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Russo D, Accarino R, Varricchio S, Franca RA, Potestio L, Patruno C, Napolitano M, Mascolo M. Granuloma annulare after SARS-CoV-2 vaccination: A case report and a literature review. Pathol Res Pract 2023; 242:154300. [PMID: 36638589 PMCID: PMC9804962 DOI: 10.1016/j.prp.2022.154300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION During the Cov-19 pandemic, many studies reported a broad spectrum of cutaneous reactions presenting as erythematous rashes or pernio-like, urticaria-like or vesicular/bullous patterns associated with Cov-19-infection and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. METHODS The authors documented the clinical and histopathological features of an unexpected case of granuloma annulare (GA) arising a few days after the SARS-CoV-2 vaccination and reviewed all GAs reported in the literature following the SARS-CoV-2 vaccination and Cov-19-infection. CASE REPORT A 69-year-old woman developed a single reddish lesion on the left deltoid region, where the SARS-CoV-2 vaccine seven days earlier was injected. The clinicians performed a punch skin biopsy, and histology revealed an interstitial GA. CONCLUSIONS Clinicians should be aware of the potential, though rare, GA occurrence as a possible adverse event after the SARS-CoV-2 vaccination. This additional case, like what happens after the administration of other vaccines, supports the idea that GA may result from the immune system activation following the vaccination. However, notwithstanding, they should encourage their patients to obtain immunization to assist the public health systems in overcoming the COVID-19 pandemic.
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Affiliation(s)
- Daniela Russo
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Naples, Italy
| | - Rossella Accarino
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Naples, Italy
| | - Silvia Varricchio
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
| | - Raduan Ahmed Franca
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Naples, Italy
| | - Luca Potestio
- Section of Dermatology, Unit of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Massimo Mascolo
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Naples, Italy
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Cazzato G. Cutaneous Manifestations of SARS-CoV-2, Cutaneous Adverse Reactions to Vaccines Anti-SARS-CoV-2 and Clinical/Dermoscopical Findings: Where We Are and Where We Will Go. Vaccines (Basel) 2023; 11:vaccines11010152. [PMID: 36679997 PMCID: PMC9861399 DOI: 10.3390/vaccines11010152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/12/2023] Open
Abstract
From the very first months of the pandemic, it became apparent that a variety of skin reactions could occur during COVID-19 disease, starting with 'erythema-pernio'-type lesions, similar to chilblains [...].
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Affiliation(s)
- Gerardo Cazzato
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, 70124 Bari, Italy
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Cazzato G, Cascardi E, Colagrande A, Foti C, Stellacci A, Marrone M, Ingravallo G, Arezzo F, Loizzi V, Solimando AG, Parente P, Maiorano E, Cormio G, Vacca A, Resta L. SARS-CoV-2 and Skin: New Insights and Perspectives. Biomolecules 2022; 12:biom12091212. [PMID: 36139051 PMCID: PMC9496354 DOI: 10.3390/biom12091212] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/22/2022] [Accepted: 08/29/2022] [Indexed: 12/15/2022] Open
Abstract
The SARS-CoV-2 pandemic has disrupted global health systems and brought the entire globe to its knees. Although born as a disease of the respiratory system, COVID-19 can affect different parts of the body, including the skin. Reports of ongoing skin manifestations of COVID-19 have gradually multiplied, pushing researchers to investigate the etiopathogenic mechanisms underlying these phenomena in more depth. In an attempt to investigate the possible association between SARS-CoV-2, ACE2, TMPRSS2 and skin manifestations, we performed immunohistochemical investigations of the ACE2 receptor and TMPRSS2 in nine skin samples from SARS-CoV-2-positive patients compared to a cohort of healthy controls. Furthermore, after consulting public databases regarding ACE2 mRNA expression in various cell populations resident in the skin, we conducted a literature review aimed at outlining the current state of this topic. We did not find statistically different immuno-expression of ACE2 and TMPRSS2 between the group of SARS-CoV-2-positive patients (nine skin biopsies) and the control group. Regarding ACE2, major immunolabeling was present in the epidermal keratinocytes and, rarely, in the fibroblasts and in the adenomeres of the eccrine sweat glands. Regarding the immune expression of TMPRSS2, we found no significant differences between the two groups, with a weak immune staining only in some skin cytotypes. From the review of the literature, we isolated 35 relevant articles according to the inclusion criteria adopted. ACE2 appears to be a target of SARS-CoV-2, although, other receptor molecules may potentially be implicated, such as TMPRSS2. Future studies with large cases and different molecular investigative methods are needed to further elucidate the mechanisms underlying the skin manifestations of SARS-CoV-2.
