Dermatology

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Dermatology

Resources for managing dermatology patients

18  articles in this collection
Written by Noémie Desgagnés, Belinda Jiao, Audrey Mathieu, Janike Pelland, 

ILDS / AAD Registry : a case series on pernio-like skin lesions

This case series demonstrates pernio-like lesions as a manifestation of COVID-19.  Patients presenting this skin lesion were generally young, with few comorbidities, and had relatively benign clinical courses.  It presented as the sole symptom in 55% of patients. In patients with other COVID-19 symptoms, pernio-like lesions typically appeared concurrently or after other symptoms.  Lesions in […]

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06/03/2020

Guidelines: Aesthetic Clinic Reopening

1. Guidelines for patient scheduling:  Advance scheduling on the phone or online should be compulsory and walk-in patients should be discouraged.  Time gap between the appointments should be evaluated according to the clinic’s features to allow social distancing.  Patient should be encouraged to visit the clinic alone, with a mask and their own pen if […]

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05/26/2020

Thrombotic occlusive vasculopathy

Llamas-Velasco M. et al. described a 61-year-old male with ischemic digits and retiform purpura and livedoid lesions. Nasopharyngeal swab was positive for SARS-CoV-2 infection. The patient was admitted to the intensive care unit. The lesions involve hands and feet. Laboratory results revealed leucopenia, increased fibrinogen, increased D-dimer and a heterozygous Factor V Leiden mutation. Histopathological […]

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05/25/2020

An Update on the Management of Patients with Pernio-like Lesions

Although there is evolving evidence suggesting that skin manifestations may occur in some COVID-19 patients, experts are not unanimous.  Current data do not allow a clear link between pernio-like lesions and COVID-19. However, due to  an increased number of cases in young patients during the pandemic and until the physiopathology is better understood, new onset […]

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05/23/2020

Isotretinoin Prescription During the Pandemic

  The benefits of starting or continuing isotretinoin must outweigh the risks while considering the uncertainty of reliable follow-up visits and the lack of laboratory testing and imaging studies.2,3 If it is not possible to have medically supervised pregnancy tests every month, pregnancy tests can be done at home and then communicated to prescriber with […]

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05/23/2020

Potential Effect of Complement Pathways in Thrombotic Microvascular Injury

Based on pulmonary and cutaneous biopsy and autopsy samples, some critically ill patients present a generalized thrombotic microvascular injury. Cutaneous manifestation consistent with a thrombotic microvascular injury included retiform purpura or livedo racemose. Histological findings suggest that some of the severe cases of COVID-19 would have thrombotic injuries mediated by a systemic activation of the […]

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05/22/2020

Management of autoimmune bullous diseases

Recommendations for AIBD patients undergoing immunosuppressive therapy during the pandemic :  Immunomodulatory therapy should be maintained when necessary since unjustified withdrawal could lead to uncontrolled AIBD activity.  Adhere to standard precautions including social distancing and hand washing.  What if AIBD patients are SARS-CoV-2 infected ?  Evaluate the risk for each patient.  May be stopped during […]

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04/30/2020

Skin Registries

International League of Dermatological Societies promotes the use of newly developed registries:  Dermatology COVID-19 Registries – COVID-19 patients who develop dermatologic manifestations and patients with an existing dermatologic condition who develop COVID-19. PsoProtect– Psoriasis patients who were COVID-19 infected.  SECURE-AD– Atopic Dermatitis patients who were COVID-19 infected Society of Pediatric Dermatology promotes a survey collecting […]

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04/22/2020

Update on Cutaneous Manifestations

  Cutaneous manifestations are reported in many countries. However,  due to the current pandemic, several case reports are being published rapidly, which raises questions about the scientific validity of these articles.   Indeed, several articles have no histopathological evidence to correlate with clinical diagnosis.  Currently, there are no cutaneous manifestations specific to COVID-19, but there are certainly some […]

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04/23/2020

Pediatric Multi-System Inflammatory Syndrome: A New Clinical Presentation in Children

The United States (including New York City) and the United Kingdom have recently reported cases of multi-system inflammatory syndrome in children and adolescents potentially associated with COVID-19. The NYC Health Department reported 15 patients hospitalized between April 17 and May 1 with symptoms consistent with this syndrome. The presentation varies between a typical Kawasaki disease, […]

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05/17/2020

Performing Dermoscopy Amidst the Pandemic

Dermatoscope, an efficient tool used to evaluate different dermatological disorders, is a potential source of nosocomial infection spread. In fact, recent studies have shown that the SARS-CoV-2 virus can remain viable in aerosol and different materials (plastic, stainless steel, cardboard…) for hours.  Appointments should be discouraged or postponed for 14 days in patients with possible […]

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05/11/2020

Dermatological Surgery

Clinics should be triaged to review only urgent patients in person, and using telemedicine where possible. Consider cancelling all elective surgeries.  To minimize COVID-19 spread during office-based excisional surgery:  All surgical patients should be considered as potentially COVID-19 positive.  Smoke extractor systems are the most effective way to minimise risk. Using bipolar diathermy rather than […]

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04/16/2020

Acral Lesions: What We Know

1. Initial reports of acute acro-ischemic lesions in children were published by Mazzotta F. and Trocolli T. 2. Terms used include acral lesions, acro-ischemic lesions, perniosis, pernio or chilblain (also -like or pseudo-). 3. Acral lesions are often reported in children and young adults. Median age: 19,9 years old (Fernandez-Nieto D. et al.), 14 years […]

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05/05/2020

Case of Postpartum Cutaneous Lesions

A case of diffuse cutaneous lesions occurred on day 10 postpartum in a 37-year-old woman with no history of dermatological or internal disorders or allergies. Delivery was uncomplicated.  Lesions appeared 3 days after the onset of general symptoms, and were described as:  “Erythematous maculopapular lesions on the trunk, neck and face”  “Nummular erythematous lesions with […]

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05/07/2020

Immunosuppressants Use in Dermatology during the Outbreak

There is currently no data about the benefits or the risks of stopping immunomodulators/immunosuppressants during the COVID-19 outbreak.  Pre-coronavirus pivotal trials for psoriasis show that patients under biologic therapies had respiratory infection rates similar to placebo.  Price et al recommend:  Consider stopping classic immunosuppressants and rituximab  when viral symptoms present, especially with known or potential […]

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04/10/2020

Skin Damage Amongst Healthcare Workers, Its Prevention and Management

Amongst first-line healthcare workers, 97% reported skin damage caused by enhanced infection-prevention measures, the nasal bridge being the most damaged site (83.1%)1 Dryness/tightness was the most frequent symptom (70.3%), and desquamation the most common sign (61.6%)1 Wearing some medical devices for > 6 hours increased skin damage risks(face shields being an exception)1 Skin damage on cheeks, nasal bridge and forehead were respectively related to N95 mask, […]

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04/18/2020

Acute Acro-Ischemic Lesions in Children

These acro-ischemic lesions were seen in healthy children/adolescents. They are mostly found on the toes, but also on the fingers and the plantar region. Generally, they do not affect all fingers and toes.  The lesions are rounded, multiple and measure a few millimeters but sometimes they can cover the entire toe/finger with a clear demarcation […]

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04/13/2020

An Initial Overview on How the Skin is Affected

Cutaneous manifestations, mostly erythematous rash, were seen in 20.4% of COVID-19 patients1 Few presented widespread urticaria and chickenpox-like vesicles1 These skin lesions are similar to those seen in common viral infections, and no link was seen with disease severity1 New onset of livedoid patterned rash with symptoms and/or risk factors for COVID-19 can indicate infection […]

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04/10/2020