COVID-19-associated leukocytoclastic vasculitis leading to gangrene and amputation

Alattar, Khalid O.; Subhi, Farah Noaman; Alshamsi, A.; Eisa, Nadereh; Shaikh, Niaz Ahmed; Mobushar, Jehangir Afzal; Qasmi, Asma Al

doi:10.1016/j.idcr.2021.e01117

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…Clinical appearance spans from classic, bilateral symmetric palpable purpura favoring dependent body sites ( Supplementary Figures 1a,b ) to vesicobullous, hemorrhagic or targetoid eruptions. Oral or intravenous CS, with or without topical CS, were the mainstay of treatment, whereas intravenous immunoglobulin (IVIg) was employed only in a minority of cases ( 19 , 20 , 23 ). As for the prognosis, most patients experienced complete recovery, except for a few who developed vasculitis-associated gangrene or died due to COVID-19-related complications ( 12 , 19 , 20 , 24 ).…”

Section: Covid-19-associated Cutaneous Vasculitis/vasculopathymentioning

confidence: 99%

“…Oral or intravenous CS, with or without topical CS, were the mainstay of treatment, whereas intravenous immunoglobulin (IVIg) was employed only in a minority of cases ( 19 , 20 , 23 ). As for the prognosis, most patients experienced complete recovery, except for a few who developed vasculitis-associated gangrene or died due to COVID-19-related complications ( 12 , 19 , 20 , 24 ).…”

Section: Covid-19-associated Cutaneous Vasculitis/vasculopathymentioning

confidence: 99%

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Cutaneous vasculitis and vasculopathy in the era of COVID-19 pandemic

et al. 2022

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Cutaneous vasculitides encompass a heterogeneous group of clinicopathological entities, which may occur as single-organ vasculitis of the skin or present as skin-limited variant of systemic vasculitis (i.e., skin-limited ANCA-associated vasculitis), and are triggered by various factors, including infections, drugs and vaccines. The COVID-19 pandemic has challenged us with a variety of both disease- and vaccine-associated skin manifestations, including vasculitis. Among the latter, cutaneous small-vessel vasculitis, previously known as leukocytoclastic vasculitis, seems to be the most reported in either scenario, i.e., natural infection and vaccination. Vasculopathy without true vasculitic changes on histology develops in but a minority of cases, mostly severe/critical COVID-19 patients, and appears to be the result of endothelial injury due to pauci-immune thromboembolic mechanisms. Herein, we provide an overview of the available literature on COVID-19-associated and anti-SARS-CoV-2-vaccine-associated cutaneous vasculitis. Although evidence is mostly limited to isolated reports, with a proportion of cases lacking histopathological confirmation, ample overlap with pre-pandemic forms is shown.

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Section: Covid-19-associated Cutaneous Vasculitis/vasculopathymentioning

confidence: 99%

Section: Covid-19-associated Cutaneous Vasculitis/vasculopathymentioning

confidence: 99%

Cutaneous vasculitis and vasculopathy in the era of COVID-19 pandemic

et al. 2022

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“…On the other hand, retiform purpuric lesions, branching, non-blanching violaceous plaque or patch, are present in 6.4% of patients with COVID skin manifestations and laboratory-confirmed COVID-19 who were entered into the registry [ 11 ••]. Case reports and case series are scarce and predominantly report cases of leukocytoclastic vasculitis [ 38 , 39 ]. Population-level incidence of vasculitis after COVID-19 is unknown.…”

Section: Cutaneous Reactions To Sars-cov-2 Infectionsmentioning

confidence: 99%

Viruses, Variants, and Vaccines: How COVID-19 Has Changed the Way We Look at Skin

Singh

Freeman

2022

Curr Derm Rep

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Purpose of Review This review aims to evaluate the spectrum of cutaneous reactions after both SARS-CoV-2 infection and COVID-19 vaccination while simultaneously understanding the evolution of the field of dermatology in the face of an ongoing pandemic. Recent Findings The most commonly reported cutaneous reactions after COVID-19 infection in the literature to date include morbilliform or maculopapular rashes, chilblains, and urticaria. The incidence of cutaneous reactions after COVID-19 vaccination was 9% in larger cohort studies and more commonly occurred after mRNA-based COVID-19 vaccines than adenovirus vector vaccines. The most frequently reported cutaneous reactions after COVID-19 vaccines were delayed large local reactions, local injection site reactions, urticarial eruptions, and morbilliform eruptions. Summary With the ongoing pandemic, and continued development of new COVID-19 variants and vaccines, the landscape of cutaneous reactions continues to rapidly evolve. Dermatologists have an important role in evaluating skin manifestations of the virus, as well as discussion and promoting COVID-19 vaccination for their patients.

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“…The novel coronavirus disease 2019 (COVID-19) is caused by a positive-sense single-stranded ribonucleic acid (RNA) virus [ 1 ]. It was first detected in Wuhan, China, in December 2019 as declared by WHO, and it was declared a global pandemic in March 2020 [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Acute Limb Ischemia: A Catastrophic COVID-19 Sequel Leading to Amputation

Biswal¹,

Mohanty²,

Behera³

et al. 2021

Cureus

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A positive-sense single-stranded ribonucleic acid (RNA) virus causes the novel coronavirus illness 2019 . COVID-19 symptoms range from mild to moderate to severe and very severe. Fever, cough, headache, anosmia, ageusia, body ache, and diarrhoea are mild to moderate grade symptoms, whereas systemic involvements (pneumonia, myocarditis, stroke, and other coagulation abnormalities) are more serious. Except for a few patients who have mild complaints of cough and shortness of breath, the majority of patients are recuperating entirely from the viral infection. Patients with severe to very severe illnesses experience significant lung damage and fibrosis. These are the patients who are more likely to experience extrapulmonary complications after COVID-19. The disease's aberrant presentation may be related to systemic involvement and a hypercoagulable condition with micro and macro-angiopathy. Acute limb ischemia is one of the symptoms of the hypercoagulable condition. Its presentation can be in the form of chilblains, bullae, acral cyanosis, bruising, blood blisters, dry gangrene, or life-threatening acute limb ischemia. Unfortunately, most patients have to undergo amputation due to a delay in presentation or rapidly progressing disease. Here we present a case series of two COVID-19 infected patients who were initially discharged from the hospital after proper treatment but developed acute limb ischemia within the home isolation period and their treatment strategy.

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COVID-19-associated leukocytoclastic vasculitis leading to gangrene and amputation

Cited by 7 publications

References 9 publications

Cutaneous vasculitis and vasculopathy in the era of COVID-19 pandemic

Cutaneous vasculitis and vasculopathy in the era of COVID-19 pandemic

Viruses, Variants, and Vaccines: How COVID-19 Has Changed the Way We Look at Skin

Acute Limb Ischemia: A Catastrophic COVID-19 Sequel Leading to Amputation

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