medigraphic.com
Órgano Oficial del Hospital Angeles Health System

2021, Number S1

<< Back Next >>

Acta Med 2021; 19 (S1)

SARS-CoV-2: a clinical and histopathological mosaic in dermatology

Quintero BG, Saeb LM

Language: Spanish
References: 75
Page: s58-63
PDF size: 171.94 Kb.


ABSTRACT

The SARS-CoV-2 pandemic has brought with it both immeasurable damage to humanity and countless clinical and pathophysiological questions in the medical field, with mucocutaneous diseases being some of the most visible, but the least studied. In this article we present a bibliographic review that includes the histopathological findings published in 70 articles concerning dermatoses associated with COVID-19, among which two main patterns stand out: that secondary to thrombotic vasculopathy and that associated to nonspecific mixed inflammatory infiltrate. Without a doubt, it is necessary to delve further into the possibility that these findings can be translated into prognostic and therapeutic factors for affected patients.


REFERENCES

  1. Gómez-Carballa A, Bello X, Pardo-Seco J, Martinón-Torres F, Salas A. Mapping genome variation of SARS-CoV-2 worldwide highlights the impact of COVID-19 super-spreaders. Genome Res. 2020; 30 (10): 1434-1448. doi: 10.1101/gr.266221.120.

  2. WHO Coronavirus Disease (COVID-19) Dashboard. (2021). Re trieved 22 January 2021, Available from: https://covid19.who.int/

  3. Guan W, Ni Z, Hu Y, Liang W, Ou C, He J et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020; 382: 1708-1720.

  4. Kanitakis J, Lesort C, Danset M, Jullien D. Chilblain-like acral lesions during the COVID-19 pandemic "COVID toes": histologic, immunofluorescence, and immunohistochemical study of 17 cases. J Am Acad Dermatol. 2020; 83 (3): 870-875. doi: 10.1016/j.jaad.2020.05.145.

  5. Magro C, Mulvey JJ, Berlin D, Nuovo G, Salvatore S, Harp J et al. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases. Translational Research: the journal of Laboratory and Clinical Medicine. 2020; 220: 1-13. Available in: https://doi.org/10.1016/j.trsl.2020.04.007

  6. Llamas-Velasco M, Muñoz-Hernández P, Lázaro-González J, Reolid-Pérez A, Abad-Santamaría B, Fraga J, Daudén-Tello E. Thrombotic occlusive vasculopathy in a skin biopsy from a livedoid lesion of a patient with COVID-19. Br J Dermatol. 2020; 183 (3): 591-593. doi: 10.1111/bjd.19222.

  7. Garrido RMC, Santos-Briz A, Santos-Briz A, Sánchez A, Alonso-Riaño M, Burgos J et al. Spectrum of clinicopathologic findings in COVID-19-induced skin lesions. Am J Surg Pathol. 2021; 45 (3): 293-303. doi: 10.1097/PAS.0000000000001634.

  8. Carrascosa JM, Morillas V, Bielsa I, Munera-Campos M. Cutaneous manifestations in the context of SARS-CoV-2 infection (COVID-19). Actas Dermosifiliogr. 2020; 111 (9): 734-742. doi: 10.1016/j.ad.2020.08.002.

  9. Gargiulo L, Pavia G, Facheris P, Valenti M, Sacrini F, Narcisi A et al. A fatal case of COVID-19 infection presenting with an erythema multiforme-like eruption and fever. Dermatol Ther. 2020; 33 (4): e13779. doi: 10.1111/dth.13779.

  10. García-Gil MF, García García M, Monte Serrano J, Prieto-Torres L, Ara-Martín M. Acral purpuric lesions (erythema multiforme type) associated with thrombotic vasculopathy in a child during the COVID-19 pandemic. J Eur Acad Dermatol Venereol. 2020; 34 (9): e443-e445. doi: 10.1111/jdv.16644.

  11. Jimenez-Cauhe J, Ortega-Quijano D, Carretero-Barrio I, Suarez-Valle A, Saceda-Corralo D, Moreno-Garcia del Real C et al. Erythema multiforme-like eruption in patients with COVID-19 infection: clinical and histological findings. Clin Exp Dermatol. 2020; 45 (7): 892-895. doi: 10.1111/ced.14281.

