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Journal of Cosmetic Dermatology Jan 2023COVID-19 is a highly contagious respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2. COVID-19 outbreak, which caused thousands of... (Review)
Review
BACKGROUND
COVID-19 is a highly contagious respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2. COVID-19 outbreak, which caused thousands of deaths, has been declared a pandemic by the World Health Organization in March 2020.
AIM
Skin manifestations related to SARS-CoV-2 infection can be divided mainly into five groups: chilblainlike lesions (CBLLs), maculopapular eruptions, urticarial eruptions, vesicular eruptions, and livedo or necrosis. Other skin findings reported are erythema multiforme (EM)-like lesions and skin findings associated with multisystem inflammatory syndrome in children (MIS-C) and rarely with multisystem inflammatory syndrome in adults (MIS-A). Other manifestations such as pityriasis rosea or shingles are also reported.
METHODS
A total of 60 articles including reviews, studies and case reports were selected for the evaluation in this review.
RESULTS
The skin manifestations associated with COVID-19 infection are numerous and can vary widely. The major dermatological patterns of COVID-19 can be classified as inflammatory reactions (maculopapular/morbilliform, urticarial and vesicular rashes), or lesions of vascular origin (chilblain like rashes, petechiae/purpura, and livedo acemose-like pattern) CONCLUSION: We believe that the dermatologist could play an important role in the response to the SARS-CoV-2 pandemic through early recognition of skin lesions suggestive of COVID-19, particularly in paucisymptomatic infections where this recognition could direct toward an early diagnosis of infection that certainly leads to a better prognosis.
Topics: Adult; Child; Humans; COVID-19; SARS-CoV-2; Skin Diseases; Purpura
PubMed: 36342945
DOI: 10.1111/jocd.15477 -
Blood Advances Jan 2024Pregnancy-onset thrombotic thrombocytopenic purpura (TTP) is a rare and life-threatening disease of which diagnosis and management requires experienced multidisciplinary...
Pregnancy-onset thrombotic thrombocytopenic purpura (TTP) is a rare and life-threatening disease of which diagnosis and management requires experienced multidisciplinary teams. The mechanisms responsible for a deficiency in the disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13 (ADAMTS13) leading to pregnancy-onset TTP may be congenital or acquired, and studying ADAMTS13 conformation could be of interest. The differential diagnosis between TTP and other pregnancy-associated thrombotic microangiopathies (TMA) is often challenging. Our retrospective multicenter study highlights the significance and the challenges associated with pregnancy-onset TTP and childbirth in terms of diagnosis, obstetric management, and follow-up aspects. Among 1174 pregnancy-onset TMA enrolled in the French Registry for TMA from 2000 to 2020, we identified 108 pregnancy-onset TTP: 52 immune-mediated TTP (iTTP, 48.1%), 27 acquired TTP of unidentified mechanism (uTTP, 25%), and 29 congenital TTP (cTTP, 26.9%). Data show that maternal outcome is good (survival rate: 95%) and fetal outcome is linked to the gestational age at the onset of the disease (survival rate: 75.5%). Three distinct entities with different natural histories emerged: pregnancy-onset iTTP appears similar to idiopathic iTTP, with an open ADAMTS13 conformation, and is marked by a relapse risk independent of subsequent pregnancies; pregnancy-onset uTTP appears to have a different pathophysiology with an unexpected open ADAMTS13 conformation and a very low relapse risk independent of subsequent pregnancies; finally, pregnancy-onset cTTP is characterized by the necessity of pregnancy as a systematic and specific trigger and a need for prophylactic plasmatherapy for subsequent pregnancies. This trial was registered at www.clinicaltrials.gov as #NCT00426686, and at the Health Authority and the French Ministry of Health (P051064/PHRC AOM05012).
Topics: Pregnancy; Female; Humans; Purpura, Thrombotic Thrombocytopenic; Follow-Up Studies; Thrombotic Microangiopathies; Retrospective Studies; Recurrence
PubMed: 38039511
DOI: 10.1182/bloodadvances.2023011972 -
JAMA Dermatology Aug 2021
Topics: Humans; Purpura
PubMed: 34190960
DOI: 10.1001/jamadermatol.2021.1792 -
International Journal of Dermatology Jun 2021
Topics: Erythema Infectiosum; Foot Dermatoses; Hand Dermatoses; Humans; Parvovirus B19, Human; Purpura; Skin Diseases
PubMed: 33565622
DOI: 10.1111/ijd.15456 -
Clinical and Experimental Dermatology Apr 2022Dermatologists should consider Achenbach syndrome in the differential diagnosis for patients with purpura on the fingers. The patient should be monitored following...
Dermatologists should consider Achenbach syndrome in the differential diagnosis for patients with purpura on the fingers. The patient should be monitored following appropriate examination and invasive tests, such as skin biopsy or angiography, should be avoided unless necessary.
