COVID‐19 and exacerbation of dermatological diseases: A review of the available literature

Abstract

Since the emergence of the new coronavirus disease 19 (COVID‐19) pandemic, there has been a concern for the patients with chronic autoimmune diseases including dermatological conditions over the potential exacerbation of these underlying conditions after infection with severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV2). We performed a systematic review to evaluate presentations, postinfection change in the manifestation, diagnosis, and management of flare‐ups of underlying dermatologic disease in patients with COVID‐19. A total of 17 articles were recovered reporting on flare‐ups of dermatological disease including pemphigus vulgaris, psoriasis, subacute cutaneous lupus erythematosus, acrodermatitis continua of Hallopeau, systemic sclerosis sine scleroderma, and Sézary syndrome (SS). Out of these, psoriasis and alopecia areata were the most common conditions. However, most cases of psoriasis could have been attributed to either antimalarial agents that were initially used for the treatment of COVID‐19 or discontinuation of treatment following SARS‐CoV2 infection.

COVID‐19 and COVID‐19 vaccine‐related dermatological reactions: An interesting case series with a narrative review of the potential critical and non‐critical mucocutaneous adverse effects related to virus, therapy, and the vaccination

“…There was no consensus over methotrexate. 23 It could be postulated that psoriatic patients are not at further risk of mortality from COVID‐19 compared with the general population. 24 According to other studies, patients with atopic dermatitis experienced 26% to 43% of exacerbation during active COVID‐19 infection.…”

“…Alopecia areata patients reported 42.5% relapse almost 2 months after COVID‐19 infection, which was found significant compared with the control group. 23 In addition, the incidence of new autoimmune diseases such as psoriasis and morphea has been reported after infection. 25 According to one study, patients with autoimmune bullous dermatoses such as pemphigus vulgaris and bullous pemphigoid are not at increased risk for severe or fatal COVID‐19; therefore, discontinuation of important immunomodulatory treatments is not recommended, however, it is advised to reduce prednisone/prednisolone to <10–20 mg/day in active infection.…”

“…Other studies indicated exacerbation or relapse of psoriasis in those abandoning their drug course or in cases in which HCQ, a known cause of drug‐induced psoriasis was administered. There was no consensus over methotrexate 23 . It could be postulated that psoriatic patients are not at further risk of mortality from COVID‐19 compared with the general population 24 .…”

“…Majority of records are confined to case reports, essentially regarding psoriasis. Some evidence report no change of pattern in psoriasis in patients who stick to their treatment regimen, particularly under treatment with biologic agents, while they experienced mild or asymptomatic COVID‐19 infection, contributed to the immunomodulatory effect of these drugs in the inflammatory phase of the infection 23 . Other studies indicated exacerbation or relapse of psoriasis in those abandoning their drug course or in cases in which HCQ, a known cause of drug‐induced psoriasis was administered.…”

Hautveränderungen bei COVID-19 und nach COVID-19-Impfung

“…B. eines bullösen Pemphigoids, eines Lichen planus oder eines Granuloma anulare beobachtet [ 12 , 29 ]. Laut Literatur und eigener Erfahrungen können auch zuvor kontrollierte Dermatosen nach einer durchgemachten COVID-19-Erkrankung exazerbieren [ 4 ].…”