  12. Torrelo A, Andina D, Santonja C, Noguera-Morel L, Bascuas-Arribas M, Gaitero-Tristán J et al. Erythema multiforme-like lesions in children and COVID-19. Pediatr Dermatol. 2020; 37 (3): 442-446.

  13. Rubio-Muniz CA, Puerta-Peña M, Falkenhain-López D, Arroyo-Andrés J, Agud-Dios M, Rodriguez-Peralto JL et al. The broad spectrum of dermatological manifestations in COVID-19: clinical and histopathological features learned from a series of 34 cases. Journal of the European Academy of Dermatology and Venereology. JEADV. 2020; 34 (10): e574-e576. https://doi.org/10.1111/jdv.167346. doi: 10.1111/pde.14246.

  14. Karaca Z, Yayli S, Caliskan O. A unilateral purpuric rash in a patient with COVID-19 infection. Dermatol Ther. 2020; 33 (4): e13798. doi: 10.1111/dth.13798.

  15. Gianotti R, Veraldi S, Recalcati S, Cusini M, Ghislanzoni M, Boggio F et al. Cutaneous clinico-pathological findings in three COVID-19-positive patients observed in the Metropolitan Area of Milan, Italy. Acta Derm Venereol. 2020; 100 (8): adv00124. doi: 10.2340/00015555-3490.

  16. Larrondo J, Cabrera R, Gosch M, Larrondo F, Aylwin M, Castro A. Papular-purpuric exanthem in a COVID-19 patient: clinical and dermoscopic description. J Eur Acad Dermatol Venereol. 2020; 34 (10): e570-e572. doi: 10.1111/jdv.16732.

  17. Diaz-Guimaraens B, Dominguez-Santas M, Suarez-Valle A, Pindado-Ortega C, Selda-Enriquez G, Bea-Ardebol S et al. Petechial skin rash associated with severe acute respiratory syndrome coronavirus 2 infection. JAMA Dermatol. 2020; 156 (7): 820-822. doi: 10.1001/jamadermatol.2020.1741.

  18. Ho W, Wang D, Tan L, Bundele MM, Tan CH, Lim H. Two cases of cutaneous eruptions due to COVID-19 infection in Singapore: new insights into the spectrum of clinical presentation and histopathology. Journal of the European Academy of Dermatology and Venereology: JEADV. 2020; 34 (10): e576-e579. Available in: https://doi.org/10.1111/jdv.16736.

  19. Zengarini C, Orioni G, Cascavilla A, Horna SC, Fulgaro C, Misciali C et al. Histological pattern in COVID-19-induced viral rash. J Eur Acad Dermatol Venereol. 2020; 34 (9): e453-e454. doi: 10.1111/jdv.16569.

  20. Young S, Fernandez A. Skin manifestations of COVID-19. Cleve Clin J Med. 2020. Doi: 10.3949/ccjm.87a.ccc031.

  21. Rivera-Oyola R, Koschitzky M, Printy R, Liu S, Stanger R, Golant AK et al. Dermatologic findings in 2 patients with COVID-19. JAAD Case Rep. 2020; 6 (6): 537-539. doi: 10.1016/j.jdcr.2020.04.027.

  22. Sanchez A, Sohier P, Benghanem S, L'Honneur AS, Rozenberg F, Dupin N et al. Digitate papulosquamous eruption associated with severe acute respiratory syndrome coronavirus 2 infection. JAMA Dermatol. 2020; 156 (7): 819-820. doi: 10.1001/jamadermatol.2020.1704.

  23. Herrero-Moyano M, Capusan TM, Andreu-Barasoain M, Alcántara-González J, Ruano-Del Salado M, Sánchez-Largo Uceda ME et al. A clinicopathological study of eight patients with COVID-19 pneumonia and a late-onset exanthema. Journal of the European Academy of Dermatology and Venereology: JEADV. 2020; 34 (9): e460-e464. Available in: https://doi.org/10.1111/jdv.16631.

  24. Reymundo A, Fernáldez-Bernáldez A, Reolid A, Butrón B, Fernández-Rico P, Muñoz-Hernández P et al. Clinical and histological characterization of late appearance maculopapular eruptions in association with the coronavirus disease 2019. A case series of seven patients. J Eur Acad Dermatol Venereol. 2020; 34 (12): e755-e757. doi: 10.1111/jdv.16707.

