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Title: Skin manifestations in COVID-19: prevalence and relationship with disease severity
Author: Giavedoni, Priscila
Podlipnik, Sebastian
Pericàs, Juan M.
Fuertes de Vega, Irene
García Herrera, Adriana
Alós i Hernández, Llúcia
Carrera Álvarez, Cristina
Andreu Febrer, Cristina
Sanz Beltran, Judit
Riquelme Mc Loughlin, Constanza
Riera Monroig, Josep
Combalia, Andrea
Bosch Amate, Xavier
Morgado-Carrasco, Daniel
Pigem, Ramon
Toll Abelló, Agustí
Martí Martí, Ignasi
Rizo Potau, Daniel
Serra García, Laura
Alamon Reig, Francesc
Iranzo, Pilar
Almuedo Riera, Alex
Muñoz, José
Puig i Sardà, Susana
Mascaró, José María
Keywords: COVID-19
Issue Date: 12-Oct-2020
Publisher: MDPI
Abstract: Background: Data on the clinical patterns and histopathology of SARS-CoV-2 related skin lesions, as well as on their relationship with the severity of COVID-19 are limited. Methods and Materials: Retrospective analysis of a prospectively collected cohort of patients with SARS-CoV-2 infection in a teaching hospital in Barcelona, Spain, from 1 April to 1 May 2020. Clinical, microbiological and therapeutic characteristics, clinicopathological patterns of skin lesions, and direct immunofluorescence and immunohistochemical findings in skin biopsies were analyzed. Results: Fifty-eight out of the 2761 patients (2.1%) either consulting to the emergency room or admitted to the hospital for COVID-19 suspicion during the study period presented COVID-19 related skin lesions. Cutaneous lesions could be categorized into six patterns represented by the acronym "GROUCH": Generalized maculo-papular (20.7%), Grover's disease and other papulo-vesicular eruptions (13.8%), livedo Reticularis (6.9%), Other eruptions (22.4%), Urticarial (6.9%), and CHilblain-like (29.3%). Skin biopsies were performed in 72.4%, including direct immunofluorescence in 71.4% and immunohistochemistry in 28.6%. Patients with chilblain-like lesions exhibited a characteristic histology and were significantly younger and presented lower rates of systemic symptoms, radiological lung infiltrates and analytical abnormalities, and hospital and ICU admission compared to the rest of patients. Conclusion: Cutaneous lesions in patients with COVID-19 appear to be relatively rare and varied. Patients with chilblain-like lesions have a characteristic clinicopathological pattern and a less severe presentation of COVID-19.
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It is part of: Journal of Clinical Medicine, 2020, vol. 9, num. 10
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ISSN: 2077-0383
Appears in Collections:Articles publicats en revistes (ISGlobal)
Articles publicats en revistes (Medicina)

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