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Ciccarese G, Drago F, Herzum A, Atzori L, Dattola A, Galluzzo M, Maronese C, Patrizi A, Piraccini BM, Recalcati S, Fargnoli MC, Marzano AV, Papini M. Anti-Herpes zoster vaccination in patients with dermatologic diseases: a position statement from the Italian SIDeMaST group of sexually transmitted, infectious and tropical diseases. Ital J Dermatol Venerol 2024; 159:375-379. [PMID: 38780911 DOI: 10.23736/s2784-8671.24.07895-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Herpes zoster (HZ) is a condition caused by the reactivation of varicella-zoster virus (VZV), the virus responsible for chickepox, which is the clinical manifestation of the primary infection. Congenital or acquired immune system deficiencies, as well as the physiological decline in immune response occurring in the elderly, known as immune senescence, can allow VZV reactivation and, consequently, HZ. One out of 3 people develops HZ during their lifetime. Moreover, thirty percent of the affected subjects develop post-herpetic neuralgia, the most frequent complication after HZ skin rash. Patients with dermatological conditions characterized by alteration of the immune system, such as systemic lupus erythematosus, psoriasis, atopic dermatitis, bullous diseases, and cutaneous lymphomas, are at higher risk of developing HZ and post-herpetic neuralgia, even when their disease is in remission. In the present work, we described the currently available vaccinations against HZ and provided recommendations for the vaccination against HZ in patients with dermatological diseases.
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Affiliation(s)
- Giulia Ciccarese
- Section of Dermatology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Francesco Drago
- Section of Dermatology, Department of Health Sciences (DISSAL), IRCCS San Martino University Hospital, University of Genoa, Genoa, Italy
| | - Astrid Herzum
- Unit of Dermatology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Laura Atzori
- Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Annunziata Dattola
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Marco Galluzzo
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
- Dermatology Unit, Tor Vergata Polyclinic Foundation, Rome, Italy
| | - Carlo Maronese
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Annalisa Patrizi
- Unit of Dermatology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Bianca M Piraccini
- Unit of Dermatology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Unit of Dermatology, University Hospital of Bologna, Bologna, Italy
| | | | - Maria C Fargnoli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Angelo V Marzano
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Manuela Papini
- Terni Dermatology Clinic, Terni, Italy -
- University of Perugia, Perugia, Italy
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Drago F, Fidanzi C, Ciccarese G. Pityriasis Rosea and Immunosuppressive Drugs [Letter]. Clin Cosmet Investig Dermatol 2024; 17:1075-1076. [PMID: 38745872 PMCID: PMC11093120 DOI: 10.2147/ccid.s476488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 05/07/2024] [Indexed: 05/16/2024]
Affiliation(s)
- Francesco Drago
- Dermatology Clinic, Casa di Cura Villa Montallegro, Genoa, Italy
| | - Cristian Fidanzi
- Unit of Dermatology, Department of Medical and Oncological Area, University of Pisa, Pisa, Italy
- Unit of Dermatology, Carrara Hospital, Carrara, Italy
| | - Giulia Ciccarese
- Unit of Dermatology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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Ciccarese G, Broccolo F, Fidanzi C, Serviddio G, Drago F. Atypical hand foot and mouth disease related Coxsackievirus-A10 infection in an adult patient. Travel Med Infect Dis 2024; 59:102716. [PMID: 38537927 DOI: 10.1016/j.tmaid.2024.102716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/09/2024] [Accepted: 03/21/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Giulia Ciccarese
- Unit of Dermatology, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Francesco Broccolo
- Department of Experimental Medicine, University of Salento, 73100, Lecce, Italy
| | - Cristian Fidanzi
- Unit of Dermatology, Department of Medical and Oncology Area, University of Pisa, Pisa, Italy; Unit of Dermatology, Hospital of Carrara, Carrara, Italy.