  25. Macedo-Pérez M, Barragán-Estudillo ZF, Castillo-Montufar E, Choi SJ, Fernández-Rueda P, Donis-Hernández J et al. Dermatological findings in COVID-19 patients: Mexican experience. Int J Dermatol. 2020; 59 (7): 872-873. doi: 10.1111/ijd.14958.

  26. Rosell-Díaz AM, Mateos-Mayo A, Nieto-Benito LM, Balaguer-Franch I, Hernández de la Torre-Ruiz E, Lainez-Nuez A et al. Exanthema and eosinophilia in COVID-19 patients: has viral infection a role in drug induced exanthemas? Journal of the European Academy of Dermatology and Venereology. 2020; 34 (10): e561-e563. Available in: https://doi.org/10.1111/jdv.16709

  27. Rodríguez-Jiménez P, Chicharro P, De Argila D, Muñoz-Hernández P, Llamas-Velasco M. (Urticaria-like lesions in COVID-19 patients are not really urticaria - a case with clinicopathological correlation. Journal of the European Academy of Dermatology and Venereology. 2020; 34 (9): e459-e460. Available in: https://doi.org/10.1111/jdv.16618

  28. Ahouach B, Harent S, Ullmer A, Martres P, Bégon E, Blum L et al. Cutaneous lesions in a patient with COVID-19: are they related? Br J Dermatol. 2020; 183 (2): e31. doi: 10.1111/bjd.19168.

  29. Amatore F, Macagno N, Mailhe M, Demarez B, Gaudy-Marqueste C, Grob JJ et al. SARS-CoV-2 infection presenting as a febrile rash. J Eur Acad Dermatol Venereol. 2020; 34 (7): e304-e306. doi: 10.1111/jdv.16528.

  30. Perosanz-Lobo D, Fernandez-Nieto D, Burgos-Blasco P, Selda-Enriquez G, Carretero I, Moreno C, Fernández-Guarino M. Urticarial vasculitis in COVID-19 infection: a vasculopathy-related symptom? J Eur Acad Dermatol Venereol. 2020; 34 (10): e566-e568. doi: 10.1111/jdv.16713.

  31. Carreras-Presas CM, Sánchez JA, López-Sánchez AF, Jané-Salas E, Somacarrera-Pérez ML. Oral vesiculobullous lesions associated with SARS-CoV-2 infection. Oral Dis. 2020; 5: 10.1111/odi.13382. doi: 10.1111/odi.13382.

  32. Soares CD, Carvalho RA, Carvalho KA, Carvalho MG, Almeida OP. Letter to Editor: Oral lesions in a patient with Covid-19. Med Oral Patol Oral Cir Bucal. 2020; 25 (4): e563-564. Available in: https://doi.org/10.4317/medoral.24044

  33. Ansari R, Gheitani M, Heidari F, Heidari F. Oral cavity lesions as a manifestation of the novel virus (COVID-19). Oral Dis. 2021; 27 Suppl 3: 771-772. doi: 10.1111/odi.13465.

  34. Bosch-Amate X, Giavedoni P, Podlipnik S, Andreu-Febrer C, Sanz-Beltran J, Garcia-Herrera A et al. Retiform purpura as a dermatological sign of coronavirus disease 2019 (COVID-19) coagulopathy. J Eur Acad Dermatol Venereol. 2020; 34 (10): e548-e549. doi: 10.1111/jdv.16689.

  35. El Hachem M, Diociaiuti A, Concato C, Carsetti R, Carnevale C, Ciofi Degli Atti M et al. A clinical, histopathological and laboratory study of 19 consecutive Italian paediatric patients with chilblain-like lesions: lights and shadows on the relationship with COVID-19 infection. J Eur Acad Dermatol Venereol. 2020; 34 (11): 2620-2629. doi: 10.1111/jdv.16682.

  36. Calvao J, Relvas M, Pinho A, Brinca A, Cardoso JC. Acro-ischaemia and COVID-19 infection: clinical and histopathological features. J Eur Acad Dermatol Venereol. 2020; 34 (11): e653-e754. doi: 10.1111/jdv.16687.

  37. Andina D, Noguera-Morel L, Bascuas-Arribas M, Gaitero-Tristán J, Alonso-Cadenas JA, Escalada-Pellitero S et al. Chilblains in children in the setting of COVID-19 pandemic. Pediatr Dermatol. 202; 37 (3): 406-411. doi: 10.1111/pde.14215.

