Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases
Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases
复制标题
DOI：
10.1111/bjd.19163
复制
发表时间：
2020-06-10
影响因子：
10.3
通讯作者：
Garcia-Doval, I.
中科院分区：
文献类型：
--
作者：
Galvan Casas, C.;Catala, A.;Garcia-Doval, I.
背景COVID-19疾病的皮肤表现特征不佳。目的描述COVID-19疾病的皮肤表现并将其与其他临床表现联系起来。方法我们在全国范围内进行了图像和临床数据的病例收集调查。使用共识，我们描述了五个临床模式。我们后来描述了这些模式与患者的人口统计学，在有关的疾病的症状，严重程度和预后的时间的关联。结果病变可被归类为肢端地区的红斑与水泡或脓疱（假性冻疮）（19%），其他水泡性皮疹（9%），荨麻疹病变（19%），斑丘疹（47%）和青斑或坏死（6%）。水疱性皮疹出现在疾病的早期（比其他症状早15%）。假性冻疮模式经常出现在COVID-19疾病演变的后期（59%出现在其他症状之后），而其余的往往与COVID-19的其他症状一起出现。COVID-19的严重程度显示出从肢端病变中较不严重的疾病到后一组中较严重的疾病的梯度。就临床和流行病学调查结果而言，确诊病例和疑似病例的结果相似。其他诊断进行了讨论，但似乎不太可能为最具体的模式（假性冻疮和水泡）。结论我们提供了与COVID-19感染相关的皮肤表现的描述。这些可以帮助临床医生接近患有这种疾病的患者，并识别症状很少的病例。
Background The cutaneous manifestations of COVID-19 disease are poorly characterized.Objectives To describe the cutaneous manifestations of COVID-19 disease and to relate them to other clinical findings.Methods We carried out a nationwide case collection survey of images and clinical data. Using a consensus we described five dinical patterns. We later described the association of these patterns with patient demographics, the timing in relation to symptoms of the disease, the severity and the prognosis.Results The lesions may be classified as acral areas of erythema with vesicles or pustules (pseudo-chilblain) (19%), other vesicular eruptions (9%), urticarial lesions (19%), maculopapular eruptions (47%) and livedo or necrosis (6%). Vesicular eruptions appear early in the course of the disease (15% before other symptoms). The pseudo-chilblain pattern frequently appears late in the evolution of the COVID-19 disease (59% after other symptoms), while the rest tend to appear with other symptoms of COVID-19. The severity of COVID-19 shows a gradient from less severe disease in acral lesions to more severe in the latter groups. The results are similar for confirmed and suspected cases, in terms of both dinical and epidemiological findings. Alternative diagnoses are discussed but seem unlikely for the most specific patterns (pseudo-chilblain and vesicular).Conclusions We provide a description of the cutaneous manifestations associated with COVID-19 infection. These may help clinicians approach patients with the disease and recognize cases presenting with few symptoms.