From Your Nose to Your Toes: A Review of Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic‒Associated Pernio

Abstract

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Negative SARS‐CoV‐2 antibodies in patients with positive immunohistochemistry for spike protein in pityriasis rosea‐like eruptions

“…In SARS‐CoV‐2‐associated perniosis, recent hypotheses have postulated that a robust innate and intrinsic immune activity driven by interferon‐1 may explain the negative serological and PCR testing as it may drive viral clearance without inducing detectable antibody production. 8 , 9 If a similar immunological cascade happens in other COVID‐19‐associated manifestations, it warrants further investigation, but may explain the negative testing in the patients reported herein. More studies with IHC analysis of skin biopsies and lymphocyte assays for SARS‐CoV‐2‐reactive T cells are necessary to clarify the relationship between SARS‐CoV‐2 and skin manifestations.…”

Common skin signs of COVID-19 in adults: An update

“…However, proponents of the association with COVID-19 point to "outbreaks" of chilblain-like lesions corresponding to CO-VID-19 waves and propose that an effi cient, type I interferon-driven antiviral response could induce pernio-like lesions and suppress both symptoms and confi rmatory testing. [25][26][27][28][29] Interestingly, information is accumulating about pernio-like lesions in "long-hauler" patients, with a signifi cant association reported between persistent cutaneous and extracutaneous symptoms. [30][31][32] While the debate continues, if these lesions are truly a COVID-19 manifestation, they are fortunately associated with high survival rates (96.4% 6 to 98.7% 3 ) and few or no systemic symptoms.…”

Hautveränderungen bei COVID-19 und nach COVID-19-Impfung

“…Für Interessierte verweisen wir daher auf weiterführende Literatur [ 10 , 21 , 27 ]. Im Folgenden gehen wir auf einige ausgewählte, mögliche Mechanismen ein, die zur Erklärung der auftretenden Hautläsionen in der Literatur besprochen werden: SARS-CoV‑2 kann Zellen der Haut direkt infizieren und hierdurch eine Entzündungsreaktion auslösen [ 5 ]. Die intrazelluläre Aufnahme des Virus wird dabei primär durch die Bindung des viralen Spike-Proteins an den Angiotensin-konvertierendes Enzym-2-Rezeptor (ACE2) vermittelt [ 24 , 25 ].…”

“…SARS-CoV‑2 kann Zellen der Haut direkt infizieren und hierdurch eine Entzündungsreaktion auslösen [ 5 ]. Die intrazelluläre Aufnahme des Virus wird dabei primär durch die Bindung des viralen Spike-Proteins an den Angiotensin-konvertierendes Enzym-2-Rezeptor (ACE2) vermittelt [ 24 , 25 ].…”