Clinics in dermatology
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Clinics in dermatology · Nov 2020
ReviewParaviral eruptions in the era of COVID-19: Do some skin manifestations point to a natural resistance to SARS-CoV-2?
Paraviral eruptions, such as the papular-purpuric gloves and socks syndrome or eruptive pseudoangiomatosis, share the following features that distinguish them from a classic viral eruption: they are highly recognizable; the eruption usually lasts a few weeks; many different viruses and sometimes other agents can trigger them; on microscopic examination, there is no specific cytopathogenic viral effect. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can induce both a classic viral eruption and a paraviral eruption, the meaning of which in terms of pathophysiology and prognosis is very different. Some patients infected with coronavirus disease 2019 (COVID-19) have a papulovesicular eruption involving mainly the trunk. ⋯ In the case of paraviral chilblains, I hypothesize that it is the innate immune system that rejects SARS-CoV-2. Chilblains are also observed in rare monogenic disorders called type 1 interferonopathies, where antiviral innate imunity is abormally activated. This would explain why these individuals do not develop specific antibodies, because they are probably naturally resistant to SARS-CoV-2 infection via their innate immuen system.
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"COVID toes" are a new phenomenon of pernio-like lesions that has been associated with coronavirus disease 2019 (COVID-19) infection. As dermatology practices reopen and increase patient volumes amid the waning of the coronavirus pandemic, it is important to consider the finding of pernio and pernio-like lesions in the context of both COVID-19 and its other possible etiologies. This contribution will discuss possible causes of pernio and pernio-like lesions and offer suggestions for appropriate diagnostic workup and management when indicated.
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The world has changed dramatically since the COVID-19 pandemic began. In addition to our social, occupational, and personal lives, the new coronavirus also poses novel challenges for all physicians, including dermatologists. ⋯ Pressure injury, contact dermatitis, itch, pressure urticaria, and exacerbation of preexisting skin diseases, including seborrheic dermatitis and acne, have been described. We have focused on the dermatologic aspects of the COVID-19 infection so that dermatologists are aware of the skin complications and preventive measures can be taken in the COVID-19 pandemic.