RESUMEN
COVID-19 is an infectious disease caused by severe acute respiratory coronavirus 2 (SARS-CoV-2). Vesicular skin rashes have been reported as associated with COVID-19, but there is little information about this cutaneous manifestation. We designed a prospective observational study of patients diagnosed with COVID-19 who had vesicular lesions. Clinical characterization of skin findings was conducted by dermatologists. When possible, histological analysis and detection of SARS-CoV-2 in the content of the vesicles was performed. In total, 24 patients were included. A disseminated pattern was found in 18 patients (75%), and a localized pattern was found in 6 (25%). Median duration of the skin rash was 10 days. Of the 24 patients, 19 (79.2%) developed the skin rash after the onset of COVID-19 symptoms. Histological examination in two patients was consistent with viral infection, SARS-CoV-2 was not detected in four patients. This single-centre study shows the clinical characteristics of vesicular skin rashes in patients with COVID-19.
Asunto(s)
Vesícula/virología , COVID-19/complicaciones , Exantema/virología , Adulto , Anciano , Vesícula/patología , Exantema/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , SARS-CoV-2/aislamiento & purificación , Adulto JovenAsunto(s)
COVID-19/patología , Eritema Multiforme/patología , Corticoesteroides/uso terapéutico , Anciano , Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , Azitromicina/uso terapéutico , Proteína C-Reactiva/metabolismo , COVID-19/sangre , COVID-19/fisiopatología , Ceftriaxona/uso terapéutico , Combinación de Medicamentos , Eritema Multiforme/sangre , Eritema Multiforme/tratamiento farmacológico , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Hospitalización , Humanos , Hidroxicloroquina/uso terapéutico , Lopinavir/uso terapéutico , Recuento de Linfocitos , Persona de Mediana Edad , Ritonavir/uso terapéutico , Tratamiento Farmacológico de COVID-19Asunto(s)
Antivirales/uso terapéutico , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Síndrome Respiratorio Agudo Grave/diagnóstico , Vasculitis Leucocitoclástica Cutánea/etiología , Anciano , Biopsia con Aguja/métodos , COVID-19 , Prueba de COVID-19 , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/patología , Diagnóstico Diferencial , Quimioterapia Combinada , Servicio de Urgencia en Hospital , Femenino , Humanos , Inmunohistoquímica , Pandemias , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/patología , Radiografía Torácica/métodos , Síndrome Respiratorio Agudo Grave/tratamiento farmacológico , Síndrome Respiratorio Agudo Grave/patología , Resultado del Tratamiento , Vasculitis Leucocitoclástica Cutánea/patología , Tratamiento Farmacológico de COVID-19RESUMEN
The development of perianal ulcers related to the use of a hemorrhoidal ointment has not been reported in the literature. We describe a series of 11 patients who were treated for perianal ulcers in 10 Spanish hospitals after they used the same ointment containing the active ingredients triamcinolone acetonide, lidocaine, and pentosan polysulfate sodium. No prior or concomitant conditions suggesting an alternative cause for the condition could be identified, and after the patients stopped using the ointment, their ulcers cleared completely in 8 weeks on average. This case series shows the damage that can be caused by an over-the-counter pharmaceutical product used without medical follow-up. It also illustrates the need to ask patients with perianal ulcers about any topical agents used before the lesions appeared.
RESUMEN
La aparición de úlceras perianales en relación con una pomada antihemorroidal es una condición nunca antes reportada en la literatura. Presentamos una serie de 11 casos de 10 hospitales españoles con diagnóstico de úlceras perianales tras la aplicación de una misma pomada antihemorroidal con acetónido de triamcinolona, lidocaína y pentosano polisulfato sódico como principios activos. No se ha podido identificar ninguna condición previa o enfermedad concomitante que pudiera justificar un diagnóstico etiológico alternativo y tras retirar la pomada antihemorroidal se ha evidenciado una resolución completa de las úlceras en un periodo medio de 8 semanas. Esta serie de casos evidencia el potencial efecto dañino de un producto farmacéutico no sujeto a prescripción ni seguimiento médico y la necesidad de interrogar por el uso de agentes tópicos ante la aparición de úlceras perianales (AU)
The development of perianal ulcers related to the use of a hemorrhoidal ointment has not been reported in the literature. We describe a series of 11 patients who were treated for perianal ulcers in 10 Spanish hospitals after they used the same ointment containing the active ingredients triamcinolone acetonide, lidocaine, and pentosan polysulfate sodium. No prior or concomitant conditions suggesting an alternative cause for the condition could be identified, and after the patients stopped using the ointment, their ulcers cleared completely in 8 weeks on average. This case series shows the damage that can be caused by an over-the-counter pharmaceutical product used without medical follow-up. It also illustrates the need to ask patients with perianal ulcers about any topical agents used before the lesions appeared (AU)