Pernio-like skin lesions associated with COVID-19: A case series of 318 patients from 8 countries
Pernio-like skin lesions associated with COVID-19: A case series of 318 patients from 8 countries
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DOI：
10.1016/j.jaad.2020.05.109
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发表时间：
2020-08-01
影响因子：
13.8
通讯作者：
Fox, Lindy P.
中科院分区：
文献类型：
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作者：
Freeman, Esther E.;McMahon, Devon E.;Fox, Lindy P.
背景：越来越多的证据表明，腹股沟样病变是2019冠状病毒传染病（COVID-19）的皮肤表现。目的：描述确诊或疑似COVID-19患者腹股沟样病变的临床和病理表现。方法：通过美国皮肤病学会、国际皮肤病学会联盟和其他组织向全世界的卫生保健提供者分发国际皮肤病登记处。结果：我们记录了505例与COVID-19相关的皮肤病表现，其中318例（63%）有腹股沟样病变。腹股沟样病变患者多为年轻健康，COVID-19症状较轻。318例医院确诊或疑似病例中，实验室确诊阳性23例（7%），与确诊病例密切接触者20例（6%）。鉴于目前的检测标准，许多患者无法获得COVID-19检测。55%的患者，腹股沟样病变是他们唯一的症状。在有其他COVID-19症状的患者中，腹股沟样病变通常出现在其他症状之后。腹股沟样病变持续时间中位数为14天（四分位数间距为10-21天）。局限性：病例序列不能估计人群水平的发病率或流行率。此外，报告中可能存在确认偏误。我们不能排除附带现象。结论：手足类皮肤变化，无其他解释，可能提示COVID-19感染，应及时进行确认性检测。
Background: Increasing evidence suggests pernio-like lesions are cutaneous manifestations of coronavirus infectious disease 2019 (COVID-19).Objective: To describe clinical and pathologic findings of pernio-like lesions in patients with confirmed or suspected COVID-19.Methods: An international dermatology registry was circulated to health care providers worldwide through the American Academy of Dermatology, International League of Dermatologic Societies, and other organizations.Results: We documented 505 patients with dermatologic manifestations associated with COVID-19, including 318 (63%) with pernio-like lesions. Patients with pernio-like lesions were generally young and healthy, with relatively mild COVID-19. Of 318 patients with confirmed or suspected COVID-19 by providers, 23 (7%) were laboratory-confirmed COVID-19 positive, and 20 others (6%) were close contacts of patients with confirmed COVID-19. Given current testing criteria, many patients lacked COVID-19 testing access. For 55% of patients, pernio-like lesions were their only symptom. In patients with other COVID-19 symptoms, pernio-like lesions typically appeared after other symptoms. Pernio-like lesions lasted a median of 14 days (interquartile range, 10-21 days).Limitations: A case series cannot estimate population-level incidence or prevalence. In addition, there may be confirmation bias in reporting. We cannot exclude an epiphenomenon.Conclusions: Pernio-like skin changes of the feet and hands, without another explanation, may suggest COVID-19 infection and should prompt confirmatory testing.