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- Coronavirus.Urticaria, chilblains ... Covid-19 also attacks the skin
Chilblain-like rashes in acral areas (19%), vesicular eruptions (9%), urticarial lesions (19%), maculopapuleous eruptions (47%) and livedo-reticularis or necrosis (6%), as revealed the 'Covid-Piel' study , launched three weeks ago by a group of Spanish dermatologists, and in which, for now, 375 cases have been analyzed .
According to this work, the results of which have been published in the 'British Journal of Dermatology' and which has received the support of the Spanish Academy of Dermatology and Venereology , skin manifestations can be classified into these five patterns associated with a specific prognosis of Covid-19 infection.
Acral rashes
Similar to chilblains (hands and feet), they appeared as areas of erythema or purplish, vesicles and pustules. This type of injury was detected in 19% of cases, in younger patients, in the late stages of the Covid-19 process, lasting 12.7 days and associated with a less severe prognosis.
Vesicular eruptions
Detected in 9% of cases, they have been seen mainly in the trunk. They consisted of small monomorphic vesicles (lesions very similar to each other) unlike those that appear in chickenpox that are polymorphic. Sometimes they settled on the extremities and could have hemorrhagic content , enlarge or spread.
The study has shown that this type of manifestation is associated with intermediate severity and is more frequent in middle-aged patients . In fact, they usually last for about ten days and appear along with general symptoms, sometimes before them.
Urticarial lesions
They have been recorded in 19% of cases, they have been seen mainly on the trunk or scattered throughout the body, in some cases on the palms of the hands. Their average duration is 6.8 days, they usually produce intense itching and have been observed in more severe patients and more frequently have appeared at the same time as other symptoms related to Covid-19.
Maculo-papules
The most frequent manifestations were detected in 47% of cases, the dermatological picture is frequently similar to that of other viral infections. Sometimes you show specific patterns, such as the peri-follicular distribution, or similar to pityriasis rosea or erythema multiforme. They last 8 or 9 days on average and have also been seen in more severe patients.
Livedo-reticularis lesions
Lesions that target vascular obstruction and necrosis have been found in 6% of cases. These are marks on the skin reminiscent of a network, before they were typical for the use of braziers, and they have appeared in older and more severe patients (10% mortality was recorded in this group). The patients showed different degrees of involvement, including areas of acral or trunk ischemia.
It cannot be ruled out that there are other causes
"What we have seen, in addition to categorizing skin manifestations into five groups, is a disease gradient, from less severe in cases where there were pseudo-chilblains to more severe in patients with livedo-reticularis lesions, who had more cases of pneumonia , hospital admissions and need for intensive care care ", explained the director of the AEDV Research Unit, Ignacio García-Doval .
It should be borne in mind, the study points out, that it cannot be ruled out that there are other causes behind some of these skin manifestations, especially in the case of urticariform lesions or maculopapules, which could have other causes, such as the reactions to any of the many drugs that have received.
According to the criteria of The Trust Project
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