Cutaneous manifestations in COVID‐19: familial cluster of urticarial rash

Cepeda‐Valdés, Rodrigo; Carrión-Álvarez, Diego; Trejo‐Castro, A.; Hernández-Torre, Martín; Salas‐Alanís, Julio C.

doi:10.1111/ced.14290

Cited by 23 publications

(24 citation statements)

References 5 publications

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“…Therefore, the authors of the reports suggested that isolation is needed for patients developing such skin symptoms if COVID-19 infection is suspected in order to prevent possible SARS-CoV-2 transmission [11-13]. COVID-19-related urticaria occurred also in a familial cluster, involving 2 patients belonging to a Mexican family of 5 people, all infected by SARS-CoV-2 and suffering also from anosmia, ageusia, chills and dizziness [14]. Angioedema may accompany COVID-19-related urticaria, as evidenced by the case published in June 2020 of an elderly man presenting with urticaria, angioedema, general malaise, fatigue, fever and pharyngodynia [15].…”

Section: Urticarial Rashmentioning

confidence: 99%

Skin Manifestations Associated with COVID-19: Current Knowledge and Future Perspectives

et al. 2020

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Background: Coronavirus disease-19 (COVID-19) is an ongoing global pandemic caused by the “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2), which was isolated for the first time in Wuhan (China) in December 2019. Common symptoms include fever, cough, fatigue, dyspnea and hypogeusia/hyposmia. Among extrapulmonary signs associated with COVID-19, dermatological manifestations have been increasingly reported in the last few months. Summary: The polymorphic nature of COVID-19-associated cutaneous manifestations led our group to propose a classification, which distinguishes the following six main clinical patterns: (i) urticarial rash, (ii) confluent erythematous/maculopapular/morbilliform rash, (iii) papulovesicular exanthem, (iv) chilblain-like acral pattern, (v) livedo reticularis/racemosa-like pattern, (vi) purpuric “vasculitic” pattern. This review summarizes the current knowledge on COVID-19-associated cutaneous manifestations, focusing on clinical features and therapeutic management of each category and attempting to give an overview of the hypothesized pathophysiological mechanisms of these conditions.

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Section: Urticarial Rashmentioning

confidence: 99%

Skin Manifestations Associated with COVID-19: Current Knowledge and Future Perspectives

et al. 2020

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“…Similarly, an extensive review of 997 patients from 9 different countries analyzed by Jia et al found that approximately 22% of patients had urticarial eruptions [4••]. Urticaria with or without angioedema in the setting of confirmed or highly suspected COVID-19 infection has been observed in several reports and case series [2,5,[39][40][41][42][43][44][45][46][47]. Similar to other viral infections, urticarial rash may precede or occur simultaneously with COVID-19 systemic manifestations (i.e., fever, cough) and last for several days [5,39,43,44,47,48].…”

Section: Urticaria and Angioedemamentioning

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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“…As of May 7, 2020, a total of 3,672,238 confirmed cases and 254,045 deaths have been reported in more than 214 countries (86,095 confirmed cases and 4643 deaths in China) 3 . Considering its worldwide reach and severity, WHO declared the COVID‐19 outbreak a global pandemic—the first pandemic sparked by a coronavirus 4 . In contrast to the global infection rate reached by SARS‐CoV‐2, severe acute respiratory syndrome‐coronavirus (SARS‐CoV, 2002–2003) and Middle East respiratory syndrome coronavirus (MERS‐CoV, 2012) were largely localized to China and Saudi Arabia, respectively 5 .…”

Section: Introductionmentioning

confidence: 99%

Cytokine storm and leukocyte changes in mild versus severe SARS-CoV-2 infection: Review of 3939 COVID-19 patients in China and emerging pathogenesis and therapy concepts

Wang

Jiang

Chen

et al. 2020

Journal of Leukocyte Biology

626

577

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Clinical evidence indicates that the fatal outcome observed with severe acute respiratory syndrome‐coronavirus‐2 infection often results from alveolar injury that impedes airway capacity and multi‐organ failure—both of which are associated with the hyperproduction of cytokines, also known as a cytokine storm or cytokine release syndrome. Clinical reports show that both mild and severe forms of disease result in changes in circulating leukocyte subsets and cytokine secretion, particularly IL‐6, IL‐1β, IL‐10, TNF, GM‐CSF, IP‐10 (IFN‐induced protein 10), IL‐17, MCP‐3, and IL‐1ra. Not surprising, therapies that target the immune response and curtail the cytokine storm in coronavirus 2019 (COVID‐19) patients have become a focus of recent clinical trials. Here we review reports on leukocyte and cytokine data associated with COVID‐19 disease in 3939 patients in China and describe emerging data on immunopathology. With an emphasis on immune modulation, we also look at ongoing clinical studies aimed at blocking proinflammatory cytokines; transfer of immunosuppressive mesenchymal stem cells; use of convalescent plasma transfusion; as well as immunoregulatory therapy and traditional Chinese medicine regimes. In examining leukocyte and cytokine activity in COVID‐19, we focus in particular on how these levels are altered as the disease progresses (neutrophil NETosis, macrophage, T cell response, etc.) and proposed consequences to organ pathology (coagulopathy, etc.). Viral and host interactions are described to gain further insight into leukocyte biology and how dysregulated cytokine responses lead to disease and/or organ damage. By better understanding the mechanisms that drive the intensity of a cytokine storm, we can tailor treatment strategies at specific disease stages and improve our response to this worldwide public health threat.

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Cutaneous manifestations in COVID‐19: familial cluster of urticarial rash

Abstract: Miravalles G et al. Comment on: Cutaneous manifestations in COVID-19: a first perspective. Safety concerns of clinical images and skin biopsies.

Cited by 23 publications

References 5 publications

Skin Manifestations Associated with COVID-19: Current Knowledge and Future Perspectives

Skin Manifestations Associated with COVID-19: Current Knowledge and Future Perspectives

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

Cytokine storm and leukocyte changes in mild versus severe SARS-CoV-2 infection: Review of 3939 COVID-19 patients in China and emerging pathogenesis and therapy concepts

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