No antibody response in acral cutaneous manifestations associated with COVID‐19?

Abstract

Skins symptoms during COVID-19 have been recently described, but their relation to SARS-CoV-2 is unclear while results for

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

“…Acral lesions present as asymmetric, self-limited, painful, erythematous to violaceous papules or plaques in an acral distribution with predominance for the feet [22,27,71]. Some may have associated bullous eruption or digital swelling [22,25]. A description of 74 cases of acral lesions among pediatric and adult patients reported variable findings from erythematous to purpuric macules or papules [24•].…”

“…Mid to high potency topical corticosteroids can be considered in the management of acral lesions, particularly if they are pruritic or painful. Overall, acral lesions tend to resolve over the course of several weeks [25]. Although chilblain-like lesions during the COVID-19 pandemic are reportedly common, SARS-CoV-2 infection was not detected or not tested for in some cases [23][24][25]70].…”

“…Overall, acral lesions tend to resolve over the course of several weeks [25]. Although chilblain-like lesions during the COVID-19 pandemic are reportedly common, SARS-CoV-2 infection was not detected or not tested for in some cases [23][24][25]70]. Some patients had cough and fever prior to the onset of acral lesions, whereas many had no COVID-19 symptoms and some had negative nasopharyngeal and rectal SARS-CoV-2 RT-PCR swabs; the authors suggested that patients had brief, asymptomatic COVID-19 infection prior to the onset of skin lesions [22].…”

“…The pathogenesis of acral chilblain-like lesions remains unclear. Several proposed mechanisms include cutaneous microthrombi, acquired coagulopathy, or CD8+ T lymphocyte endothelial cell cytotoxicity [23,25]. Of note, SARS-CoV-2 viral particles were detected via electron microscopy in endothelial cells of lesional skin biopsies in pediatric patients, suggesting that chilblains are the result of vascular damage [73•].…”

Caractéristiques cliniques et épidémiologiques de la Covid-19

“…Les symptômes dermatologiques sont le reflet du tropisme du virus pour l’ACE2 exprimé à la surface des cellules endothéliales. Une réaction inflammatoire lymphocytaire cluster de différenciation 8 (CD8) périvasculaire est responsable de manifestations de type vascularite des petits vaisseaux [7] . Les patients présentent alors des engelures, parfois caractérisées par des évolutions bulleuses, dont la guérison est la règle en quelques jours à quelques semaines.…”