Reply to “Varicella-like exanthem as a specific COVID-19-associated skin manifestation: Multicenter case series of 22 patients”: To consider varicella-like exanthem associated with COVID-19, virus varicella zoster and virus herpes simplex must be ruled out

Llamas‐Velasco, Mar; Rodríguez‐Jiménez, Pedro; Chicharro, Pablo; Argila, D. de; Muñoz‐Hernández, Patricia; Daudén, Esteban

doi:10.1016/j.jaad.2020.04.180

Cited by 40 publications

(50 citation statements)

References 2 publications

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“…One patient was excluded from our study with a diagnosis of varicella or disseminated herpes zoster. The list of case reports or case series is growing fast, 3 and other authors have shown that patients with COVID‐19 can have a vesicular eruption with presence of several herpesviruses 4 . Their images show haemorrhagic bullae of different sizes and with a diameter > 1 cm, larger than the eruption described in our paper, 2 with many equal, 2–3‐mm vesicles.…”

supporting

confidence: 46%

‘Vesicular eruption in COVID‐19 – to exclude varicella’: reply from the authors

2020

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supporting

confidence: 46%

‘Vesicular eruption in COVID‐19 – to exclude varicella’: reply from the authors

2020

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“…Albeit several hypotheses on pathophysiological mechanisms at the basis of these skin findings are present in the literature [50, 92, 93], none of them is substantiated by strong evidence, and this field needs to be largely elucidated. Moreover, cutaneous eruptions due to viruses other than SARS-CoV-2 [35, 37] or drugs prescribed for the management of this infection [94, 95] always need to be ruled out.…”

Section: Resultsmentioning

confidence: 99%

“…The controversy regarding the role of herpesvirus in the etiology of papulovesicular exanthems fuelled an intense scientific debate. Indeed, some authors raised the question whether papulovesicular exanthem associated with COVID-19 could be diagnosed without ruling out varicella zoster virus and herpes simplex virus with Tzanck smear or polymerase chain reaction (PCR) for the Herpesviridae family in the vesicle fluid or on the skin [36, 37]. In our opinion, even if seeking DNA of Herpesviridae family members is ideally advisable, clinical diagnosis may be reliable in most cases, and the role of herpes viruses as mere superinfection in patients with dysfunctional immune response associated with COVID-19 needs to be considered [38].…”

Section: Papulovesicular Exanthemmentioning

confidence: 99%

Skin Manifestations Associated with COVID-19: Current Knowledge and Future Perspectives

et al. 2020

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Background: Coronavirus disease-19 (COVID-19) is an ongoing global pandemic caused by the “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2), which was isolated for the first time in Wuhan (China) in December 2019. Common symptoms include fever, cough, fatigue, dyspnea and hypogeusia/hyposmia. Among extrapulmonary signs associated with COVID-19, dermatological manifestations have been increasingly reported in the last few months. Summary: The polymorphic nature of COVID-19-associated cutaneous manifestations led our group to propose a classification, which distinguishes the following six main clinical patterns: (i) urticarial rash, (ii) confluent erythematous/maculopapular/morbilliform rash, (iii) papulovesicular exanthem, (iv) chilblain-like acral pattern, (v) livedo reticularis/racemosa-like pattern, (vi) purpuric “vasculitic” pattern. This review summarizes the current knowledge on COVID-19-associated cutaneous manifestations, focusing on clinical features and therapeutic management of each category and attempting to give an overview of the hypothesized pathophysiological mechanisms of these conditions.

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“…However, three studies with COVID-19 patients with complicated HZ described five patients with low lymphocyte count and one patient with a normal lymphocyte count. [7][8][9] Although our case's normal lymphocyte…”

Section: Discussionmentioning

confidence: 55%

Herpes zoster as a potential complication of coronavirus disease 2019

Pona

Jiwani

Afriyie

et al. 2020

Dermatologic Therapy

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Although coronavirus disease 2019 (COVID-19) primarily manifests pulmonary symptoms, providers are recognizing extrapulmonary symptoms including cutaneous manifestations. Cutaneous manifestations in COVID-19 patients include acroischemic, chilblain-like eruption, petechiae and purpura, vesicles, urticaria, and erythematous maculopapules. 1 Herpes zoster (HZ) is caused by the varicella-zoster virus, which reactivates and spreads from the dorsal root ganglia to its respective dermatome. Patients at risk of HZ include elders and immunocompromised hosts. Although COVID-19 is known to affect the immune system and may increase the risk of HZ, limited reports confirm an association between HZ and COVID-19. 2,3 Here, we present a 70-year-old COVID-19 patient complicated by HZ.

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Reply to “Varicella-like exanthem as a specific COVID-19-associated skin manifestation: Multicenter case series of 22 patients”: To consider varicella-like exanthem associated with COVID-19, virus varicella zoster and virus herpes simplex must be ruled out

Cited by 40 publications

References 2 publications

‘Vesicular eruption in COVID‐19 – to exclude varicella’: reply from the authors

‘Vesicular eruption in COVID‐19 – to exclude varicella’: reply from the authors

Skin Manifestations Associated with COVID-19: Current Knowledge and Future Perspectives

Herpes zoster as a potential complication of coronavirus disease 2019

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