Systemic Medications of Dermatological Importance in COVID-19

Abstract

Early December 2019 witnessed an international outbreak of a novel coronavirus (COVID 19) designated severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2). Since then, a number of therapeutic molecules have been explored to have potential efficacy against the SARS-Cov-2 per se or its sequelae. There are no Food and Drug Administration specific therapies approved so far; however, numerous drugs based on varying levels of evidence, in vitro studies and compassionate drug trials are being established as therapeutic agents, especially drugs approved for previous emergence of the severe acute respiratory syndrome (SARS-CoV-1) and Middle east respiratory syndrome coronavirus (MERS-Cov). Numerous active clinical trials for COVID-19 with more than 150 drugs and products are under study. Needless to say, many dermatological drugs are being employed to mitigate this pandemic threat. We aim to review drugs with potential against SARS-Cov-2 widely used in dermatology practice. Additionally, rampant and overzealous use of these drugs as well as introduction of new molecules might lead to emergence of adverse effects associated with these agents. Dermatologists must be on lookout for any cutaneous adverse effects of these drugs.

Morphea in two patients after being infected to and being vaccinated against SARS‐CoV‐2 infection

“… 39 For example, Stevens–Johnson‐like syndrome, acute generalized exanthematous pustulosis, and urticarial eruptions have been reported following hydroxychloroquine, acneiform eruptions, and localized scleroderma following ribavirin, and psoriasis, alopecia, cutaneous vasculitis, and lichenoid drug reactions have been observed after receiving interferons. 40 , 41 Our first patient had received interferon beta‐1a for her SARS‐CoV‐2 infection. There have been rare reports of localized morphea at the site of interferon injection 42 ; however, no case of generalized morphea has been reported in patients who had received this medication.…”

“…We should take into account that some of the therapeutics utilized for managing COVID‐19 can lead to florid cutaneous reactions 39 . For example, Stevens–Johnson‐like syndrome, acute generalized exanthematous pustulosis, and urticarial eruptions have been reported following hydroxychloroquine, acneiform eruptions, and localized scleroderma following ribavirin, and psoriasis, alopecia, cutaneous vasculitis, and lichenoid drug reactions have been observed after receiving interferons 40,41 . Our first patient had received interferon beta‐1a for her SARS‐CoV‐2 infection.…”

Morphea in two patients after being infected to and being vaccinated against SARS-CoV-2 infection

“…We should take into account that some of the therapeutics utilized for managing COVID-19 can lead to florid cutaneous reactions (39). For example, Stevens-Johnson-like syndrome, acute generalized exanthematous pustulosis and urticarial eruprtions have been reported following hydroxychloroquine, acneiform eruptions and localized scleroderma following ribavirin, and psoriasis, alopecia, cutaneous vasculitis, and lichenoid drug reactions have been observed after receiving interferons (40,41). Our first patient had received interferon beta-1a for her SARS-CoV-2 infection.…”

COVID-19–specific skin changes related to SARS-CoV-2: Visualizing a monumental public health challenge

“…COVID-19 disease may be associated with adverse reactions to anti-COVID-19 disease medications ( 11 , 34 , 37 , 38 , 39 ), particularly as there is an understandable and appropriate effort to find and explore inexpensive, safe, easy-to-use, and readily avoidable options such as azithromycin ( 37 ), some with years of clinical experience with both oral and topical administration ( 38 , 39 ). Many clinical trials are in progress.…”