Friendly Foot Care, P.C., Crown Point, Indiana, USA.
Department of Dermatology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
J Cutan Pathol. 2022 Sep;49(9):791-794. doi: 10.1111/cup.14240. Epub 2022 Apr 18.
During the 2020 coronavirus (SARS-CoV-2) pandemic, several cutaneous lesions were identified, including pseudo-chilblain, vesicular, urticarial, maculopapular, and livedo/necrosis. A 59-year-old obese man with probable COVID-19 developed painful cyanosis with histopathologic capillary thrombosis of toes, and the cyanosis persisted for nearly 22 months. Shortly after initial exposure to family members with documented SARS-CoV-2, he developed upper respiratory symptoms, yet his anti-SARS-CoV-2 antibody and nasal swab RT-PCR tests were repeatedly negative. Two family members were hospitalized and one of them succumbed with documented SARS-CoV-2 pneumonia within 10 days of exposure. Biopsy specimen of the distal toe 16 weeks after initial exposure showed papillary dermal capillary thrombosis with endothelial swelling, telangiectasia, and peri-eccrine lymphocytic infiltrates resembling pernio. Overall, this is the first case of biopsy specimen of "long COVID toe" following presumed SARS-CoV-2 exposure, with a demonstration of thrombotic vasculopathy, toe cyanosis, and pernio-like pathology.
在 2020 年冠状病毒（SARS-CoV-2）大流行期间，发现了几种皮肤损伤，包括假性冻疮、水疱、荨麻疹、斑丘疹和瘀斑/坏死。一名 59 岁肥胖男子患有疑似 COVID-19，出现疼痛性发绀，伴有组织病理学毛细血管血栓形成的脚趾，发绀持续了近 22 个月。在最初接触有记录的 SARS-CoV-2 的家庭成员后不久，他出现了上呼吸道症状，但他的抗 SARS-CoV-2 抗体和鼻拭子 RT-PCR 检测反复呈阴性。两名家庭成员住院，其中一名在接触后 10 天内因有记录的 SARS-CoV-2 肺炎而死亡。初次接触后 16 周时远端脚趾的活检标本显示乳头状真皮毛细血管血栓形成，伴有内皮肿胀、毛细血管扩张和类似冻疮的外分泌汗腺周围淋巴细胞浸润。总的来说，这是首例疑似 SARS-CoV-2 暴露后“长 COVID 脚趾”的活检标本，表现为血栓性血管病变、脚趾发绀和类似冻疮的病理学。
