Elaine Melody T. Co, MD, MBA, Sher Claranza O. Liquido, MD,
Rosario Salud A. Blas, MD, FPDS, Ma. Lourdes Anna M.Nebrida-Idea, MD, FPDS, Angela Katrina M. Esguerra, MD, FPDS, Donna Marie L. Sarrosa, MD, FPDS
Introduction: COVID-19 was unexpectedly detected in late 2019, swiftly becoming a global pandemic in early 2020. Knowledge about the disease is still evolving, and though much has been written about the serious effects on the respiratory, cardiovascular, and neurological systems, it has only been of late that the skin was observed to be affected as well. In many different countries, case reports have presented clues to the possible pathomechanisms explaining the two most commonly found dermatological presentations: viral exanthem or vasculopathy-related. In children, COVID-19 may present as chilblain-like lesions or may be related to Kawasaki disease.
Case Summary: A 51-year-old Filipino female without comorbidities presented with cough, rhinitis, and low-grade fever. Four days later, she developed pruritic, localized wheals on the arms, gradually involving the trunk and lower extremities. A 49-year-old Filipino female without comorbidities based in the Middle East presented with cough and fever. Four days after, she developed a generalized distribution of wheals and livedoid patches on both legs. Both patients recovered from COVID-19 with complete resolution of skin lesions.
Conclusion: To the best of our knowledge, this is the first report of COVID-19 related dermatology cases collected in the Philippines.
COVID-19 pandemic, SARS-CoV-2, cutaneous manifestations, viral exanthem, vasculopathy, COVID toes, Kawasaki disease
Co EMT, Liquido SCO, Blas RSA, Nebrida-Idea MLAM, Esguerra AKM, Sarrosa DML. Skin manifestations of COVID-19: a preliminary report on 2 patients and review of related literature. Journal of the Philippine Dermatological Society 2020, 29(1), 77-84
1. Recalcati S. Cutaneous manifestations in COVID-19: a first perspective. J Eur Acad Dermatol Venereol. 2020;https://doi.org/10.1111/jdv.16387
2. Joob B, Wiwanitkit V. COVID-19 can present with a rash and be mistakenfor dengue. J Am Acad Dermatol. 2020;82(5):e177. 2020. https://doi.org/10.1016/j.jaad.2020.03.036
3. Jimenez-Cauhe J, Ortega-Quijano D, Prieto-Barrios M, Moreno-Arrones O,Fernandez-Nieto D. Reply to “COVID-19 can present with a rash and be mistaken for dengue”: Petechial rash in a patient with COVID-19 infection. J Am Acad Dermatol. 2020. https://doi.org/10.1016/j.jaad.2020.04.016
4. Diaz-Guimaraens B, Dominguez-Santas M, Suarez-Valle A, Pindado-Ortega C, Selda-Enriquez G, Bea-Ardebol S, Fernandez-Nieto D.Petechial Skin Rash Associated With Severe Acute Respiratory Syndrome Coronavirus 2 Infection. JAMA Dermatol. 2020. https://doi.org/10.1001/jamadermatol.2020.1741
5. Najarian D. Morbilliform exanthem associated with COVID19. JAAD Case Reports. 2020; https://doi.org/10.1016/j.jdcr.2020.04.015
6. Avellana Moreno R, Villa E, Avellana Moreno V, Estela Villa C, Aparicio M, Fontanella A. Cutaneous manifestation of COVID-19 in images: A case report. J Eur Acad Dermatol Venereol. 2020. https://doi.org/10.1111/ jdv.16531
7. Zengarini C, Orioni G, Cascavilla A, Horna Solera C, Fulgaro C, Misciali C, Patrizi A, Gaspari V. Histological pattern in Covid-19 induced viral rash. J Eur Acad Dermatol Venereol. 2020. https://doi.org/10.1111/jdv.16569
8. Van Damme C, Berlingin E, Saussez S, Accaputo O. Acute urticaria with pyrexia as the first manifestations of a COVID-19 infection. J Eur Acad Dermatol Venereol. 2020. https://doi.org/10.1111/jdv.16523
9. Quintana-Castanedo L, Feito-Rodríguez M, Valero-López I, Chiloeches- Fernández C, Sendagorta-Cudós E, Herranz-Pinto P. Urticarial exanthem as early diagnostic clue for COVID-19 infection. JAAD Case Reports. 2020.
10. Marzano A, Genovese G, Fabbrocini G, Pigatto P, Monfrecola G, Piraccini B, Veraldi S, Rubegni P, Cusini M, Caputo V, Rongioletti F, Berti E, Calzavara-Pinton P. Varicella-like exanthem as a specific COVID-19-associated skin
manifestation: multicenter case series of 22 patients. J Am Acad Dermatol. 2020.https://doi.org/10.1016/j.jaad.2020.04.044
11. Manalo I, Smith M, Cheeley J, Jacobs R. A Dermatologic Manifestation of COVID-19: Transient Livedo Reticularis. J Am Acad Dermatol. 2020. https://doi.org/10.1016/j.jaad.2020.04.018
12. Zhang et al., Clinical and coagulation characteristics of 7 patients with critical COVID-19 pneumonia and acro-ischemia. 2020. https://doi.org/10.3760/cma.j.issn.0253-2727.2020.0006.
13. Magro C, Mulvey J, Berlin D, Nuovo G, Salvatore S, Harp J, Baxter-Stoltzfus A, Laurence J. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases.
