Cutaneous Manifestations in Patients With COVID-19 Treated at a University Hospital in Southern Brazil.

Objectives The aim of this study was to ascertain whether pattern of cutaneous lesions, age, sex, ethnicity, long-term medication use, arterial oxygen saturation at the first examination, setting of care, and number of medications used to treat SARS-CoV-2 infection are associated with mortality in patients with a confirmed diagnosis of coronavirus disease 2019 (COVID-19) and cutaneous manifestations. In addition, to evaluate the occurrence of cutaneous manifestations in patients with a confirmed diagnosis of COVID-19 through a review of medical records and in-person evaluation by a dermatologist. Methods This investigation consisted of two components - (A) a cross-sectional study with a retrospective review of the medical records of all patients with a positive reverse-transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 treated at Santa Casa de Misericórdia de Porto Alegre between March 2020 and November 2020, and (B) a prospective case series with in-person skin examination by an attending dermatologist of all patients admitted to COVID-19 wards between April 2021 and July 2021. The pattern of skin lesions and other variables were assessed. Results Information from 2968 individuals with COVID-19 was collected (2826 from the medical records and 142 from the in-person examination by a dermatologist). Of these, a total of 51 patients (1.71%) had COVID-19-related cutaneous lesions - 36 from the medical records group (1.27% of cutaneous manifestations) and 15 from the examinated group (10.56% of cutaneous manifestations). Of 51 patients, 15 (29.41%) died. There was no association between mortality and patterns of cutaneous manifestations. The variables male sex (p=0.021), intensive care unit (ICU) admission (p=0.001), and use of three or more antibiotics (p=0.041) were associated with higher mortality. Conclusions The risk factors, proven by our study, for mortality in patients with COVID-19 and cutaneous manifestations were male sex, ICU stays, and use of three or more antibiotics. Using the review of medical records as a tool for evaluating cutaneous manifestations related to COVID-19, there are about 10 times fewer occurrences when compared to in-person evaluation by a dermatologist.

Sensitivity and specificity of self-reported acne in 18-year-old adolescent males.

BACKGROUND: Self-reporting is widely used in medical research. The objective of the present study was to evaluate the specificity and sensitivity of self-reported lesions of acne (scars and active lesions) obtained by an interview with the examination carried out by a dermatologist. METHODS: A questionnaire was applied to male adolescents who registered for obligatory military service. After that, skin examination was carried out. RESULTS: Of the 2,191 adolescents examined, 474 (21.60%) showed acne scars, and 625 (28.51%) admitted to having scars. The sensitivity of self-reported scars was 50.84%, and the specificity was 77.65%. The prevalence of active acne obtained by the dermatological examination was 85.76% and from self-reported acne was 76.12%, with a sensitivity of 80.95% and a specificity of 52.88%. Neither schooling nor social class made any difference to sensitivity or specificity. CONCLUSIONS: Our findings showed that sensitivity and specificity of self-reported acne was very low, pointing out that, in a sample of adolescents, self-reporting of acne shows itself as an inadequate instrument for epidemiological studies.

Most common patterns of acne in male adolescents: a population-based study.

BACKGROUND: Acne vulgaris is a common skin disease affecting more than 85% of adolescents and often continuing into adulthood. Population-based studies to assess the patterns and severity of acne have not been achieved. OBJECTIVES: The aim of this study was to assess the most common patterns of facial and trunk acne in young (18-year-old) men in a representative sample of male adolescents in a city in southern Brazil and to investigate the severity of inflammatory and non-inflammatory lesions in these individuals. METHODS: In Brazil, military service is compulsory for all males. Every adolescent male must report to his military service headquarters to submit to a medical screening examination. The study included 2201 adolescents, each of whom underwent a skin examination conducted by a dermatologist to identify and quantify all non-inflammatory (comedones) and inflammatory (papules, pustules, and nodules) lesions. RESULTS: Non-inflammatory lesions (comedones) were observed on 1487 individuals, and inflammatory lesions (papules and pustules) were noted on 1497 individuals. The most common patterns of facial acne were the full-face, bilateral malar and frontal mentonian distributions. CONCLUSIONS: This is the first population-based study to evaluate patterns of acne. Facial involvement was very prevalent, and the frontal region was found to dominate patterns of distribution of acne vulgaris. Comedonian acne of the face was much more intense and affected the entire face. In inflammatory facial acne, the majority of the study subjects exhibited up to five lesions in the region under study.