| | - Gaetano Serviddio
- Liver Unit, Department of Medical and Surgical Sciences, C.U.R.E. (University Centre for Liver Disease Research and Treatment), University of Foggia, Foggia, Italy
| | - Francesco Drago
- Section of Dermatology, DISSAL, University of Genoa, IRCCS Ospedale Policlinico San Martino, Largo R.Benzi, 10, 16132, Genova, Italy
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Venturi C, Guadagno A, Varesano S, Ricucci V, Nigro N, Di Biagio A, Bassetti M, Nozza P, Drago F, Parodi A, Ciccarese G. Histopathologic and transmission electron microscopic findings in monkeypox cutaneous lesions. LE INFEZIONI IN MEDICINA 2024; 32:76-82. [PMID: 38456031 PMCID: PMC10917568 DOI: 10.53854/liim-3201-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/25/2024] [Indexed: 03/09/2024]
Abstract
Background a few pathologic and ultrastructural findings of monkeypox skin lesions are available in the literature. To integrate such evidence, we aimed to describe the pathologic features of monkeypox skin lesions and to show monkeypox virions by transmission electron microscopy (TEM). Methods we studied the cutaneous biopsies of three patients affected by monkeypox during the 2022 monkeypox outbreak. Skin biopsies have been collected only from body sites with a recent laboratory-confirmed mpox virus infection, defined by a polymerase chain reaction (PCR) positive result in specimens taken through skin swabs. Results in all the samples the epidermis showed keratinocytes ballooning degeneration; perivascular/periadnexal infiltrates composed of neutrophils and lymphocytes were observed in the deep dermis. Immunohistochemistry showed that the infiltrate was mostly composed of CD3+ T-cells. TEM revealed monkeypox virus-like particles in various stages of morphogenesis in the dermis and epidermis; virions were interspersed among keratinocytes and within their cytoplasm. At the intracellular level, virions showed a biconcaveshaped central core, surrounded by lateral bodies and an external membrane; they also appeared as rectangular, brick-shaped, or oval particles with eccentric nucleoids. The histologic features of our skin samples confirmed the few other studies on this topic, except for the eosinophilic inclusions of the cytoplasm of keratinocytes (Guarnieri's bodies). Conclusion the role of molecular biology is crucial for monkeypox diagnosis but when it is not disposable and/or in doubtful cases, skin biopsy and TEM may be helpful to establish the diagnosis.
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Affiliation(s)
- Consuelo Venturi
- Pathology Unit, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Antonio Guadagno
- Pathology Unit, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Serena Varesano
- Hygiene Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Nicola Nigro
- Hygiene Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Antonio Di Biagio
- Department of Specialist Medicine, Infectious Disease Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Bassetti
- Department of Health Sciences, Division of Infectious Diseases, University of Genoa, Genoa, Italy
| | - Paolo Nozza
- Pathology Unit, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Francesco Drago
- Section of Dermatology, DISSAL, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Aurora Parodi
- Section of Dermatology, DISSAL, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giulia Ciccarese
- Unit of Dermatology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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Kot WY, Li JW, Chan AKY, Zheng LW. A reflection on COVID-19 and oral mucosal lesion: a systematic review. FRONTIERS IN ORAL HEALTH 2023; 4:1322458. [PMID: 38169876 PMCID: PMC10759230 DOI: 10.3389/froh.2023.1322458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction The aim of this systematic review is to provide a clinical update of the current knowledge on COVID-19 and oral mucosal lesions, to analyze the types and prevalence of oral mucosal lesions in patients with COVID-19, and to clarify the potential association between COVID-19 and oral mucosal lesions. Methods The literature search was conducted using PubMed, Web of Science, Scopus and the Cochrane Library, as well as literatures via manual searches of the reference lists of included studies. Studies published in English that mentioned oral mucosal lesions in patients with COVID-19 were included, resulting in a total of 31 studies. Results Most of the included studies were considered to have a moderate to high risk of bias according to the Joanna Briggs Institute bias assessment tools. Based on COVID-19 severity, the characteristics and patterns of oral mucosal lesions in COVID-19 patients were described, analyzed and synthesized. Overall, ulcers without specific diagnosis had the highest prevalence in COVID-19 patients, followed by traumatic ulcers, candidiasis, petechiae and aphthous-like lesions. Homogeneity of data cannot be achieved in statical analysis, indicating randomness of outcome (ulcers without specific diagnosis, 95% CI: 28%-96%, I2 = 98.7%). Discussion Given the limited evidence from currently available studies, the association between COVID-19 and oral mucosal lesions remains difficult to clarify. Healthcare professionals should be aware of the possible association between COVID-19 and oral mucosal lesions, and we hereby discuss our findings.
