Classification and pathophysiology of cutaneous manifestations of COVID-19

Abstract

<p>Cutaneous manifestation of in COVID-19 patients are varied and needs proper categorization and classification. Various morphological manifestation on skin are seen. The pathophysiology of this virus is not well understood because of it being a novel virus. This disease involves all organs of the body, primarily the respiratory system, heart, kidneys, liver, spleen and the skin as well. In addition to pneumonia which is a hall mark feature of this virus, multiorgan failure occurs as a result of its cascading pathological pathways. Another fatal feature of this virus is hyperimmune response (because of IL-6), known as, ‘cytokine storm’. The pathophysiological changes in skin leading to different kinds of rashes range from vasculitis changes to formation of microthrombi obliterating the dermal vessels. After reviewing current literature, we have proposed a simplified classification of cutaneous manifestations of COVID-19 is proposed based on morphological features, relation with severity of disease and histopathological changes. Pathophysiology of cutaneous changes is also being described.</p>

Dermatologic manifestation of COVID-19: a systematic review

“…It is suspected that cutaneous eruptions, especially inflammatory eruptions such as exanthems and vesicular rashes, to be caused by antibody-antigen reaction in or near dermatologic tissues. 24 It has been further demonstrated that SARS-CoV-2 entry factor, angiotensin converting enzyme-2 (ACE2), was found to be expressed in skin tissue as well, mainly in keratinocytes and basal layer, probably contributing to local inflammation in those tissue in event of SARS-CoV-2 infection. 25 Meanwhile, this immune system and antibody mediated pathophysiology is found to be less likely mechanism for vascular eruptions of COVID-19, such as petechiae, purpura, and chilblain-like lesions.…”

Cutaneous Manifestation of Coronavirus Disease 2019 (COVID-19)

“…Coronavirus disease (COVID- 19) is an infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This disease was first discovered in December 2019 in China [1][2][3][4], currently COVID-19 has spread throughout the world and was declared as a pandemic by the World Health Organization (WHO) on March 11, 2020 [1,2]. In Indonesia, until now (28 February 2021) there were 1,334,634 new cases found, 36,166 people died, and 1.142,703 people recovered [5].…”

“…Some patients may experience soreness and pain, nasal congestion, headache, conjunctivitis, sore throat [1], rhinorrhea, anosmia, ageusia [1,2], and the presence of skin rashes [1,3,6,7]. In vital signs there is an increase in temperature, decreased oxygen saturation [2], the chest X-ray shows pneumonia [3], and a ground glass appearance on chest CT scan [2,3]. Results of laboratory tests in COVID-19 patients found normal leukocyte count or leukocytosis [3].…”

“…In vital signs there is an increase in temperature, decreased oxygen saturation [2], the chest X-ray shows pneumonia [3], and a ground glass appearance on chest CT scan [2,3]. Results of laboratory tests in COVID-19 patients found normal leukocyte count or leukocytosis [3]. often found lymphopenia, and increased lactate dehydrogenase (LDH).…”

Temporal and spatial concomitance of exanthema and dysesthesia in a patient with SARS-cov-2 infection

“…Exact pathophysiology of exanthema during viral infection is not clearly known but antigens-antibodies complexes are widely reported as a potential explanation ( Gupta et al., 2020 ; Mims, 1966 ). Dysesthesia is the consequence of peripheral nerve damage ( Asbury and Fields, 1984 ) and could be in part in relation to small fibers inflammation ( Levine, 2018 ).…”