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2021, Number S1

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Acta Med 2021; 19 (S1)

The thousand faces of skin in patients with COVID-19 disease

Guzmán PMG, Flores OJ, López GMI

Language: Spanish
References: 60
Page: s9-20
PDF size: 264.66 Kb.


ABSTRACT

The actual frequency of skin manifestations associated with SARS-CoV-2 infection is unknown. Even with advanced immunohistochemical techniques with viral proteins, the finding of the virus in the skin is still controversial, therefore, it is considered that the lesions are paraviral. The pathophysiology of COVID-19 skin lesions is complex and their morphology is heterogeneous. Cytotoxic mechanisms of SARS-CoV-2 appear to cause mast cell stimulation, endothelial damage, vascular dilation, perivascular and periglandular infiltration by lymphocytes and neutrophils, interface damage, and occasionally focal epidermal necrosis. The host defense mechanisms against infection seem to contribute to the genesis of lesions reported in the literature. Also, the direct toxicity of SARS-CoV-2; activation of immediate, late, humoral and cellular immune responses; cytokine storm with micro-thrombosis; as well as the probable activation of other viruses (herpes 6-7) and the use of multiple drugs can play an important role. From a clinical point of view, patients present a wide spectrum of combinations of elementary lesions. European series report a high incidence of acral inflammatory lesions. In Mexico, maculopapular rashes are the most frequent manifestations. There are a large number of differential diagnosis, viral, bacterial, parasitic infections and reactional clinical pictures, must continue to take into account.


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