Erupción tipo pitiriasis rosada de Gibert en una paciente asintomática con positividad para COVID-19

Enguix, David Martín; Nievas, María Del Carmen Salazar; Romero, Divina Tatiana Martín

doi:10.1016/j.medcli.2020.05.024

Cited by 8 publications

(2 citation statements)

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“…Topical therapy with dermatocorticosteroids and emollients allowed almost complete remission of lesions within 1 month after the initial diagnosis. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

Pityriasis rosea Gibert triggered by SARS-CoV-2 infection

2021

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Rationale: Pityriasis rosea Gibert is an erythematous-papulosquamous dermatosis that frequently occurs in young adults. The etiopathogenesis of PR is still unknown, but is frequently associated with episodes of upper respiratory tract infections. It is likely that a new viral trigger of pityriasis rosea is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patient concerns: We present the case of a female patient in whom the diagnosis of pityriasis rosea led to the investigation and diagnosis of the SARS-CoV-2 infection. The patient presented to the Department of Dermatology for a 3 week duration of an extremely pruritic erythematous-squamous lesion, initially on the trunk and upper limbs, with extension to the lower limbs in the last week and the lesion respected the cephalic extremity, palms, and soles. One week before the rash, respiratory tract infection symptomatology was observed by the patient. At home, she underwent systemic treatment with antihistamines and topical medication with dermatocorticosteroids. The evolution was unfavorable, with the spread of the lesions and the accentuation of the pruritus. Diagnoses: Considering the actual epidemiological context, we performed a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay from nasal and pharyngeal swabs for coronavirus disease 2019 (COVID-19) to investigate the PR etiology. The patient had a positive RT-PCR result, and was confirmed with SARS-CoV-2 infection. Interventions: Treatment was initiated with systemic corticosteroid therapy - hydrocortisone hemisuccinate 200 mg/day for 7 days, and loratadine 10 mg 2 times a day. Also, topical medication with dermatocorticosteroids and emollients was associated. Outcome: Under the treatment that was initiated a partial remission of the lesions after 7 days was observed. Lessons: Our reported case adds to the other findings regarding the association of PR with SARS-CoV-2 infection, in the context of the pandemic, suggesting the need to test patients with PR skin lesions for SARS-CoV-2 infection.

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“…Topical therapy with dermatocorticosteroids and emollients allowed almost complete remission of lesions within 1 month after the initial diagnosis. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

Pityriasis rosea Gibert triggered by SARS-CoV-2 infection

2021

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“…Although literature data on the relationship PR-COVID-19 are poor, [1][2][3][4][5] it is possible that PR is a cutaneous manifestation related to COVID-19. 2,3,5 Although a causal relation in these cases is not assured, we would suggest the search for SARS-CoV-2 in patients with PR or PR-like eruptions living in endemic areas for COVID-19. 5 In addition, PR may appear, as in our two patients, some weeks following the first clinical manifestations of COVID-19.…”

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confidence: 99%

Pityriasis rosea and COVID‐19

Veraldi

Spigariolo

2020

Journal of Medical Virology

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Coronavirus disease 2019 and pityriasis rosea: A review of the immunological connection

Borgia

Pomi

Alessandrello

et al. 2022

The Journal of Dermatology

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Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is characterized by the activation of a cytokine storm derived from an excess release of cytokine (interleukin [IL]‐6, interferon [IFN] I, C‐X‐C motif chemokine ligand [CXCL]10, tumor necrosis factor [TNF]‐α, macrophage inflammatory protein [MIP]1) due to an uncontrolled immune activation. There has been a fivefold increase in the number of cases of pityriasis rosea during the SARS‐CoV‐2 pandemic. Using the keywords “pityriasis” and “COVID‐19”, we carried out a PubMed search, including all articles in the English language published until November 2021. We aimed to investigate the possible connection between SARS‐CoV‐2 and pityriasis rosea (PR). Pityriasis could be considered an immunological disease due to the involvement of cytokines and chemokines. Our analysis yielded 65 articles of which 53 were not considered; the others (n = 12) concerning the association between PR and COVID‐19 were included in our study. We suggest two mechanisms underlying the involvement of the skin in viral infections: (i) viruses directly affecting the skin and/or inducing host immune response thus causing cutaneous manifestations; and (ii) viruses as a possible inducer of the reactivation of another virus. The first mechanism is probably related to a release of pro‐inflammatory cytokine and infection‐related biomarkers; in the second, several pathways could be involved in the reactivation of other latent viruses (human herpesviruses 6 and 7), such as a cytokine–cytokine receptor interaction, the Janus kinase–signal transducer and activator of transcription signaling pathway, and the IL‐17 signaling pathway. We thus believe that a cytokine storm could be directly or indirectly responsible for a cutaneous manifestation. More investigations are needed to find specific pathways involved and thus confirm our speculations.

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Erupción tipo pitiriasis rosada de Gibert en una paciente asintomática con positividad para COVID-19

Cited by 8 publications

References 0 publications

Pityriasis rosea Gibert triggered by SARS-CoV-2 infection

Pityriasis rosea Gibert triggered by SARS-CoV-2 infection

Pityriasis rosea and COVID‐19

Coronavirus disease 2019 and pityriasis rosea: A review of the immunological connection

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