Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China.
J Eur Acad Dermatol Venereol. 2020 Nov;34(11):2505-2510. doi: 10.1111/jdv.16778. Epub 2020 Aug 26.
The cutaneous manifestations of COVID-19 patients have been increasingly reported, but not summarized, and the potential mechanisms remain to be investigated. Herein, we performed a comprehensive review of literatures (from inception to 30 May 2020) using PubMed, CNKI, medRxiv and bioRxiv with the terms "((novel coronavirus) OR (2019 novel coronavirus) OR (2019-nCoV) OR (Coronavirus disease 2019) OR (COVID-19) OR (SARS-CoV-2)) AND ((Dermatology) OR (skin) OR (rash) OR (cutaneous))" and "((ACE2) OR (Angiotensin-converting enzyme)) AND ((skin) OR (epidermis) OR (dermis))." Totally, 44 articles met the inclusion criteria. A total of 507 patients with cutaneous manifestations were summarized, and 96.25% patients were from Europe. The average age of the patients was 49.03 (range: 5-91) with a female ratio of 60.44%. The skin lesions were polymorphic, and erythema, chilblain-like and urticarial lesions were most common, occurring on an average of 9.92 days (range: 1-30) after the onset of systemic symptoms. The receptor of SARS-CoV-2, ACE2, was found to be expressed on skin, mainly on keratinocytes. Our review systematically presented the clinical characteristics of 507 patients and showed that skin might be the potential target of the infection according to ACE2 expression. More work should be done to better understand the underlying pathogenesis.
COVID-19 患者的皮肤表现已被越来越多地报道，但尚未进行总结，其潜在机制仍有待研究。在此，我们使用 PubMed、CNKI、medRxiv 和 bioRxiv 对文献（从开始到 2020 年 5 月 30 日）进行了全面综述，检索词为“((novel coronavirus) OR (2019 novel coronavirus) OR (2019-nCoV) OR (Coronavirus disease 2019) OR (COVID-19) OR (SARS-CoV-2)) AND ((Dermatology) OR (skin) OR (rash) OR (cutaneous))”和“((ACE2) OR (Angiotensin-converting enzyme)) AND ((skin) OR (epidermis) OR (dermis))”。共纳入 44 篇符合条件的文章。总结了 507 例有皮肤表现的患者，其中 96.25%的患者来自欧洲。患者的平均年龄为 49.03 岁（范围：5-91 岁），女性比例为 60.44%。皮肤损害表现多样，以红斑、冻疮样和荨麻疹样损害最常见，平均在全身症状出现后 9.92 天（范围：1-30 天）出现。SARS-CoV-2 的受体 ACE2 被发现存在于皮肤中，主要存在于角质形成细胞上。本综述系统地描述了 507 例患者的临床特征，并根据 ACE2 表达显示皮肤可能是感染的潜在靶标。还需要进一步的工作来更好地理解潜在的发病机制。