  38. Colonna C, Monzani NA, Rocchi A, Gianotti R, Boggio F, Gelmetti C. Chilblain-like lesions in children following suspected COVID-19 infection. Pediatr Dermatol. 2020; 37 (3): 437-440. doi: 10.1111/pde.14210.

  39. Cordoro KM, Reynolds SD, Wattier R, McCalmont TH. Clustered cases of acral perniosis: Clinical features, histopathology, and relationship to COVID-19. Pediatr Dermatol. 2020; 37 (3): 419-423. doi: 10.1111/pde.14227.

  40. Kolivras A, Dehavay F, Delplace D, Feoli F, Meiers I, Milone L et al. Coronavirus (COVID-19) infection-induced chilblains: A case report with histopathologic findings. JAAD Case Rep. 2020; 6 (6): 489-492. doi: 10.1016/j.jdcr.2020.04.011.

  41. Locatelli AG, Robustelli Test E, Vezzoli P, Carugno A, Moggio E, Consonni L et al. Histologic features of long-lasting chilblain-like lesions in a paediatric COVID-19 patient. J Eur Acad Dermatol Venereol. 2020; 34 (8): e365-e368. doi: 10.1111/jdv.16617.

  42. Rodríguez-Villa Lario A, Vega-Díez D, González-Cañete M, Gómez-Zubiaur A, Pérez-Mesonero R, Bandini M et al. Histological findings in chilblain lupus-like COVID lesions: in search of an answer to understand their aetiology. J Eur Acad Dermatol Venereol. 2020; 34 (10): e572-e574. doi: 10.1111/jdv.16733.

  43. Romaní J, Baselga E, Mitjà O, Riera-Martí N, Garbayo P, Vicente A et al. Lesiones pernióticas y acrales en España durante el confinamiento por COVID: análisis retrospectivo de 12 casos. Chilblain and acral purpuric lesions in Spain during COVID confinement: retrospective analysis of 12 cases. Actas Dermo-Sifiliograficas. 2020; 111 (5): 426-429. Available in: https://doi.org/10.1016/j.ad.2020.04.002

  44. Neri I, Virdi A, Corsini I, Guglielmo A, Lazzarotto T, Gabrielli L et al. Major cluster of paediatric "true" primary chilblains during the COVID-19 pandemic: a consequence of lifestyle changes due to lockdown. J Eur Acad Dermatol Venereol. 2020; 34 (11): 2630-2635. doi: 10.1111/jdv.16751.

  45. Colonna C, Genovese G, Monzani NA, Picca M, Boggio F, Gianotti R et al. Outbreak of chilblain-like acral lesions in children in the metropolitan area of Milan, Italy, during the COVID-19 pandemic. J Am Acad Dermatol. 2020; 83 (3): 965-969. doi: 10.1016/j.jaad.2020.06.019.

  46. Colmenero I, Santonja C, Alonso-Riaño M, Noguera-Morel L, Hernández-Martín A, Andina D et al. SARS-CoV-2 endothelial infection causes COVID-19 chilblains: histopathological, immunohistochemical and ultrastructural study of seven paediatric cases. Br J Dermatol. 2020; 183 (4): 729-737. doi: 10.1111/bjd.19327.

  47. Santonja C, Heras F, Núñez L, Requena L. COVID-19 chilblain-like lesion: immunohistochemical demonstration of SARS-CoV-2 spike protein in blood vessel endothelium and sweat gland epithelium in a polymerase chain reaction-negative patient. Br J Dermatol. 2020; 183 (4): 778-780. doi: 10.1111/bjd.19338.

  48. García-Legaz MM, Martínez-Doménech A, Magdaleno-Tapial J, Valenzuela-Oñate C, Partarrieu-Mejías F, Lorca-Sprohnle J et al. Acute acral cutaneous manifestations during the COVID-19 pandemic: a single-centre experience. J Eur Acad Dermatol Venereol. 2020; 34 (11): e692-e694. doi: 10.1111/jdv.16777.

  49. Herman A, Peeters C, Verroken A, Tromme I, Tennstedt D, Marot L et al. Evaluation of chilblains as a manifestation of the COVID-19 pandemic. JAMA Dermatol. 2020; 156 (9): 998-1003. doi: 10.1001/jamadermatol.2020.2368.

