Atypical erythema multiforme palmar plaques lesions due to Sars‐Cov‐2

Janah, H.; Ali, Z. Hadj; Elbenaye, Jalal

doi:10.1111/jdv.16623

Cited by 47 publications

(61 citation statements)

References 8 publications

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“…A report of erythema multiforme major with mucosal involvement also exists [ 58 ]. Furthermore, there is an overlap of erythema multiforme-like lesions with non-evanescent urticarial eruptions and atypical palmar plaques [ 18 , 59 ].…”

Section: Viral Exanthemsmentioning

confidence: 99%

Cutaneous Manifestations in Adult Patients with COVID-19 and Dermatologic Conditions Related to the COVID-19 Pandemic in Health Care Workers

Mawhirt

Frankel

Diaz³

2020

Curr Allergy Asthma Rep

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Purpose of Review COVID-19 (coronavirus viral disease 2019), due to the novel SARS-CoV-2, may present with different types of cutaneous manifestations of varying pathophysiology. During the ongoing pandemic, publications reporting dermatologic findings in COVID-19 continue to emerge. Recent Findings Cutaneous vasculopathy and microthrombus-related changes including acral and sacral lesions, retiform purpura, livedo reticularis, and cutaneous vasculitis are notable findings in adult patients. Other exanthems include urticaria or angioedema, morbilliform/maculopapular exanthems, erythema multiforme, and vesicular eruptions. Increased recognition of these findings, especially those consistent with cutaneous microthrombi or vasculitis, is of particular importance. Additionally, occupational dermatologic disease related to extended personal protective equipment (PPE) use, such as skin damage and irritant or allergic contact dermatitis (ACD), represents another emerging problem amidst the pandemic. Summary In this review, we highlight the various cutaneous manifestations associated with COVID-19 in adult patients and occupational dermatitis in health care workers (HCWs) caring for this patient population. Keywords COVID-19. SARS-CoV-2. Cutaneous manifestations. Dermatologic. Rash. Contact dermatitis Abbreviations AAD American Academy of Dermatology ACD Allergic contact dermatitis ACE2 Angiotensin-converting enzyme 2 AD Atopic dermatitis AGEP Acute generalized exanthematous pustulosis ARDS Acute respiratory distress syndrome COVID-19 Coronarvirus viral disease 2019 CSSV Cutaneous small vessel vasculitis DIC Disseminated intravascular coagulation DiHS/DRESS Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms HCW Health care worker ICD Irritant contact dermatitis ITP Immune thrombocytopenic purpura PPE Personal protective equipment PT Patch test RT-PCR Reverse transcriptase polymerase chain reaction SARS-CoV-2 Severe acute respiratory distress syndrome coronavirus 2 SDRIFE Symmetrical drug-related intertriginous and flexural exanthema This article is part of the Topical Collection on Allergic Skin Diseases

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Section: Viral Exanthemsmentioning

confidence: 99%

Cutaneous Manifestations in Adult Patients with COVID-19 and Dermatologic Conditions Related to the COVID-19 Pandemic in Health Care Workers

Mawhirt

Frankel

Diaz³

2020

Curr Allergy Asthma Rep

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“…Some reports of erythemato-violaceous papules and patches with a pseudo-vesicle in the center, resembling erythema-multiforme and an enanthem of the oral cavity in some of those patients during or after improvement of COVID-19 symptoms exist (55)(56)(57)(58). If those lesions are related to SARS-CoV-2 infection or drugs applied in this context or both remains to be elucidated in further studies.…”

Section: Virus Induced Vesicular Eruptionsmentioning

confidence: 96%

SARS-CoV-2, COVID-19, skin and vascular system - what do we know so far?

