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与严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染相关的增生性大疱性血管炎

Exuberant bullous vasculitis associated with SARS-CoV-2 infection.

作者信息

Gouveia Pedro Alves da Cruz, Cipriano Ingrid Cardoso, de Melo Marina Acevedo Zarzar, da Silva Helena Texeira Araujo, Amorim Matheus Augusto de Oliveira, de Sá Leitão Clezio Cordeiro, Guedes Maria Magalhães Vasconcelos, Takano Daniela Mayumi, Filgueira Norma Arteiro, Ferraz Cláudia Elise

机构信息

Federal University of Pernambuco, Department of Internal Medicine, Recife, Brazil.

Federal University of Pernambuco, Department of Pathology, Recife, Brazil.

出版信息

IDCases. 2021;23:e01047. doi: 10.1016/j.idcr.2021.e01047. Epub 2021 Jan 12.

Abstract

We described a case of exuberant cutaneous small-vessel vasculitis in a 27-year-old male with mild CoVID-19 in Brazil. The patient presented painful purpuric papules and vesicobullous lesions with hemorrhagic content located in the larger amount in the lower limbs and, to a lesser extent in the region of the back and upper limbs, saving palms and soles of the feet. Influenza-like syndrome with anosmia and ageusia was reported seven days before the skin lesions. A real-time reverse transcription polymerase chain reaction was positive on a nasopharyngeal swab for SARS-CoV-2. Histopathological study showed leukocytoclastic cutaneous vasculitis affecting small vessels and microthrombi occluding some vessels. The patient presented an improvement in skin lesions by the fifth day of prednisone therapy. This case highlights the importance of the SARS-CoV-2 test in investigating the etiology of cutaneous vasculitis during this pandemic.

摘要

我们描述了巴西一名27岁轻度新型冠状病毒肺炎男性患者出现的一例皮疹性皮肤小血管炎病例。患者出现疼痛性紫癜丘疹及含血性内容物的水疱大疱性皮损,主要分布于双下肢,背部及上肢区域较少,手掌和足底未累及。皮肤损害出现前7天报告有嗅觉减退和味觉减退的流感样综合征。鼻咽拭子严重急性呼吸综合征冠状病毒2实时逆转录聚合酶链反应呈阳性。组织病理学研究显示白细胞破碎性皮肤血管炎累及小血管,部分血管有微血栓形成。泼尼松治疗第5天患者皮肤损害有所改善。该病例凸显了在此次大流行期间严重急性呼吸综合征冠状病毒2检测在调查皮肤血管炎病因方面的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e54e/7838715/c0d52e38a547/gr1.jpg

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