  50. Ladha MA, Dupuis EC. SARS-CoV-2-related chilblains. CMAJ. 2020; 192 (28): E804. doi: 10.1503/cmaj.201348.

  51. Mahé A, Birckel E, Merklen C, Lefebvre P, Hannedouche C, Jost M et al. Histology of skin lesions establishes that the vesicular rash associated with COVID-19 is not "varicella-like". J Eur Acad Dermatol Venereol. 2020; 34 (10): e559-e561. doi: 10.1111/jdv.16706.

  52. Marzano AV, Genovese G, Fabbrocini G, Pigatto P, Monfrecola G, Piraccini BM et al. Varicella-like exanthem as a specific COVID-19-associated skin manifestation: Multicenter case series of 22 patients. J Am Acad Dermatol. 2020; 83 (1): 280-285. doi: 10.1016/j.jaad.2020.04.044.

  53. Negrini S, Guadagno A, Greco M, Parodi A, Burlando M. An unusual case of bullous haemorrhagic vasculitis in a COVID-19 patient. J Eur Acad Dermatol Venereol. 2020; 34 (11): e675-e676. doi: 10.1111/jdv.16760.

  54. Trellu LT, Kaya G, Alberto C, Calame A, McKee T, Calmy A. Clinicopathologic aspects of a papulovesicular eruption in a patient with COVID-19. JAMA Dermatol. 2020; 156 (8): 922-924. doi: 10.1001/jamadermatol.2020.1966.

  55. Torres-Navarro I, Abril-Pérez C, Roca-Ginés J, Sánchez-Arráez J, Botella-Estrada R. A case of cefditoren-induced acute generalized exanthematous pustulosis during COVID-19 pandemics. Severe cutaneous adverse reactions are an issue. J Eur Acad Dermatol Venereol. 2020; 34 (10): e537-e539. doi: 10.1111/jdv.16664.

  56. Skroza N, Bernardini N, Balduzzi V, Mambrin A, Marchesiello A, Michelini S et al. A late-onset widespread skin rash in a previous COVID-19-infected patient: viral or multidrug effect? J Eur Acad Dermatol Venereol. 2020; 34 (9): e438-e439. doi: 10.1111/jdv.16633.

  57. Delaleu J, Deniau B, Battistella M, de Masson A, Bensaid B, Jachiet M et al. Acute generalized exanthematous pustulosis induced by hydroxychloroquine prescribed for COVID-19. J Allergy Clin Immunol Pract. 2020; 8 (8): 2777-2779.e1. doi: 10.1016/j.jaip.2020.05.046.

  58. Robustelli TE, Vezzoli P, Carugno A, Raponi F, Gianatti A, Rongioletti F et al. Acute generalized exanthematous pustulosis with erythema multiforme-like lesions induced by Hydroxychloroquine in a woman with coronavirus disease 2019 (COVID-19). J Eur Acad Dermatol Venereol. 2020; 34 (9): e457-e459. doi: 10.1111/jdv.16613.

  59. Vanegas RA, Efe D, Fischer M. Drug-induced vasculitis in a patient with COVID-19. J Eur Acad Dermatol Venereol. 2020; 34 (8): e361-e362. doi: 10.1111/jdv.16588.

  60. Monte SJ, Cruañes MJ, García-García M, García-Gil MF. Hydroxychloroquine-induced erythema multiforme in a patient with COVID-19. Eritema multiforme inducido por hidroxicloroquina en paciente con COVID-19. Medicina Clínica. 2020; 155 (5): 231. Available in: https://doi.org/10.1016/j.medcli.2020.05.004

  61. Sakaida T, Tanimoto I, Matsubara A, Nakamura M, Morita A. Unique skin manifestations of COVID-19: is drug eruption specific to COVID-19? J Dermatol Sci. 2020; 99 (1): 62-64. doi: 10.1016/j.jdermsci.2020.05.002.

  62. Suarez-Valle A, Fernandez-Nieto D, Melian-Olivera A, Dominguez-Santas M, Diaz-Guimaraens B, Garcia Del Real CM et al. Comment on "Generalized pustular figurate erythema: a newly delineated severe cutaneous drug reaction linked with hydroxychloroquine": report of a COVID-19 patient with particular findings. Dermatol Ther. 2020; 33 (6): e13852. doi: 10.1111/dth.13852.

  63. Enos T, Jeong HS, Vandergriff T, Jacobe HT, Chong BF. Acute generalized exanthematous pustulosis induced by empiric hydroxychloroquine for presumed COVID-19. Dermatol Ther. 2020; 33 (6): e13834. doi: 10.1111/dth.13834.

