Introduction: Whether biologic therapies enhance the risk of coronavirus 2019 or affect the disease outcome in patients with chronic plaque psoriasis remains to be ascertained. Objective: We sought to investigate the incidence of hospitalization and death for COVID-19 in a large sample of patients with plaque psoriasis receiving biologic therapies compared with the general population. Methods: This is a retrospective multicenter cohort study including patients with chronic plaque psoriasis (n 5 6501) being treated with biologic therapy and regularly followed up at the divisions of dermatology of several main hospitals in the Northern Italian cities of Verona,
Drug reaction with eosinophilia and systemic symptoms syndrome (DRESS) syndrome associated with azithromycin presenting like septic shock: a case report.
performing serology for the viral infections associated with cutaneous manifestations, for example parvovirus B19 and enterovirus. Most of them reported itching and burning sensation. Only two of them referred pain. They were variably symptomatic for the respiratory tract, but none of them had such a severe lung involvement as to require intubation. One of them was completely asymptomatic, and only the acral vascular manifestation led us the suspicion of coronavirus infection. In six of the patients showing exanthematic rashes, a punch biopsy for histological examination was obtained (Fig. 1F), showing features of perivascular dermatitis and vasculitis, which are compatible with that of a viral exanthem. It is known that exanthematic rashes can occur during viral infection. 4 We can say that erythematous rashes during coronavirus infections may have the same origin as the other viral rashes. 5 Instead, the vasculitic eruptions could be due to the vascular changes observed in these patients. Degeneration of the endothelium and vascular damages, including both formation of thrombus and congestion in small vessels, were observed in organs other than the lung in autopsies from skin. Indeed, while the 2019-nCoV is mainly distributed in the lung, the damage caused by the infection also involves the vessels, with the possibility of ischaemic and embolic damages. 6 The clinical patterns of the rashes described in COVID-19 patients till now include urticaria, acral ischaemia, morbilliform, livedo reticularis, vesicular and petechial. 5,7-9 As regards, the histological patterns, perivascular dermatitis and transient acantholytic dermatosis are those described till now. 10. We are presenting this paper to share our cases of skin involvement during the coronavirus disease. Undoubtedly, no certain association can be established between COVID-19 and skin eruptions, and further studies are needed. Acknowledgement The patients in this manuscript have given written informed consent to the publication of her case details.
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