COVID‐19 and implications for dermatological and allergological diseases

Abstract

Summary COVID‐19, caused by the coronavirus SARS‐CoV‐2, has become pandemic. A further level of complexity opens up as soon as we look at diseases whose pathogenesis and therapy involve different immunological signaling pathways, which are potentially affected by COVID‐19. Medical treatments must often be reassessed and questioned in connection with this infection. This article summarizes the current knowledge of COVID‐19 in the light of major dermatological and allergological diseases. It identifies medical areas lacking sufficient data and draws conclusions for the management of our patients during the pandemic. We focus on common chronic inflammatory skin diseases with complex immunological pathogenesis: psoriasis, eczema including atopic dermatitis, type I allergies, autoimmune blistering and inflammatory connective tissue diseases, vasculitis, and skin cancers. Since several other inflammatory skin diseases display related or comparable immunological reactions, clustering of the various inflammatory dermatoses into different disease patterns may help with therapeutic decisions. Thus, following these patterns of skin inflammation, our review may supply treatment recommendations and thoughtful considerations for disease management even beyond the most frequent diseases discussed here.

COVID-19 vaccination of patients with allergies and type-2 inflammation with concurrent antibody therapy (biologicals) – A Position Paper of the German Society of Allergology and Clinical Immunology (DGAKI) and the German Society for Applied Allergo

“…Chronic inflammatory skin diseases such as atopic dermatitis and chronic spontaneous urticaria are commonly treated with systemic immunomodulatory therapy in severe courses, which arises concern about potential risks of COVID-19 infection and vaccination under this systemic therapy [ 21 ].…”

Beau‐Lines of the fingernails in association with pediatric SARS‐CoV‐2 infections

“…It has been suggested that insult to the nail matrix results in transient growth inhibition with subsequent recovery and thus the appearance of the transverse superficial grooves, usually more marked in the middle aspect of the nail, characteristic of Beau lines [3]. Dermatologic diseases involving different immunological signaling pathways are directly affected by COVID-19 [9]. Similarly, SARS-CoV-2 may itself cause immunological changes, leading to lymphopenia as observed in the described pediatric patients, cytokine storms, and further organ damage [10].…”

The Effect of SARS-CoV-2 Virus Infection on the Course of Atopic Dermatitis in Patients

“…The use of glucocorticoids may predispose patients to a more severe course of COVID-19 [15,18,19]. On the other hand, it was not observed that biological drug therapy also used in AD and psoriasis had similar effects [15,16,18,[20][21][22][23][24][25][26].…”