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Affiliation(s)
- Gerardo Cazzato
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
- Correspondence: ; Tel.: +39-34-0520-3641
| | - Eliano Cascardi
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
- Pathology Unit, FPO-IRCCS Candiolo Cancer Institute, Str. Provinciale 142 lm 3.95, 10060 Candiolo, Italy
| | - Anna Colagrande
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Sciences and Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Alessandra Stellacci
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Bari Policlinico Hospital, University of Bari, 70124 Bari, Italy
| | - Maricla Marrone
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Bari Policlinico Hospital, University of Bari, 70124 Bari, Italy
| | - Giuseppe Ingravallo
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Francesca Arezzo
- Section of Gynecology and Obstetrics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Vera Loizzi
- Section of Gynecology and Obstetrics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Antonio Giovanni Solimando
- Section of Internal Medicine, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Paola Parente
- Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, 71100 San Giovanni Rotondo, Italy
| | - Eugenio Maiorano
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Gennaro Cormio
- Oncology Unit IRCCS Istituto Tumori Giovanni Paolo II and Department of Interdisciplinary Medicine (DIM), University of Bari, 70124 Bari, Italy
| | - Angelo Vacca
- Section of Internal Medicine, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Leonardo Resta
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
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Resta L, Vimercati A, Cazzato G, Fanelli M, Scarcella SV, Ingravallo G, Colagrande A, Sablone S, Stolfa M, Arezzo F, Lettini T, Rossi R. SARS-CoV-2, Placental Histopathology, Gravity of Infection and Immunopathology: Is There an Association? Viruses 2022; 14:v14061330. [PMID: 35746801 PMCID: PMC9227044 DOI: 10.3390/v14061330] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/11/2022] [Accepted: 06/13/2022] [Indexed: 12/14/2022] Open
Abstract
(1) Background: As the pandemic months progress, more and more evidence shows that the placenta acts as a “barrier” to SARS-CoV-2, although rare cases of vertical transmission have been described. (2) Methods: In an attempt to investigate whether the symptoms’ severity was related to different placental histological characteristics and the immune microenvironment, we subdivided 29 placentas from 29 mothers positive for SARS-CoV-2 into two groups, depending on the symptomatology (moderate/severe vs. asymptomatic/mild), performing immunohistochemical investigations for CD4 + and CD8 + T lymphocytes, as well as for CD68 + macrophage. We also evaluated the immuno-expression of the ACE2 receptor at the placental level. These two groups were compared to a control group of 28 placentas from 28 SARS-CoV-2-negative healthy mothers. (3) Results: The symptoms (likely to be related to viremia) were statistically significantly correlated (p < 0.05) with histopathological changes, such as maternal malperfusion, decidual arteriopathy, blood vessel thrombus of fetal relevance. Furthermore, the immuno-expression of ACE2 was significantly lower in SARS-CoV-2-positive groups vs. control group (p = 0.001). (4) Conclusions: There is still much to study and discover regarding the relationship between SARS-CoV-2 and histological changes in placentas and how the latter might contribute to various neonatal clinical outcomes, such as prematurity.
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Affiliation(s)
- Leonardo Resta
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.R.); (M.F.); (S.V.S.); (G.I.); (A.C.); (M.S.); (T.L.); (R.R.)
| | - Antonella Vimercati
- Section of Ginecology and Obstetrics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.V.); (F.A.)
| | - Gerardo Cazzato
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.R.); (M.F.); (S.V.S.); (G.I.); (A.C.); (M.S.); (T.L.); (R.R.)
- Correspondence: ; Tel.: +39-34-0520-3641
| | - Margherita Fanelli
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.R.); (M.F.); (S.V.S.); (G.I.); (A.C.); (M.S.); (T.L.); (R.R.)
| | - Sara Vincenza Scarcella
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.R.); (M.F.); (S.V.S.); (G.I.); (A.C.); (M.S.); (T.L.); (R.R.)
| | - Giuseppe Ingravallo
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.R.); (M.F.); (S.V.S.); (G.I.); (A.C.); (M.S.); (T.L.); (R.R.)
| | - Anna Colagrande
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.R.); (M.F.); (S.V.S.); (G.I.); (A.C.); (M.S.); (T.L.); (R.R.)
| | - Sara Sablone
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Bari Policlinico Hospital, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Mary Stolfa
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.R.); (M.F.); (S.V.S.); (G.I.); (A.C.); (M.S.); (T.L.); (R.R.)
| | - Francesca Arezzo
- Section of Ginecology and Obstetrics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.V.); (F.A.)
| | - Teresa Lettini
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.R.); (M.F.); (S.V.S.); (G.I.); (A.C.); (M.S.); (T.L.); (R.R.)
| | - Roberta Rossi
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.R.); (M.F.); (S.V.S.); (G.I.); (A.C.); (M.S.); (T.L.); (R.R.)
