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Marino A, Cacciaguerra G, Spampinato S, Palermo M, Biasco A, Liotta E, Cocuzza S, Venanzi Rullo E, Nunnari G, Pavone P. SARS-CoV-2 associated unilateral parotitis in children: A case report and literature review. Biomed Rep 2024; 20:83. [PMID: 38628628 PMCID: PMC11019641 DOI: 10.3892/br.2024.1771] [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: 01/24/2024] [Accepted: 03/14/2024] [Indexed: 04/19/2024] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection usually affects the respiratory system; however, a number of atypical manifestations of this disease have also been reported, especially in children. The present study reports a case of a 12-year-old presenting with right unilateral parotitis and sialadenitis and SARS-CoV-2 infection. The young patient, after a 3-day history of fever, was brought to our clinic (Polyclinic University Hospital 'G. Rodolico', Catania, Italy) for the sudden onset of unilateral parotitis accompanied by sialadenitis and hyperaemia of the skin, which was tender to touch. The SARS-CoV-2 molecular swab was positive; the ultrasound of the affected region showed an increase in the volume of the parotid and sublingual gland and reactive lymph nodes compatible with parotitis and sialadenitis. This case suggests that, in the present Coronavirus disease 2019 pandemic, SARS-CoV-2 should be included in the differential diagnosis of parotitis and sialadenitis along with mumps and flue. Notably, a respiratory panel and serology for other potential causes are needed in case of parotitis-like disease.
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Affiliation(s)
- Andrea Marino
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Catania, ARNAS Garibaldi Hospital, I-95122 Catania, Italy
| | - Giovanni Cacciaguerra
- Department of Clinical and Experimental Medicine, Section of Paediatrics and Child Neuropsychiatry, School of Specialization in Paediatrics, University of Catania, I-95124 Catania, Italy
| | - Serena Spampinato
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Catania, ARNAS Garibaldi Hospital, I-95122 Catania, Italy
- Department of Clinical and Experimental Medicine, University of Messina, I-98124 Messina, Italy
| | - Monica Palermo
- Department of Medical Surgical Sciences and Advanced Technologies ‘GF Ingrassia’, Radiology Unit 1, University of Catania, I-95125 Catania, Italy
| | - Arturo Biasco
- Department of Clinical and Experimental Medicine, Section of Paediatrics and Child Neuropsychiatry, School of Specialization in Paediatrics, University of Catania, I-95124 Catania, Italy
| | - Emanuele Liotta
- Department of Clinical and Experimental Medicine, Section of Paediatrics and Child Neuropsychiatry, School of Specialization in Paediatrics, University of Catania, I-95124 Catania, Italy
| | - Salvatore Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies ‘GF Ingrassia’, ENT Section, University of Catania, I-95124 Catania, Italy
| | - Emmanuele Venanzi Rullo
- Department of Clinical and Experimental Medicine, University of Messina, I-98124 Messina, Italy
| | - Giuseppe Nunnari
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Catania, ARNAS Garibaldi Hospital, I-95122 Catania, Italy
| | - Piero Pavone
- Department of Clinical and Experimental Medicine, Section of Paediatrics and Child Neuropsychiatry, School of Specialization in Paediatrics, University of Catania, I-95124 Catania, Italy
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Masood W, Ahmad S, Khan NA, Shakir A, Rokni GR, Gold MH, Cockerell CJ, Schwartz RA, Goldust M. Pathobiology of Cutaneous Manifestations Associated with COVID-19 and Their Management. Viruses 2022; 14:1972. [PMID: 36146777 PMCID: PMC9500986 DOI: 10.3390/v14091972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 01/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) has been a rising concern since its declaration as a pandemic by the World Health Organization on 11 March 2020. Recently, its association with multiple underlying organs has been identified that includes cardiac, renal, gastrointestinal, nervous systems, and cutaneous manifestations. Cutaneous COVID-19 findings have been supposedly classified into the following categories: vesicular (varicella-like), papulo-vesiculsar, chilblains-like ("COVID toes") maculopapular, and urticarial morphologies. In this review, we aim to focus on the proposed pathophysiology behind the various dermatological manifestations associated with COVID-19 and their associated management. We also included prevalence and clinical features of the different COVID-19-related skin lesions in our review. A comprehensive narrative review of the literature was performed in PubMed databases. Data from case reports, observational studies, case series, and reviews till June 2022 were all screened and included in the review.