  64. Caputo V, Schroeder J, Rongioletti F. A generalized purpuric eruption with histopathologic features of leucocytoclastic vasculitis in a patient severely ill with COVID-19. J Eur Acad Dermatol Venereol. 2020; 34 (10): e579-e581. doi: 10.1111/jdv.16737.

  65. Ordieres-Ortega L, Toledo-Samaniego N, Parra-Virto A, Fernández-Carracedo E, Lavilla-Olleros C, Demelo-Rodríguez P. Atypical erythema nodosum in a patient with COVID-19 pneumonia. Dermatol Ther. 2020; 33 (4): e13658. doi: 10.1111/dth.13658.

  66. Taskin B, Vural S, Altug E, Demirkesen C, Kocatürk E, Celebi I et al. Coronavirus 19 presenting with atypical Sweet's syndrome. J Eur Acad Dermatol Venereol. 2020; 34 (10): e534-e535. doi: 10.1111/jdv.16662.

  67. Bitar C, Chan MP, Harms PW, Fullen DR, Gudjonsson JE, Eshaq M et al. Cutaneous manifestations of hospitalized coronavirus disease 2019 patients: a report of six cases with clinicopathologic features and viral RNA in situ hybridization. J Eur Acad Dermatol Venereol. 2020; 34 (11): e656-e659. doi: 10.1111/jdv.16741.

  68. Mayor-Ibarguren A, Feito-Rodriguez M, Quintana Castanedo L, Ruiz-Bravo E, Montero Vega D, Herranz-Pinto P. Cutaneous small vessel vasculitis secondary to COVID-19 infection: a case report. J Eur Acad Dermatol Venereol. 2020; 34 (10): e541-e542. doi: 10.1111/jdv.16670.

  69. Dominguez-Santas M, Diaz-Guimaraens B, Garcia Abellas P, Moreno-Garcia Del Real C, Burgos-Blasco P, Suarez-Valle A. Cutaneous small-vessel vasculitis associated with novel 2019 coronavirus SARS-CoV-2 infection (COVID-19). J Eur Acad Dermatol Venereol. 2020;34(10):e536-e537. doi: 10.1111/jdv.16663.

  70. Hashizume H, Sano Y, Furukawa S, Imokawa S. Eosinophilic granulomatosis with polyangiitis mimicking coronavirus disease 2019: a case report. Journal of the European Academy of Dermatology and Venereology: JEADV. 2020; 34 (10): e557-e559. https://doi.org/10.1111/jdv.16705

  71. Schnapp A, Abulhija H, Maly A, Armoni-Weiss G, Levin Y, Faitatziadou SM et al. Introductory histopathological findings may shed light on COVID-19 paediatric hyperinflammatory shock syndrome. J Eur Acad Dermatol Venereol. 2020; 34 (11): e665-e667. doi: 10.1111/jdv.16749.

  72. Leis-Dosil VM, Sáez Vicente A, Lorido-Cortés MM. Paniculitis eosinofílica secundaria a infección por COVID-19 [Eosinophilic Panniculitis Associated With COVID-19]. Actas Dermo-Sifiliograficas. 2020; 111 (9): 804-805. https://doi.org/10.1016/j.ad.2020.05.003

  73. Tehranchinia Z, Asadi-Kani Z, Rahimi H. Lichenoid eruptions with interface dermatitis and necrotic subepidermal blister associated with COVID-19. Dermatol Ther. 2020; 33 (6): e13828. doi: 10.1111/dth.13828.

  74. Shaigany S, Gnirke M, Guttmann A, Chong H, Meehan S, Raabe V et al. An adult with Kawasaki-like multisystem inflammatory syndrome associated with COVID-19. Lancet. 2020; 396 (10246): e8-e10. Available in: https://doi.org/10.1016/S0140-6736(20)31526-9

  75. Gianotti R, Recalcati S, Fantini F, Riva C, Milani M, Dainese E et al. Histopathological study of a broad spectrum of skin dermatoses in patients affected or highly suspected of infection by COVID-19 in the Northern Part of Italy: analysis of the many faces of the viral-induced skin diseases in previous and new reported cases. Am J Dermatopathol. 2020; 42 (8): 564-570. doi: 10.1097/DAD.0000000000001707.




2020     |     www.medigraphic.com