Novak

Peng

Naegeli

et al. 2020

Preprint

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The pandemic condition Coronavirus-disease (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can take asymptomatic, mild, moderate, and severe courses. COVID-19 affects primarily the respiratory airways leading to dry cough, fever, myalgia, headache, fatigue, and diarrhea and can end up in interstitial pneumonia and severe respiratory failure. Different clinical symptoms caused by involvement of organs outside the respiratory system have been also described. Interestingly, reports about the manifestation of various skin lesions and lesions of the vascular system in some subgroups of SARS-CoV-2 positive patients as such features outside the respiratory sphere, are rapidly emerging. However, knowledge about prevalence and pattern of skin involvement, time of onset, predilection, and its direct or indirect relation to SARS-CoV-2 is still limited. In order to update information gained, we provide a systematic overview of the skin lesions described in COVID-19 patients, discuss potential causative factors and describe differential diagnostic evaluations.

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“…Maculopapular lesions resembling pityriasis rosea, erythema elevatum diutinum, erythema multiforme, and Grover disease have been described among COVID-19 patients [25,32,49,83,84]. A case report also documented the appearance of confluent and pruritic erythematous-yellowish papules limited to both heels 10 days after the onset of respiratory symptoms in a female patient with confirmed SARS-CoV-2 infection [26].…”

Section: Other Manifestationsmentioning

confidence: 99%

“…The spectrum of mucocutaneous manifestations of SARS-CoV-2 infection Other cutaneous manifestations reported in COVID-19 patients include maculopapular lesions resembling pityriasis rosea, erythema elevatum diutinum, erythema multiforme, Grover disease, cutaneous vasculitis, and elbow/knee joint erythematous-edematous plaques[16,22,25,32,49,83,84] …”

mentioning

confidence: 99%

Dermatological aspects of SARS-CoV-2 infection: mechanisms and manifestations

2020

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The human infection caused by the novel SARS-CoV-2 is a public health emergency of international concern. Although the disease associated to this virus, named COVID-19, mainly affects the lungs, the infection can spread to extrapulmonary tissues, causing multiorgan involvement in severely ill patients. The broad infective capacity of SARS-CoV-2 is related to the pattern of expression of the viral entry factors ACE2 and TMPRSS2 in human tissues. As such, the respiratory and gastrointestinal tracts are at high risk for SARS-CoV-2 infection due to their high expression of ACE2 and TMPRSS2, which explains the clinical phenotype described in the vast majority of infected patients that includes pneumonia and diarrhea. Recently, preoccupation about the potential of the virus to infect the skin has been raised by dermatologists due to the increasing observations of cutaneous manifestations in patients with SARS-CoV-2 infection. Although there is little evidence of the expression of ACE2 and TMPRSS2 in the normal skin, the dermatological findings observed among COVID-19 patients warrants further investigation to delineate the mechanisms of skin affection after SARS-CoV-2 infection. Here, we provide a summary of the dermatological findings observed among patients with laboratory-confirmed SARS-CoV-2 infection based on recent reports. In addition, we analyze possible mechanisms of skin injury in COVID-19 patients and discuss about the risk of individuals with chronic skin conditions for SARS-CoV-2 infection. The present review constitutes a useful informative tool to improve our understanding of the pathophysiological mechanisms of COVID-19 and the possible implications of the current pandemic in dermatology.

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Atypical erythema multiforme palmar plaques lesions due to Sars‐Cov‐2

Abstract: JEADVCoV-2 antigens present in skin. Limitation of our observations was a lack of histology and MP serology. Further studies are expected to validate our findings. AcknowledgementThe patients in this manuscript have given written informed consent to publication of their case details.

Cited by 47 publications

References 8 publications

Cutaneous Manifestations in Adult Patients with COVID-19 and Dermatologic Conditions Related to the COVID-19 Pandemic in Health Care Workers

Cutaneous Manifestations in Adult Patients with COVID-19 and Dermatologic Conditions Related to the COVID-19 Pandemic in Health Care Workers

SARS-CoV-2, COVID-19, skin and vascular system - what do we know so far?

Dermatological aspects of SARS-CoV-2 infection: mechanisms and manifestations

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