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Affiliation(s)
- Waniyah Masood
- Department of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi 75271, Pakistan
| | - Shahzaib Ahmad
- Department of Medicine, Mayo Hospital Lahore, King Edward Medical University Lahore, Lahore 54000, Pakistan
| | - Noor Ayman Khan
- Department of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi 75271, Pakistan
| | - Amaima Shakir
- Department of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi 75271, Pakistan
| | - Ghasem Rahmatpour Rokni
- Department of Dermatology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari 48175866, Iran
| | - Michael H. Gold
- Gold Skin Care Center, Nashville, TN 37215, USA
- Tennessee Clinical Research Center, Nashville, TN 37215, USA
| | - Clay J. Cockerell
- Departments of Dermatology and Pathology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Cockerell Dermatopathology, Dallas, TX 75235, USA
| | | | - Mohamad Goldust
- Department of Dermatology, University Medical Center Mainz, 55131 Mainz, Germany
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Lange K, Matthies M, Firouzi-Memarpuri P, Homey B. COVID-19 und Hautmanifestationen: Übersicht der aktuellen Literatur im Rückblick auf die bisherige Pandemie. Hautarzt 2022; 73:291-297. [PMID: 35254461 PMCID: PMC8898998 DOI: 10.1007/s00105-022-04961-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 01/08/2023]
Abstract
Zusammenfassung
Hintergrund
Die durch das Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) ausgelöste anhaltende globale Pandemie manifestiert sich neben bekannten Organsystemen auch an der Haut. In der Literatur wurden verschiedene klinische Muster von Hauterscheinungen mit COVID-19 in Verbindung gebracht. Die Kenntnis der kutanen Manifestationen kann bei der Früherkennung, Risikostratifizierung von Patienten, Diagnose und den therapeutischen Strategien hilfreich sein. In dem vorliegenden Artikel wird der aktuelle Kenntnisstand zu dermatologischen Befunden im Zusammenhang mit COVID-19 unter Berücksichtigung der klinischen Präsentation, aktuellen pathophysiologischen Konzepten und Management zusammengefasst. Zukünftig sollen auch Erkenntnisse aus einem aktuell geführten Register der Universität Harvard gezogen werden können. Derzeit werden hier Hautveränderungen in Assoziation mit COVID-19 gesammelt (https://ilds.org/covid-19/international-dermatology-covid19-registry/).
Ziel der Arbeit
Ziel dieses Übersichtsartikels ist es, die aktuell verfügbare Literatur mit Hinweisen auf Hautveränderungen im Zusammenhang mit COVID-19 zu analysieren, zu strukturieren und die wichtigsten Aspekte zusammenzufassen.
Material und Methoden
Es wurde eine systematische Literaturrecherche in der medizin-wissenschaftlichen Datenbank PubMed und Medline für englischsprachige Originalartikel, Fallserien und -berichte sowie Übersichtsarbeiten unter Verwendung der Suchbegriffe „Covid“, „COVID-19“ oder „SARS-CoV-2“ in Kombination mit „skin“ oder „dermatol“ durchgeführt, welche bis Februar 2021 (Einträge bis zum 28.02.2021) veröffentlicht wurden. Untersucht wurde der Zusammenhang zwischen bestätigten oder vermuteten SARS-CoV-2-Infektionen in Assoziation mit Hautmanifestationen. Eingeschlossen wurden vorwiegend Arbeiten, welche ein möglichst großes Patientenkollektiv, das Erwachsenenalter und einen positiven Corona-Nachweis beinhalteten. Ziel der Arbeit ist es, einen Überblick der am häufigsten beobachteten Hautmanifestationen bei Infektionen mit SARS-CoV‑2 zu geben.
Ergebnisse und Diskussion
Die Zuordnung der Hautmanifestationen im Rahmen einer SARS-CoV-2-Infektion nach klinisch dermatologischen Mustern kann dazu beitragen, Patienten mit erhöhtem Risiko frühzeitig zu identifizieren und adäquat zu behandeln, um einem möglicherweise schwereren Krankheitsverlauf wie er beispielsweise bei der Livedo auftritt, entgegenzuwirken. Die erworbenen Kenntnisse der pathophysiologischen Mechanismen können zu einem verbesserten Management der Erkrankung und Hilfestellung möglicher Gegenmaßnahmen in der Bewältigung der Erkrankung beitragen.