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Affiliation(s)
- Wai Ying Kot
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jing Wen Li
- Division of Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Alice Kit Ying Chan
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Li Wu Zheng
- Division of Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Sahu A, Koutrakis NE, Vasilyeva D, Peters SM. Painless lip sore in a young male. J Am Dent Assoc 2023; 154:948-952. [PMID: 35970672 DOI: 10.1016/j.adaj.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022]
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Mukherjee AG, Wanjari UR, Kannampuzha S, Das S, Murali R, Namachivayam A, Renu K, Ramanathan G, Doss C GP, Vellingiri B, Dey A, Valsala Gopalakrishnan A. The pathophysiological and immunological background of the monkeypox virus infection: An update. J Med Virol 2023; 95:e28206. [PMID: 36217803 DOI: 10.1002/jmv.28206] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 01/18/2023]
Abstract
In addition to the COVID-19 waves, the globe is facing global monkeypox (MPX) outbreak. MPX is an uncommon zoonotic infection characterized by symptoms similar to smallpox. It is caused by the monkeypox virus (MPXV), a double-stranded DNA virus that belongs to the genus Orthopoxvirus (OPXV). MPXV, which causes human disease, has been confined to Africa for many years, with only a few isolated cases in other areas. Outside of Africa, the continuing MPXV outbreak in multiple countries in 2022 is the greatest in recorded history. The current outbreak, with over 10 000 confirmed cases in over 50 countries between May and July 2022, demonstrates that MPXV may travel rapidly among humans and pose a danger to human health worldwide. The rapid spread of such outbreaks in recent times has elevated MPX to the status of a rising zoonotic disease with significant epidemic potential. While the MPXV is not as deadly or contagious as the variola virus that causes smallpox, it poses a threat because it could evolve into a more potent human pathogen. This review assesses the potential threat to the human population and provides a brief overview of what is currently known about this reemerging virus. By analyzing the biological effects of MPXV on human health, its shifting epidemiological footprint, and currently available therapeutic options, this review has presented the most recent insights into the biology of the virus. This study also clarifies the key potential causes that could be to blame for the present MPX outbreak and draw attention to major research questions and promising new avenues for combating the current MPX epidemic.
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Affiliation(s)
- Anirban Goutam Mukherjee
- Department of Biomedical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Uddesh Ramesh Wanjari
- Department of Biomedical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Sandra Kannampuzha
- Department of Biomedical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Soumik Das
- Department of Biomedical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Reshma Murali
- Department of Biomedical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Arunraj Namachivayam
- Department of Biomedical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Kaviyarasi Renu
- Department of Biochemistry, Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Gnanasambandan Ramanathan
- Department of Biomedical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - George Priya Doss C
- Department of Integrative Biology, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
| | - Balachandar Vellingiri
- Department of Human Genetics and Molecular Biology, Human Molecular Cytogenetics and Stem Cell Laboratory, Bharathiar University, Coimbatore, Tamil Nadu, India
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata, West Bengal, India
| | - Abilash Valsala Gopalakrishnan
- Department of Biomedical Sciences, School of Bio Sciences and Technology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu, India
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Li J, Wen W, Mu Z, Du X, Han X. Prevalence of cutaneous manifestations in COVID-19: A meta-analysis. J Dermatol 2022; 50:622-636. [PMID: 36540031 PMCID: PMC9878074 DOI: 10.1111/1346-8138.16672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/31/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022]
Abstract
The global epidemic of coronavirus disease 2019 (COVID-19) endangers more and more people. Many studies on cutaneous manifestations related to COVID-19 have emerged, but their prevalence has varied widely. The objective of this study was to conduct a meta-analysis estimating the prevalence of skin manifestations in COVID-19. Four databases PubMed, Web of Science, CBM, and CNKI were searched, and the results were screened by two reviewers. A random-effects model was used to evaluate the overall prevalence. Heterogeneity was assessed by I2 . Further subgroup analyses were conducted by region, sample size, sex, age, and severity of COVID-19. A funnel plot and Egger's test were performed to assess publication bias. The pooled prevalence of cutaneous manifestation of 61 089 patients in 33 studies was 5.6% (95% confidence intervals [CI] = 0.040-0.076, I2 = 98.3%). Severity of COVID-19 was probably the source of heterogeneity. Studies with sample size <200 report higher prevalence estimates (10.2%). The prevalence of detailed types was as follows: maculopapular rash 2%, livedoid lesions 1.4%, petechial lesions 1.1%, urticaria 0.8%, pernio-like lesions 0.5%, vesicular lesions 0.3%. Petechial lesions and livedoid lesions contain a higher proportion of severe patients than other skin manifestations. The prevalence rates of pernio-like lesions, urticaria and petechial lesions vary greatly in different regions.