Topics: Diagnosis, Differential; Fingers; Hematoma; Humans; Male; Purpura; Syndrome
PubMed: 34856004
DOI: 10.1111/ced.15042 -
The New England Journal of Medicine Nov 2023
Topics: Pregnancy; Female; Humans; Purpura, Thrombocytopenic, Idiopathic; Thrombocytopenia; Platelet Count
PubMed: 37913520
DOI: 10.1056/NEJMc2310642 -
Blood Jan 2023
Topics: Humans; Purpura, Thrombotic Thrombocytopenic; Plasma Exchange; Recurrence; Chronic Disease
PubMed: 36656610
DOI: 10.1182/blood.2022019297 -
Medizinische Klinik, Intensivmedizin... Nov 2023Febrile seizures, which are relatively common in young children, are often triggered by an infection and resolve quickly. Prompt presentation to a pediatric department... (Review)
Review
Febrile seizures, which are relatively common in young children, are often triggered by an infection and resolve quickly. Prompt presentation to a pediatric department is mandatory after any first seizure and every time for children ≤ 12 months. Central nervous system (CNS) diseases in childhood are able to cause seizures or other neurological disorders. Even the slightest suspicion of a seizure with CNS involvement must be promptly treated. In case of doubt, both an antiviral and an antibacterial treatment are started in parallel, which can be stopped after detecting the pathogen. Lumbar puncture is strictly indicated unless there are contraindications. Meningococcal sepsis is a severe clinical feature comprising high fever, chills and disorders of consciousness. The first skin symptoms are petechiae as a red flag sign. With progression, potentially lethal purpura fulminans may develop. Waterhouse-Friderichsen syndrome is a severe complication of acute bacterial meningitis. Lethality rate is 35%. The pediatric assessment triangle and the ABCDE algorithm help to identify critically ill children in a standardized, structured, and rapid manner.
Topics: Child; Humans; Infant; Child, Preschool; Seizures, Febrile; Purpura Fulminans; Emergencies; Meningitis, Bacterial; Spinal Puncture
PubMed: 37466696
DOI: 10.1007/s00063-023-01031-w -
Seminars in Thrombosis and Hemostasis Apr 2020The impact of thrombocytopenia varies widely depending on the underlying pathophysiology driving it. The biggest challenge in managing thrombocytopenia in pregnancy is... (Review)
Review
The impact of thrombocytopenia varies widely depending on the underlying pathophysiology driving it. The biggest challenge in managing thrombocytopenia in pregnancy is accurately identifying the responsible pathophysiology-a task made difficult given the tremendous overlap in clinical and laboratory abnormalities associated with different thrombocytopenia processes. The most common etiologies of thrombocytopenia in pregnancy range from physiology deemed benign to those that are life-threatening to the mother and fetus. Even in cases in which the responsible etiology is deemed benign, such as gestational thrombocytopenia, there are still implications for the management of labor and delivery, a time where hemostatic challenges may prove life-threatening. In most institutions, a minimum platelet count will be mandated for epidural anesthesia to be deemed a safe option. The causes of thrombocytopenia can also include diagnoses that are pregnancy-specific (such as preeclampsia or gestational thrombocytopenia), potentially triggered by pregnancy (such as thrombotic thrombocytopenic purpura), or unrelated to or predating the pregnancy (such as liver disease, infections, or immune thrombocytopenia purpura). It is imperative that the source of thrombocytopenia is identified accurately and expeditiously, as intervention can range from observation alone to urgent fetal delivery. In this review, the approach to diagnosis and the pathophysiological mechanisms of the most common etiologies of thrombocytopenia in pregnancy and associated management issues are presented.
Topics: Female; Humans; Pregnancy; Pregnancy Complications, Hematologic; Purpura, Thrombotic Thrombocytopenic
PubMed: 32259876
DOI: 10.1055/s-0040-1708842 -
Anasthesiologie, Intensivmedizin,... Feb 2021Roll-over trauma and associated traumatic entrapments frequently result in serious polytraumatisation. In rare cases, severe extrathoracic compressions and a protracted...
Roll-over trauma and associated traumatic entrapments frequently result in serious polytraumatisation. In rare cases, severe extrathoracic compressions and a protracted entrapment period can lead to Perthes syndrome, also known as traumatic asphyxia. The Perthes syndrome manifests itself by a triad of craniocervical cyanosis, facial petechiae and subconjunctival haemorrhages, enabling a rapid diagnosis based on these typical clinical features. In addition, a contusion of the heart, lungs or even the liver may occur as well as neurological and other ophthalmological complications. An early identification of this condition, the elevation of the upper body to allow adequate venous drainage in addition to ensuring sufficient oxygenation are essential for optimal therapy. In general, no long-term complications are to be expected for Perthes syndrome. The stasis usually disappears completely within a few months.
Topics: Asphyxia; Face; Humans; Purpura; Syndrome; Thoracic Injuries
PubMed: 33607674
DOI: 10.1055/a-1299-0546