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Affiliation(s)
- Kristin Lange
- Klinik für Dermatologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
| | - Maja Matthies
- Klinik für Dermatologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
| | - Parnian Firouzi-Memarpuri
- Klinik für Dermatologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - Bernhard Homey
- Klinik für Dermatologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
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Akuffo-Addo E, Nicholas MN, Joseph M. COVID-19 Skin Manifestations in Skin of Colour. J Cutan Med Surg 2022; 26:189-197. [PMID: 34663122 PMCID: PMC8950713 DOI: 10.1177/12034754211053310] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/24/2021] [Accepted: 09/26/2021] [Indexed: 12/15/2022]
Abstract
Coronavirus disease (COVID-19) skin manifestations have been increasingly reported in medical literature. Recent discussions have identified a lack of images of skin of color (SOC) patients with COVID-19 related skin findings despite people with skin of color being disproportionately affected with the disease. There have been calls to prioritize the identification of COVID-19 skin manifestations in patients with SOC and disseminate these findings. The objective of this article is to review the existing literature on COVID-19 skin manifestations and, where possible, discuss how they may present differently in patients with SOC. Further research is needed to allow primary care physicians and dermatologists to be aware of and easily identify patients with cutaneous findings that may be secondary to COVID-19. Patients presenting with idiopathic dermatologic manifestations should be considered for COVID-19 testing and follow public health guidelines for self-isolation.
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Affiliation(s)
- Edgar Akuffo-Addo
- Undergraduate Medical Education, Faculty of Medicine, University of Toronto, ON, Canada
| | - Mathew N. Nicholas
- Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada
| | - Marissa Joseph
- Department of Pediatrics, Faculty of Medicine, University of Toronto, ON, Canada
- Section of Dermatology, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Division of Dermatology, Women’s College Hospital, Toronto, ON, Canada
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Dondi A, Sperti G, Gori D, Guaraldi F, Montalti M, Parini L, Piraccini BM, Lanari M, Neri I. Epidemiology and clinical evolution of non-multisystem inflammatory syndrome (MIS-C) dermatological lesions in pediatric patients affected by SARS-CoV-2 infection: A systematic review of the literature. Eur J Pediatr 2022; 181:3577-3593. [PMID: 35948654 PMCID: PMC9365226 DOI: 10.1007/s00431-022-04585-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/19/2022] [Accepted: 08/03/2022] [Indexed: 02/07/2023]
Abstract
UNLABELLED COVID-19 can present with a range of skin manifestations, some of which specific of the pediatric age. The aim of this systematic literature review was to determine the type, prevalence, time of onset, and evolution of cutaneous manifestations associated with COVID-19 in newborns, children, and adolescents, after excluding multisystem inflammatory syndrome in children (MIS-C). PubMed, Tripdatabase, ClinicalTrials, and Cochrane Library databases were searched using an ad hoc string for case reports/series and observational studies, published between December 2019 and February 2022. Study quality was assessed using the STROBE and CARE tools. Seventy-three (49 case reports/series and 24 studies) out of 26,545 identified articles were included in the analysis. Dermatological lesions were highly heterogeneous for clinical presentation, time of onset, and association with other COVID-19 manifestations. Overall, they mainly affected the acral portions, and typically presented a favorable outcome. Pseudo-chilblains were the most common. CONCLUSIONS Mucocutaneous manifestations could be the only/predominant and early manifestation of COVID-19 that could precede other more severe manifestations by days or weeks. Therefore, physicians of all disciplines should be familiar with them. WHAT IS KNOWN • A variety of cutaneous manifestations have been reported in association with COVID-19. • Urticaria, maculopapular, or vesicular rashes can occur at any age, while chilblains and erythema multiforme are more common in children and young patients. WHAT IS NEW • Skin lesions related to SARS-CoV-2 infection often show a peculiar acral distribution. • Mucocutaneous lesions of various type may be the only/predominant manifestation of COVID-19; they could present in paucisymptomatic and severely ill patients and occur at different stages of the disease.
