Patients with specific skin disorders who are affected by COVID ‐19: What do experiences say about management strategies? A systematic review

Abstract

In patients with specific dermatologic disorders who are affected by new corona virus, we know little about disease course (underlying disease and new onset infection), and the most proper management strategies include both issues that are what this systematic review targets. Databases of PubMed, Scopus, Google Scholar, Medscape, and Centre of Evidence-Based Dermatology, coronavirus dermatology resource of Nottingham University searched completely up to May 15, 2020, and initial 237 articles were selected to further review and finally 9 articles (including 12 patients) entered to this study. From 12 patients with chronic underlying dermatologic disease treated with systemic therapies, only 1 patient required Intensive Care Unit admission, the others have been treated for mild-moderate symptoms with conventional therapies. The biologic or immunosuppressive/immunomodulator agents have been ceased during the course of disease. The course of coronovirus diseases 2019 (COVID-19) and its management was as similar as normal populations. Their underlying dermatologic disease were exacerbating from mild to moderate. Their treatment has been continued as before, after the symptoms improved. Exacerbation of patients underlying dermatologic disease was mild to moderate. Discontinuing the treatment in the acute period of COVID and the restart after recovery may prevent severe recurrence and disturbing cytokine storms in these patients.

Pemphigus and COVID ‐19: Critical overview of management with a focus on treatment choice

“…She never experienced cough, shortness of breath, anosmia, or other symptoms of the infection. The authors stated that they planned to test the patient 2 weeks after the end of symptoms to repeat a swab and restart the immunosuppressive treatment 12,13 . In another study conducted in Italy, the authors interviewed 83 patients (30 males, 53 females; average age 58.6 years) with the autoimmune bullous diseases 14 .…”

“…The authors stated that they planned to test the patient 2 weeks after the end of symptoms to repeat a swab and restart the immunosuppressive treatment. 12,13 In another study conducted in Italy, the authors interviewed 83 patients (30 males, 53 females; average age 58.6 years) with the autoimmune bullous diseases. 14 The guideline provided by the European Academy of Dermatology and Venereology Task Force Autoimmune Blistering Diseases recommended not to stop or reduce ongoing treatment unless there is a particular reason.…”

N-acetylcysteine and coronavirus disease 2019: May it work as a beneficial preventive and adjuvant therapy? A comprehensive review study

“…In addition, the field of COVID is of interest of the authors of this study and the author have been focused on other multi-potential drugs and specific manifestation of COVID and COVID in patients with specific disorders. [ 112 113 114 ]…”

COVID-19: The experience from Iran

“…Dermatology patients who were receiving systemic corticosteroids, biologics, and traditional immunosuppressives are generally considered vulnerable to COVID-19 infection and severity. 91 , 92 , 93 The challenging question of the early days of the pandemic was whether to continue these medications, how much each drug is considered tolerable, and how to assess the risks and benefits. No experience or evidence-based guideline was available in the literature except limited data from severe acute respiratory syndrome and Middle East respiratory syndrome outbreaks.…”

“…Guidelines recommend discontinuing immunosuppressive drugs during active COVID-19 and using steroids at the lowest possible dose. 8 , 92 , 93 , 94 , 95 This strategy, as well as respiratory infection, may ensue with a disease flare-up. 96 , 97 , 98 In noninfected patients, besides the controversies about systemic corticosteroids, the question was mainly focused on three categories of drugs that were available and widely used in Iran: tumor necrosis factor inhibitors (biosimilar etanercept; biosimilar adalimumab, and brand infliximab); anti-CD20 monoclonal antibodies (biosimilar rituximab), and Janus kinase inhibitors (tofacitinib).…”