Martora Fabrizio, Battista Teresa, Fabbrocini Gabriella, Megna Matteo
Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy.
Trop Med Infect Dis. 2023 Feb 8;8(2):107. doi: 10.3390/tropicalmed8020107.
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first isolated in Wuhan, China, is currently a pandemic. At the beginning of the pandemic, pulmonary issues were the most discussed and studied. However, now 3 years later, the role of the dermatologist has become increasingly central. Often the diversity in the presentation of these manifestations has made it difficult for the dermatologist to recognize them. In addition to the common symptoms involving fever, cough, dyspnea, and hypogeusia/hyposmia that have been widely discussed in the literature, much attention has been paid to dermatologic manifestations in the past year. The vaccination campaign has been the most important strategy to combat the COVID-19 pandemic. Specifically, two viral vector-based vaccines [Vaxzervria (AstraZeneca; AZD1222) and COVID-19 Janssen vaccine (Johnson & Johnson; Ad26.COV2. S)] and two mRNA-based vaccines [Comirnaty (Pfizer/BioNTech; BNT162b2) and Spikevax (Moderna; mRNA-1273)]. However, several cutaneous adverse reactions have been reported following vaccination, making the dermatologist's role critical. It is possible to group these adverse reactions according to a classification with six main clinical pictures: urticarial rash, erythematous/maculopapular/morbid rash, papulovesicular rash, chilblain-like acral pattern, livedo reticularis/racemose-like, and purpuric "vasculitic" pattern. Beyond this classification, there are several reports of other dermatologic manifestations associated with the infection, such as pityriasis rosea, herpes zoster, or, particularly, the worsening of pre-existing chronic inflammatory dermatologic diseases. Here we report the case of a 61-year-old patient who presented at our clinic with a diffuse psoriasiform eruption mixed with a concomitant blistering rash induced by COVID-19. The uniqueness of our case has two features: the first is the concomitance of the two events after infection that seems to be unprecedented; the second is the management of the patient that could help dermatology colleagues in the management of these conditions during infection.
2019冠状病毒病（COVID-19）由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起，该病毒最早在中国武汉被分离出来，目前已成为大流行病。在大流行初期，肺部问题是讨论和研究最多的。然而，3年后，皮肤科医生的作用变得越来越重要。这些表现形式的多样性常常使皮肤科医生难以识别它们。除了文献中广泛讨论的发热、咳嗽、呼吸困难和味觉减退/嗅觉减退等常见症状外，过去一年对皮肤表现也给予了很多关注。疫苗接种运动一直是抗击COVID-19大流行的最重要策略。具体来说，有两种基于病毒载体的疫苗[Vaxzervria（阿斯利康；AZD1222）和COVID-19杨森疫苗（强生公司；Ad26.COV2.S）]以及两种基于mRNA的疫苗[Comirnaty（辉瑞/生物科技公司；BNT162b2）和Spikevax（莫德纳公司；mRNA-1273）]。然而，接种疫苗后报告了几种皮肤不良反应，这使得皮肤科医生的作用至关重要。可以根据六种主要临床表现的分类对这些不良反应进行分组：荨麻疹样皮疹、红斑/斑丘疹/病态皮疹、丘疹水疱性皮疹、冻疮样肢端型、网状青斑/总状样以及紫癜性“血管炎”型。除了这种分类外，还有几篇关于与感染相关的其他皮肤表现的报告，如玫瑰糠疹、带状疱疹，特别是既往慢性炎症性皮肤病的恶化。在此，我们报告一例61岁患者，该患者因COVID-19在我们诊所出现弥漫性银屑病样皮疹并伴有水疱性皮疹。我们病例的独特之处有两个特点：一是感染后这两种情况同时出现，这似乎是前所未有的；二是对该患者的治疗有助于皮肤科同行在感染期间对这些情况进行管理。