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Affiliation(s)
- Arianna Dondi
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Giacomo Sperti
- School of Pediatrics, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Davide Gori
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Federica Guaraldi
- IRCCS Istituto Delle Scienze Neurologiche Di Bologna, 40139, Bologna, Italy.
| | - Marco Montalti
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, Public Health and Medical Statistics, University of Bologna, Bologna, Italy
| | - Lorenza Parini
- School of Pediatrics, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, Public Health and Medical Statistics, University of Bologna, Bologna, Italy
| | - Marcello Lanari
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Iria Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Gisondi P, Di Leo S, Bellinato F, Cazzaniga S, Piaserico S, Naldi L. Time of Onset of Selected Skin Lesions Associated with COVID-19: A Systematic Review. Dermatol Ther (Heidelb) 2021; 11:695-705. [PMID: 33811315 PMCID: PMC8018690 DOI: 10.1007/s13555-021-00526-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Distinct skin lesions associated with coronavirus disease 2019 (COVID-19) have been described, but data regarding their time of onset during the COVID-19 course are scant. Our objective was to systematically review the studies reporting the time of onset of selected skin lesions with respect to the reported onset of the COVID-19 core symptoms. METHODS A comprehensive search of studies published before 21 January 2021 was performed on MEDLINE via PubMed database using a predefined strategy to identify relevant articles. RESULTS Out of 354 references, 87 were selected, reporting a total of 895 patients with skin lesions associated with COVID-19. The most frequent pattern was exanthema (n = 430, 48%), followed by vascular (n = 299, 33%), urticarial (n = 105, 12%) and others (n = 66, 7%). Skin lesions occurred more frequently in the first 4 weeks from the COVID-19 onset (n = 831, 92%), whereas prodromal or late lesions were rarer (n = 69, 8%). The urticarial and exanthema patterns were more frequent in the first 2 weeks. About the vascular pattern some differences were noted among its subtypes. Livedoid lesions occurred mainly in the first 2 weeks, while chilblain-like lesions between weeks 2 and 4. Purpuric/petechial lesions were equally distributed during the first 4 weeks. Several skin manifestations did not fall into the pattern classification, including erythema multiforme, generalized pruritus, Kawasaki disease and others. CONCLUSION The diversity in the time of onset of skin lesions as well as their polymorphic nature likely reflects the diversity of the pathogenetic underlying mechanisms. PROSPERO DATABASE REGISTRATION NUMBER CRD42021236331.
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Affiliation(s)
- Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy.
| | - Sara Di Leo
- Division of Dermatology, San Bortolo Hospital, Vicenza, Italy
| | - Francesco Bellinato
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Simone Cazzaniga
- Centro Studi GISED, Bergamo, Italy
- Department of Dermatology, Inselspital University Hospital of Bern, Bern, Switzerland
| | - Stefano Piaserico
- Section of Dermatology, Department of Medicine, University of Padua, Padua, Italy
| | - Luigi Naldi
- Division of Dermatology, San Bortolo Hospital, Vicenza, Italy
- Centro Studi GISED, Bergamo, Italy
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Vitamin D Deficiency Rickets and COVID-19 Pandemic. Case Rep Pediatr 2021; 2021:5512668. [PMID: 33927910 PMCID: PMC8051520 DOI: 10.1155/2021/5512668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/18/2021] [Accepted: 04/04/2021] [Indexed: 12/28/2022] Open
Abstract
In a breastfed infant, the main source of vitamin D comes from the mother. Thus, maternal vitamin D deficiency is the key reason for vitamin D deficiency (VDD) and rickets during infancy. As they grow older, inadequate sun exposure, diet and lack of supplements also contribute. Individuals with darker skin require at least three to five times longer exposure to the sun than a person with lighter skin to produce adequate endogenous vitamin D. Not many food items naturally contain vitamin D; most of those are less affordable to the poor. We report an 18-month-old child with vitamin D deficiency rickets during strict self-isolation measures during the coronavirus disease 2019 (COVID-19) pandemic. Prolonged periods of confining indoors, low dietary intake of vitamin D, economic distress, maternal deficiency, and nonsupplementation could have contributed to vitamin D deficiency rickets in this child. During an unprecedented pandemic of this nature, simple sun exposure and diet advice may suffice for most. This case report highlights the importance of strengthening individuals and communities with information and formulating strong public health policies to prevent vitamin D deficiency.
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