COVID-19 Adds skin condition to long range effect

Preliminary data from the International Registry suggests that in some patients with COVID-19, benign but potentially painful skin conditions can last for months.

About 5% of patients with chilblains or chilblains had “long-distance” toe symptoms that lasted more than 60 days. In two cases, toe symptoms lasted 4-5 months. Some patients also had symptoms commonly associated with COVID-19, such as persistent dry cough and fever, while others, especially those with persistent skin symptoms beyond the normal symptomatological stage, Dermatology was the predominant symptom.

Other specific skin conditions of COVID-19 lasted for more than a month in at least one case, reported Esther Freeman, MD, PhD at Massachusetts General Hospital in Boston. European Academy of Dermatology and Signalology (EADV) Virtual Congress..

“There is a subset of patients whose skin symptoms of COVID show long-distance or long-distance COVID symptoms,” says Freeman. “This is especially noticeable with pernio chilblains, and I think this phenomenon is actually underreported in the registry. It’s probably even more common than you can see in this data.”

In response to the question, Freeman said that limited correlation data had been collected to date to make a definitive statement about the association between long-distance skin symptoms and other COVID-19 symptoms. Persistent pain and discomfort associated with chilblains also seem to be rare.

“I think the COVID-19 setting should reassure most patients who develop chilblains or chilblains,” she added. “In both the registry and my own patient cohort, the symptoms resolved after a median of 15 days. I think it’s an underestimate because I’ve seen many patients last for 4 and 6 weeks. In most cases, pain and discomfort lasts only about a week for our patients. “

Pernio-related toe discoloration is not associated with necrosis or other underlying tissue damage, according to Freeman. Today’s MedPage on mail. Chilblains / chilblains are more commonly associated with cold, but unlike frostbite, she states that they can cause gangrene.

The findings are from the international COVID-19 Dermatology Registry sponsored by the American Academy of Dermatology. Founded in early April with the support of the International League of Dermatologic Society, the registry has accumulated data on more than 1,000 patients from 41 countries. Approximately 30% of the cases collected so far have been confirmed in the COVID-19 laboratory.Freeman and colleagues Recently reported Findings of the first 716 patients registered in the registry.

The EADV presentation focused on 224 patients (90 confirmed in the COVID-19 laboratory) for whom clinicians provided information on the duration of skin symptoms. The cohort included 98 pernio patients, 29 morbilliform rashes, 28 urticaria, 25 erythema erythema, 20 bullous rashes, 20 papular squamous rashes, and 3 reticular purpura.

The median duration of all symptoms was 12 days, with a subset of the diseases identified by the test being 7 days. The median duration ranged from 5 days for urticaria to 20 days for papular squamous cell rash and reticular purpura.

The Pernio subgroup was the most outlier or long-haul carrier, as 5 of 98 had toe symptoms lasting 60 days or longer, compared to each of the subgroups with follicular and papular eruptions. Had. The median duration of patients with morbilliform rash was 7 days, and symptoms in 2 of 29 patients lasted about 30 days. Urticaria lasted for 5 days, and in one patient the symptoms lasted for 30 days. Laboratory confirmation was generally associated with shorter duration of symptoms, except for papular squamous cell carcinoma with a median duration of 20 days.

Freeman described the clinical course of a pernio long-haul carrier with toe symptoms lasting 133 days. The patient first complained of fatigue and cough, and the onset of erythema and painful chilblains was reported on day 7. As for the test result, COVID-19 was confirmed 24 days after the previous negative test, and the chilblains had worsened. On day 41, the patient was positive again and continued to be tired. At the final follow-up, the patient’s malaise improved, but pernio persisted.

According to Freeman, patients with COVID-19 symptoms, such as fatigue, neurological symptoms, and heart symptoms, have been announced for several months since the summer. It is unclear if the same applies to the skin symptoms of the disease, and the enrollment data provided evidence that some patients have long-distance skin symptoms.

“Nine months after the onset of the COVID-19 pandemic, there is increasing awareness of persistent prevalence beyond the acute phase of the disease,” Freeman concludes. “The duration of urticaria and measles-like rash was relatively short, but the eruptions of chilblains and papular squamous epithelium were long-lasting.”