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Cazzato G, Colagrande A, Cimmino A, Cicco G, Scarcella VS, Tarantino P, Lospalluti L, Romita P, Foti C, Demarco A, Sablone S, Candance PMV, Cicco S, Lettini T, Ingravallo G, Resta L. HMGB1-TIM3-HO1: A New Pathway of Inflammation in Skin of SARS-CoV-2 Patients? A Retrospective Pilot Study. Biomolecules 2021; 11:biom11081219. [PMID: 34439887 PMCID: PMC8392002 DOI: 10.3390/biom11081219] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/07/2021] [Accepted: 08/13/2021] [Indexed: 02/05/2023] Open
Abstract
The SARS-CoV-2 pandemic has completely disrupted the health systems of the entire planet. From the earliest months, it became increasingly clear that in addition to affecting the upper airways and lungs, there were other organs that could be affected. Among these, the skin became a real "sentinel signal" to be able to even suspect COVID-19. Background: this study deals with a little-explored issue for now: the study of skin immunopathology in SARS-CoV-2 positive subjects ascertained using the most reliable methods available. Methods: we used skin biopsy samples from SARS-CoV-2 positive and negative patients, studying morphology (Hematoxylin-Eosin), T lymphocyte population (CD4 and CD8), three markers such as HMGB-1, TIM-3 and HO-1 by immunohistochemistry. Results: although the presence of the CD4 and CD8 T population did not differ statistically significantly, we found greater activation and release of HMGB-1 in skin samples from SARS-CoV-2 positive patients, greater immunolabeling for TIM-3 at the level of CD4 and CD8 and a reduced expression of Heme oxygenase 1. Conclusions: these results support the possibility that there is immune deregulation in SARS-CoV-2 positive patients who develop skin manifestations of various kinds.
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Affiliation(s)
- Gerardo Cazzato
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
- Correspondence: (G.C.); (G.I.); Tel.: +39-340-520-3641 (G.C.); +39-338-853-6505 (G.I.)
| | - Anna Colagrande
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
| | - Antonietta Cimmino
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
| | - Gerolamo Cicco
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
| | - Vincenza Sara Scarcella
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
| | - Paola Tarantino
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
| | - Lucia Lospalluti
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.L.); (P.R.); (C.F.); (A.D.)
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.L.); (P.R.); (C.F.); (A.D.)
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.L.); (P.R.); (C.F.); (A.D.)
| | - Aurora Demarco
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (L.L.); (P.R.); (C.F.); (A.D.)
| | - Sara Sablone
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Bari Policlinico Hospital, University of Bari, 70124 Bari, Italy;
| | - Pragnell Maria Victoria Candance
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
| | - Sebastiano Cicco
- Section of Internal Medicine “G. Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy;
| | - Teresa Lettini
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
| | - Giuseppe Ingravallo
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
- Correspondence: (G.C.); (G.I.); Tel.: +39-340-520-3641 (G.C.); +39-338-853-6505 (G.I.)
| | - Leonardo Resta
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (A.C.); (G.C.); (V.S.S.); (P.T.); (P.M.V.C.); (T.L.); (L.R.)
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Cazzato G, Romita P, Foti C, Cimmino A, Colagrande A, Arezzo F, Sablone S, Barile A, Lettini T, Resta L, Ingravallo G. Purpuric Skin Rash in a Patient Undergoing Pfizer-BioNTech COVID-19 Vaccination: Histological Evaluation and Perspectives. Vaccines (Basel) 2021; 9:760. [PMID: 34358176 PMCID: PMC8310051 DOI: 10.3390/vaccines9070760] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/03/2021] [Accepted: 07/06/2021] [Indexed: 02/05/2023] Open
Abstract
The COVID-19 pandemic has affected the entire planet, and within about a year and a half, has led to 174,502,686 confirmed cases of COVID-19 worldwide, with 3,770,361 deaths. Although it is now clear that SARS-CoV-2 can affect various different organs, including the lungs, brain, skin, vessels, placenta and others, less is yet known about adverse reactions from vaccines, although more and more reports are starting to emerge. Among the adverse events, we focused particularly on skin rashes. In this short report, we describe the case of a patient vaccinated with Comirnaty, who developed a purpuric rash resistant to oral steroid therapy after 2 weeks. To date, this is one of the very few cases in which skin biopsy was performed to better characterize the histopathological picture of this rash. Finally, we conduct a literature review of the cases of rashes from SARS-CoV-2 vaccines described in the literature, with the aim of laying foundations for future, larger case studies.