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Affiliation(s)
- Jingmin Li
- Department of Dermatology, Shengjing HospitalChina Medical UniversityShenyangChina
| | - Weijing Wen
- Department of Emergency Medical CenterFirst Affiliated Hospital of Shanxi Medical UniversityShanxiChina
| | - Zhenzhen Mu
- Department of Dermatology, Shengjing HospitalChina Medical UniversityShenyangChina
| | - Xuefei Du
- Department of Dermatology, Shengjing HospitalChina Medical UniversityShenyangChina
| | - Xiuping Han
- Department of Dermatology, Shengjing HospitalChina Medical UniversityShenyangChina
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Oral lesions in human monkeypox disease and their management-a scoping review. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 135:510-517. [PMID: 36737264 PMCID: PMC9715264 DOI: 10.1016/j.oooo.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/10/2022] [Accepted: 11/27/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE Monkeypox (MPX) disease poses a threat to the frontline health workers, including dental practitioners; however, there is limited literature on its dental implications. The objective of this scoping review was to map the oral manifestations of MPX and its management based on existing information. MATERIALS AND METHODS Articles published up to July 31, 2022 were searched to select relevant observational and experimental studies in humans who reported oral lesions in MPX disease, including case reports. The findings of this review are based on the pooled data of 1,136 patients (age range: 2-52 years) reported from different parts of the world. RESULTS Oral lesions included mouth sores, oral mucosal lesions, ulcers on the tongue, tongue swelling, pustular lesions on the gingiva, perioral erosive lesions, oral candidiasis, and oropharyngeal lesions. Oral lesions of MPX infection and their management strategies are relevant to dentists. Dental practitioners may be the first to detect the initial symptoms of MPX disease. CONCLUSION Oral lesions may present as initial lesions of MPX suggesting that dentists and dental personnel should be aware of the nature of the disease. Clinicians must be alert to rashes resembling MPX lesions and distinguish MPX from herpetic and similar vesicular-bullous lesions for differential diagnosis. Symptomatic and supportive care for oral lesions is important.
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Refat M, Thabit AA, Siddick H, Maqboli AR, Sharah M, A.Thabet AB, Refat M, A. Mohammed AS, Al-Sabati A. Formulation and evaluation of Yemeni potash alum as hydrophilic topical preparations against bacterial skin infections. JOURNAL OF MEDICAL SCIENCE 2022. [DOI: 10.20883/medical.e713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Skin and soft tissue infections are common. Staphylococcus aureus, Streptococcus pyogenes, Escherichia coli, and Pseudomonas aeruginosa cause most bacterial skin infections. Yemen's alum is a natural mineral with potent antibacterial and antifungal activity. The current study aimed to verify Yemen alum's antibacterial activity against chosen bacterial strains to formulate a valuable topical preparation. We formulated twenty-three formulations involving four non-adjusted aqueous solutions, eight adjusted pH aqueous solutions, three Oil/Water cream formulations, and eight glycerin solutions, all with different alum concentrations. After that, we evaluated the antibacterial efficacy against the selected bacterial strains. Additionally, we performed stability testing (almost six weeks) to determine the chosen preparations' estimated shelf life (t90). Alum showed antibacterial activity against Staphylococcus aureus, Streptococcus pyogenes, Escherichia coli, and Pseudomonas aeruginosa. Finally, it was concluded that Oil/Water cream (10% alum) is viable preparation for large-scale production.
