RESUMO
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.
Assuntos
Vesícula/virologia , COVID-19/complicações , Exantema/virologia , Adulto , Idoso , Vesícula/patologia , Exantema/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , SARS-CoV-2/isolamento & purificação , Adulto JovemAssuntos
COVID-19/patologia , Eritema Multiforme/patologia , Corticosteroides/uso terapêutico , Idoso , Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Azitromicina/uso terapêutico , Proteína C-Reativa/metabolismo , COVID-19/sangue , COVID-19/fisiopatologia , Ceftriaxona/uso terapêutico , Combinação de Medicamentos , Eritema Multiforme/sangue , Eritema Multiforme/tratamento farmacológico , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Hospitalização , Humanos , Hidroxicloroquina/uso terapêutico , Lopinavir/uso terapêutico , Contagem de Linfócitos , Pessoa de Meia-Idade , Ritonavir/uso terapêutico , Tratamento Farmacológico da COVID-19Assuntos
Antivirais/uso terapêutico , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Síndrome Respiratória Aguda Grave/diagnóstico , Vasculite Leucocitoclástica Cutânea/etiologia , Idoso , Biópsia por Agulha/métodos , COVID-19 , Teste para COVID-19 , Técnicas de Laboratório Clínico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/patologia , Diagnóstico Diferencial , Quimioterapia Combinada , Serviço Hospitalar de Emergência , Feminino , Humanos , Imuno-Histoquímica , Pandemias , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/patologia , Radiografia Torácica/métodos , Síndrome Respiratória Aguda Grave/tratamento farmacológico , Síndrome Respiratória Aguda Grave/patologia , Resultado do Tratamento , Vasculite Leucocitoclástica Cutânea/patologia , Tratamento Farmacológico da COVID-19RESUMO
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.
RESUMO
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)