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Affiliation(s)
- Gerardo Cazzato
- Section of Pathology, Departmente of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (C.F.); (A.C.); (A.C.); (A.B.); (T.L.); (L.R.); (G.I.)
| | - Paolo Romita
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, 70124 Bari, Italy;
| | - Caterina Foti
- Section of Pathology, Departmente of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (C.F.); (A.C.); (A.C.); (A.B.); (T.L.); (L.R.); (G.I.)
| | - Antonietta Cimmino
- Section of Pathology, Departmente of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (C.F.); (A.C.); (A.C.); (A.B.); (T.L.); (L.R.); (G.I.)
| | - Anna Colagrande
- Section of Pathology, Departmente of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (C.F.); (A.C.); (A.C.); (A.B.); (T.L.); (L.R.); (G.I.)
| | - Francesca Arezzo
- Department of Biomedical Sciences and Human Oncology, Gynecologic and Obstetrics Clinic, 70124 Bari, Italy;
| | - Sara Sablone
- Section of Legal Medicine, Department of Interdisciplinary Medicine, Policlinico di Bari Hospital, University of Bari, 70124 Bari, Italy;
| | - Angela Barile
- Section of Pathology, Departmente of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (C.F.); (A.C.); (A.C.); (A.B.); (T.L.); (L.R.); (G.I.)
| | - Teresa Lettini
- Section of Pathology, Departmente of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (C.F.); (A.C.); (A.C.); (A.B.); (T.L.); (L.R.); (G.I.)
| | - Leonardo Resta
- Section of Pathology, Departmente of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (C.F.); (A.C.); (A.C.); (A.B.); (T.L.); (L.R.); (G.I.)
| | - Giuseppe Ingravallo
- Section of Pathology, Departmente of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (C.F.); (A.C.); (A.C.); (A.B.); (T.L.); (L.R.); (G.I.)
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7
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Cazzato G, Mazzia G, Cimmino A, Colagrande A, Sablone S, Lettini T, Rossi R, Santarella N, Elia R, Nacchiero E, Maruccia M, Marzullo A, Maiorano E, Giudice G, Ingravallo G, Resta L. SARS-CoV-2 and Skin: The Pathologist's Point of View. Biomolecules 2021; 11:biom11060838. [PMID: 34200112 PMCID: PMC8227624 DOI: 10.3390/biom11060838] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 02/05/2023] Open
Abstract
The SARS-CoV-2 pandemic has dramatically changed our lives and habits. In just a few months, the most advanced and efficient health systems in the world have been overwhelmed by an infectious disease that has caused 3.26 million deaths and more than 156 million cases worldwide. Although the lung is the most frequently affected organ, the skin has also resulted in being a target body district, so much so as to suggest it may be a real "sentinel" of COVID-19 disease. Here we present 17 cases of skin manifestations studied and analyzed in recent months in our Department; immunohistochemical investigations were carried out on samples for the S1 spike-protein of SARS-CoV-2, as well as electron microscopy investigations showing evidence of virions within the constituent cells of the eccrine sweat glands and the endothelium of small blood vessels. Finally, we conduct a brief review of the COVID-related skin manifestations, confirmed by immunohistochemistry and/or electron microscopy, described in the literature.
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Affiliation(s)
- Gerardo Cazzato
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
- Correspondence:
| | - Giulia Mazzia
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Antonietta Cimmino
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Anna Colagrande
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Sara Sablone
- Department of Interdisciplinary Medicine, Section of Legal Medicine, Policlinico di Bari Hospital, University of Bari, 70124 Bari, Italy; (S.S.); (G.G.)
| | - Teresa Lettini
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Roberta Rossi
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Nadia Santarella
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Rossella Elia
- Department of Emergency and Organ Transplantation, Section of Plastic and Reconstructive Surgery, University of Bari, 70124 Bari, Italy; (R.E.); (E.N.); (M.M.)
| | - Eleonora Nacchiero
- Department of Emergency and Organ Transplantation, Section of Plastic and Reconstructive Surgery, University of Bari, 70124 Bari, Italy; (R.E.); (E.N.); (M.M.)
| | - Michele Maruccia
- Department of Emergency and Organ Transplantation, Section of Plastic and Reconstructive Surgery, University of Bari, 70124 Bari, Italy; (R.E.); (E.N.); (M.M.)
| | - Andrea Marzullo
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Eugenio Maiorano
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Giuseppe Giudice
- Department of Interdisciplinary Medicine, Section of Legal Medicine, Policlinico di Bari Hospital, University of Bari, 70124 Bari, Italy; (S.S.); (G.G.)
| | - Giuseppe Ingravallo
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
| | - Leonardo Resta
- Department of Emergency and Organ Transplantation (DETO), Section of Pathology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.M.); (A.C.); (A.C.); (T.L.); (R.R.); (N.S.); (A.M.); (E.M.); (G.I.); (L.R.)
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