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Drago F, Broccolo F, Ciccarese G. Comment on a case of pityriasis rosea shortly after Moderna COVID-19 vaccination. Int J Infect Dis 2022; 116:166. [PMID: 34990801 PMCID: PMC8720674 DOI: 10.1016/j.ijid.2021.12.360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/26/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Francesco Drago
- Dermatology Unit, Policlinico San Martino, Largo R. Benzi, 10, 16132 Genoa, Italy.
| | - Francesco Broccolo
- Department of Medicine and Surgery, School of Medicine, University of Milano-Bicocca, Monza, Italy
| | - Giulia Ciccarese
- Dermatology Unit, Policlinico San Martino, Largo R. Benzi, 10, 16132 Genoa, Italy
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Fernández-Lázaro D, Garrosa M. Identification, Mechanism, and Treatment of Skin Lesions in COVID-19: A Review. Viruses 2021; 13:1916. [PMID: 34696346 PMCID: PMC8540564 DOI: 10.3390/v13101916] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/12/2021] [Accepted: 09/20/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a multisystem disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), that primarily causes respiratory symptoms. However, an increasing number of cutaneous manifestations associated with this disease have been reported. The aim of this study is to analyze the scientific literature on cutaneous manifestations associated with SARS-CoV-2 by means of a narrative literature review until June 2021. The search was conducted in the following electronic databases: Medline (PubMed), SciELO, and Cochrane Library Plus. The most common cutaneous manifestations in patients with COVID-19 are vesicular eruptions, petechial/purpuric rashes, acral lesions, liveoid lesions, urticarial rash, and maculopapular-erythematous rash. These manifestations may be the first presenting symptoms of SARS-CoV-2 infection, as is the case with acral lesions, vesicular eruptions, and urticaria. In relation to severity, the presence of liveoid lesions may be associated with a more severe course of the disease. Treatment used for dermatological lesions includes therapy with anticoagulants, corticosteroids, and antihistamines. Knowledge of the dermatologic manifestations associated with SARS-CoV-2 contributes to the diagnosis of COVID-19 in patients with skin lesions associated with respiratory symptoms or in asymptomatic patients. In addition, understanding the dermatologic lesions associated with COVID-19 could be useful to establish a personalized care plan.
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Affiliation(s)
- Diego Fernández-Lázaro
- Department of Cellular Biology, Histology and Pharmacology, Faculty of Health Sciences, University of Valladolid, Campus of Soria, 42004 Soria, Spain
- Neurobiology Research Group, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain;
| | - Manuel Garrosa
- Neurobiology Research Group, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain;
- Area of Histology, Faculty of Medicine, Institute of Neurosciences of Castile and Leon (INCYL), University of Valladolid, 47005 Valladolid, Spain
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Aragoneses J, Suárez A, Algar J, Rodríguez C, López-Valverde N, Aragoneses JM. Oral Manifestations of COVID-19: Updated Systematic Review With Meta-Analysis. Front Med (Lausanne) 2021; 8:726753. [PMID: 34513886 PMCID: PMC8424005 DOI: 10.3389/fmed.2021.726753] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/04/2021] [Indexed: 12/11/2022] Open
Abstract
There is increasing evidence for oral lesions and manifestations of COVID-19. The aim of this meta-analysis was to investigate the types of oral manifestations of COVID-19 and their prevalence. PubMed/Medline, Scopus, Web of Science, and Google Scholar databases were used to search for publications on oral manifestations in patients with PCR-confirmed COVID-19. A total of 310 records were selected, and 74 were included. Oral lesions in COVID-19 were classified according to their etiologies, including iatrogenic lesions caused by intubation and opportunistic infections. Of the included studies, 35 reported oral lesions probably caused by severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) infection. Meta-analysis of prevalence data on oral manifestations and aphthous lesions indicated high heterogeneity, while meta-analysis of xerostomia prevalence data revealed a pooled prevalence, with considerable heterogeneity. In conclusion, the meta-analysis yielded high heterogeneity between studies: oral lesions yielded a prevalence of 0.33 (95% CI 0.11-0.60), xerostomia lesions a prevalence of 0.44 (95% CI 0.36-0.52) and aphthous lesions 0.10 (95% CI 0.01-0.24). In addition, a gap in the evidence regarding the prevalence of oral lesions in COVID-19 was identified and the need for further observational studies focusing on this issue and on the causal relationships between oral lesions and COVID-19 was highlighted.
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Affiliation(s)
- Javier Aragoneses
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
| | - Ana Suárez
- Department of Preclinical Dentistry, School of Biomedical Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Juan Algar
- Department of Clinical Dentistry, School of Biomedical Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Cinthia Rodríguez
- Department of Dentistry, Federico Henriquez y Carvajal University, Santo Domingo, Dominican Republic
| | - Nansi López-Valverde
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
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