Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
Dermatology. 2021;237(1):1-12. doi: 10.1159/000512932. Epub 2020 Nov 24.
Coronavirus disease-19 (COVID-19) is an ongoing global pandemic caused by the "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2), which was isolated for the first time in Wuhan (China) in December 2019. Common symptoms include fever, cough, fatigue, dyspnea and hypogeusia/hyposmia. Among extrapulmonary signs associated with COVID-19, dermatological manifestations have been increasingly reported in the last few months.
The polymorphic nature of COVID-19-associated cutaneous manifestations led our group to propose a classification, which distinguishes the following six main clinical patterns: (i) urticarial rash, (ii) confluent erythematous/maculopapular/morbilliform rash, (iii) papulovesicular exanthem, (iv) chilblain-like acral pattern, (v) livedo reticularis/racemosa-like pattern, (vi) purpuric "vasculitic" pattern. This review summarizes the current knowledge on COVID-19-associated cutaneous manifestations, focusing on clinical features and therapeutic management of each category and attempting to give an overview of the hypothesized pathophysiological mechanisms of these conditions.
由“严重急性呼吸系统综合征冠状病毒 2 型”(SARS-CoV-2)引起的 2019 年冠状病毒病(COVID-19)是一场持续的全球大流行疾病,该病毒于 2019 年 12 月在中国武汉首次被分离出来。常见症状包括发热、咳嗽、乏力、呼吸困难和味觉/嗅觉丧失。在与 COVID-19 相关的肺外表现中,皮肤病表现近几个月来已越来越多地被报道。
COVID-19 相关皮肤表现的多态性促使我们小组提出了一种分类,将其分为以下六种主要临床类型:(i)荨麻疹样皮疹,(ii)融合性红斑/斑丘疹/麻疹样皮疹,(iii)丘疹水疱性发疹,(iv)冻疮样肢端模式,(v)网状青斑/racemosa 样模式,(vi)紫癜性“血管炎”样模式。这篇综述总结了 COVID-19 相关皮肤表现的现有知识,重点介绍了每种类别临床特征和治疗管理,并尝试概述这些疾病的假设病理生理学机制。