas. Além dos anticorpos anti-sintetase, nos últimos anos foram descobertos vários anticorpos associados à dermatomiosite e que parecem ter um papel importante na orientação diagnóstica e prognóstica da doença, incluindo os autoanticorpos contra melanoma differentiation antigen 5 (MDA5), transcriptional intermediary factor 1 (TIF1), nuclear matrix protein 2 (NXP2), small ubiquitin-like modifier activating enzyme (SAE) e os anti-Mi2. O autoanticorpo anti-MDA5 está associado a dermatomiosite amiopática e doença intersticial pulmonar rapidamente progressiva e potencialmente fatal, além de caraterísticas mucocutâneas distintas, como ulceração cutânea. Há uma forte correlação entre a positividade para os autoanticorpos anti-TIF-1γ e malignidade, pelo menos na dermatomiosite do adulto. Na dermatomiosite juvenil, estes autoanticorpos têm sido associados a doença cutânea mais extensa, mas não a malignidade. A positividade para anti-NXP2 está associada a calcinose cutânea e envolvimento muscular severos. Na dermatomiosite com autoanticorpos anti-SAE há frequentemente envolvimento cutâneo e disfagia severos, mas com boa resposta à terapêutica imunossupressora e bom prognóstico. Os anticorpos anti-Mi2 associam- -se igualmente a um bom prognóstico.

Primary cutaneous alveolar rhabdomyosarcoma is an extremely rare and highly aggressive soft tissue sarcoma that predominantly arises on the extremities and perineum of adolescents and young adults. Dermatologists should be aware of these tumors in order to promptly make the diagnosis and initiate treatment.

No abstract