Pendlebury Gehan A, Oro Peter, Haynes William, Merideth Drew, Bartling Samantha, Bongiorno Michelle A
College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA.
School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, AZ 85206, USA.
Dermatopathology (Basel). 2022 Jun 29;9(3):212-243. doi: 10.3390/dermatopathology9030027.
The earliest cases of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, in December 2019. Since the declaration as a pandemic on 11 March 2020, further dermatological conditions continue to be documented. We herein present a novel literature review of dermatological manifestations associated with the Coronavirus Disease 2019 (COVID-19) pandemic. To date, this literature review is the first broad-spectrum examination that analyzes a range of dermatological manifestations related to the COVID-19 pandemic: infection, vaccinations, personal protective equipment (PPE), and psychosocial factors. A detailed literature search was conducted using key terms for cutaneous manifestations associated with the scope of this review. The search retrieved 2199 articles. The COVID-19 pandemic has triggered a significant range of dermatologic sequela. Etiologies of lesions continue to be investigated. Proposed mechanisms include inflammatory response to spike protein, vitamin D deficiency, ACE2 receptor activation, androgen levels, and increased psychological stress. One prominent mechanism describes viral spike protein invasion into the dermis by binding to the angiotensin-converting enzyme 2 (ACE-2) receptors in keratinocytes, with a secondary immunological response. Dermatologists play an integral role in the proper diagnosis and treatment of COVID-related lesions. Early treatment regimens and timely prophylaxis have been shown to safely reduce infection-related dermatological sequelae. Additional investigations and data collection can reduce disease burden and improve overall prognosis.
2019年12月，中国武汉首次出现严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染病例。自2020年3月11日该疾病被宣布为大流行以来，更多的皮肤疾病仍在不断被记录。在此，我们对与2019冠状病毒病（COVID-19）大流行相关的皮肤表现进行了一项新的文献综述。迄今为止，这篇文献综述是首次对一系列与COVID-19大流行相关的皮肤表现进行的广谱研究，这些表现包括感染、疫苗接种、个人防护装备（PPE）以及社会心理因素。我们使用与本综述范围相关的皮肤表现的关键词进行了详细的文献检索。检索到2199篇文章。COVID-19大流行引发了一系列显著的皮肤后遗症。皮损的病因仍在研究中。提出的机制包括对刺突蛋白的炎症反应、维生素D缺乏、血管紧张素转换酶2（ACE2）受体激活、雄激素水平以及心理压力增加。一个突出的机制描述了病毒刺突蛋白通过与角质形成细胞中的血管紧张素转换酶2（ACE-2）受体结合侵入真皮，并引发继发免疫反应。皮肤科医生在COVID相关皮损的正确诊断和治疗中起着不可或缺的作用。早期治疗方案和及时预防已被证明可以安全地减少与感染相关的皮肤后遗症。进一步的调查和数据收集可以减轻疾病负担并改善总体预后。