Transl Res. 2020. https://doi.org/10.1016/j.trsl.2020.04.007
14. Piccolo V, Neri I, Filippeschi C, Oranges T, Argenziano G, Battarra V, Berti S, Manunza F, Belloni Fortina A, Di Lernia V, Boccaletti V, De Bernardis G, Brunetti B, Mazzatenta C, Bassi A. Chilblain-like lesions during COVID-19 epidemic: a preliminary study on 63 patients. J Eur Acad Dermatol
Venereol. 2020. https://doi.org/10.1111/jdv.16526
15. López-Robles J, de la Hera I, Pardo J, Martínez J, Cutillas-Marco E. Chilblainlike lesions: a case series of 41 patients during the COVID-19 pandemic. Clin Exp Dermatol. 2020. https://doi.org/10.1111/ced.14275
16. Kolivras A, Dehavay F, Delplace D, Feoli F, Meiers I, Milone L, Olemans C, Sass U, Theunis A, Thompson C, Van De Borne L, Richert B. Coronavirus (COVID-19) infection–induced chilblains: A case report with histopathologic findings. JAAD Case Reports. 2020. https://doi.org/10.1016/j.
17. Landa N, Mendieta-Eckert M, Fonda-Pascual P, Aguirre T. Chilblain-like lesions on feet and hands during the COVID-19 Pandemic. Int. J. Dermatol. 2020. https://doi.org/10.1111/ijd.14937
18. Kalner S, Vergilis IJ, Periorbital Erythema as a Presenting Sign of Covid-19. JAAD Case Reports 2020. doi: https://doi.org/10.1016/j.jdcr.2020.05.001.
19. Sanchez A, Sohier P, Benghanem S, L’Honneur A, Rozenberg F, Dupin N, Garel B. Digitate Papulosquamous Eruption Associated With Severe Acute Respiratory Syndrome Coronavirus 2 Infection. JAMA Dermatol. 2020.
20. Jones VG, Mills M, Suarez D, et al. COVID-19 and Kawasaki disease: novel virus and novel case. Hosp Pediatr. 2020. https://doi.org/10.1542/ hpeds.2020-0123
21. Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020. https://doi.org/10.1016/s0140-6736(20)31094-1
22. Verdoni L, Mazza A, Gervasoni A, Martelli L, Ruggeri M, Ciuffreda M, Bonanomi E, D’Antiga L. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020;. https://doi.org/10.1016/s0140-6736(20)31103-x
23. Viner R, Whittaker E. Kawasaki-like disease: emerging complication during the COVID-19 pandemic. Lancet. 2020. https://doi.org/10.1016/s0140- 6736(20)31129-6
24. Campbell D, Sample I. At least 12 UK children have needed intensive care due to illness linked to Covid-19 [Internet]. the Guardian. 2020 [cited 2020 May 18]. Available from: https://www.theguardian.com/world/2020/apr/27/nhs-warns-of-rise-in-children-with-new-illness-thatmay-be-linked-to-coronavirus
25. Suchonwanit P, Leerunyakul K, Kositkuljorn C. Cutaneous manifestations in COVID-19: Lessons learned from current evidence. J Am Acad Dermatol. 2020. https://doi.org/10.1016/j.jaad.2020.04.094
26. Bouaziz J, Duong T, Jachiet M, Velter C, Lestang P, Cassius C, Arsouze A, Domergue Than Trong E, Bagot M, Begon E, Sulimovic L, Rybojad M. Vascular skin symptoms in COVID-19: a french observational study. J Eur Acad Dermatol Venereol. 2020. https://doi.org/10.1111/jdv.16544
27. Galván Casas C, Català A, Carretero Hernández G, Rodríguez-Jiménez P,Fernández Nieto D, Rodríguez-Villa Lario A, Navarro Fernández I, Ruiz-Villaverde R, Falkenhain D, Llamas Velasco M, García-Gavín J, Baniandrés O, González-Cruz C, Morillas-Lahuerta V, Cubiró X, Figueras Nart I, Selda-
Enriquez G, Romaní J, Fustà-Novell X, Melian-Olivera A, Roncero Riesco M, Burgos-Blasco P, Sola Ortigosa J, Feito Rodriguez M, García-Doval I. Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases. Br J Dermatol. 2020;.http://doi.org/10.1111/bjd.19163
28. Hedou M, Carsuzaa F, Chary E, Hainaut E, Cazenave-Roblot F, Masson Regnault M. Comment on “Cutaneous manifestations in COVID-19: a first perspective” by Recalcati S. J Eur Acad Dermatol Venereol. 2020. https://doi.org/10.1111/jdv.16519
Authors: Katrina Carmela M. Belen, MD, DPDS, Jasmin J.Jamora, MD, FPDS , Ma. Cecilia P. Ingente MD, DPDSAbstractBackground: Dermoscopy, a non-invasive diagnostic tool, has been proven to improve the diagnostic accuracy of vascular tumors since it can aid in...
A randomized, double-blind, comparative study on the safety and efficacy of virgin coconut (Cocos nucifera l.) oil against 1% hydrocortisone lotion as an anti-inflammatory and antipruritic preparation for mosquito reactions
Authors: Uy, Veronica S, MD; Gracia B. Teodosio, MD, FPDS; Ma. Teresita G. Gabriel, MD, FPDS; Mary Catherine T. Galang, MD; Mohammad Yoga A. Waskito, MD; Johannes F. Dayrit, MD, FPDS Abstract Background: Virgin coconut oil (VCO) has been reported...
Primary Cutaneous Anaplastic Large Cell Lymphoma (PC-ALCL) is a rare Non-Hodgkin lymphoma (NHL) representing approximately 9% of all cutaneous lymphomas.3 It usually manifests as a slow-growing, solitary tumor which has a tendency to regress spontaneously. However, metastasis is reported in 5-10% of cases.