Perniosis during theCOVID-19 pandemic: Negativeanti-SARS-CoV-2 immunohistochemistry in six patients and comparison to perniosis before the emergence ofSARS-CoV-2
Perniosis during theCOVID-19 pandemic: Negativeanti-SARS-CoV-2 immunohistochemistry in six patients and comparison to perniosis before the emergence ofSARS-CoV-2
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DOI：
10.1111/cup.13830
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发表时间：
2020-09-09
影响因子：
1.7
通讯作者：
McNiff, Jennifer M.
中科院分区：
文献类型：
--
作者：
Ko, Christine J.;Harigopal, Malini;McNiff, Jennifer M.
背景在COVID-19大流行期间，多个国家描述了与特发性或自身免疫相关性冻疮（冻疮）有一定相似性的肢端炎性病变。方法我们检查了2020年5月中旬至6月中旬收到的5例患者的6例连续此类病例的组织病理学结果，评估SARS-CoV-2核衣壳蛋白的免疫组化染色。我们将这6例病例与2019年1月至6月期间诊断为冻疮的8例病例进行了比较。结果在COVID-19大流行期间，6个具有淋巴细胞样组织病理学的病变中有5个具有明显的淋巴细胞紧套; 1例存在血管内物质。SARS-CoV-2免疫组化染色使用针对核衣壳蛋白的抗体在所有6例中均为阴性。在COVID-19大流行之前收到的8份显微镜下发现有冻疮的标本中，只有1份有紧密的血管周围淋巴细胞，没有一份有明显的血管内闭塞。结论血管周围淋巴细胞的紧密袖口模式是COVID-19大流行期间败血症的一个特征。这些病例中SARS-CoV-2核衣壳蛋白的缺失表明病毒不直接存在于这些病变中。
Background Acral inflammatory lesions that have some resemblance to idiopathic or autoimmune-associated perniosis (chilblains) have been described in multiple countries during the COVID-19 pandemic. Methods We examined histopathologic findings in six consecutive such cases from five patients received in mid-May to mid-June of 2020, evaluating immunohistochemical staining for the SARS-CoV-2 nucleocapsid protein. We compared these six cases to eight cases diagnosed as perniosis between January and June of 2019. Results Five of six lesions with perniosis-like histopathology during the COVID-19 pandemic had distinctive tight cuffing of lymphocytes; intravascular material was present in one case. SARS-CoV-2 immunohistochemical staining using an antibody directed at the nucleocapsid protein was negative in all six cases. Only one of eight specimens with microscopic findings of perniosis received prior to the COVID-19 pandemic had tightly cuffed perivascular lymphocytes, and none had obvious intravascular occlusion. Conclusions A tightly cuffed pattern of perivascular lymphocytes is a feature of perniosis during the COVID-19 pandemic. The absence of SARS-CoV-2 nucleocapsid protein in these cases suggests against the virus being directly present in these lesions.