Manifestaciones cutáneas asociadas a COVID-19

Dra. Andrea Arias Argüello
Médico y curujano general.
Trabajador Independiente. 
Consulta privada, San José, Costa Rica.
Universidad de Ciencias Médicas de Costa Rica.
Miembro del Colegio de Médicos y Cirujanos de Costa Rica
Costa Rica.

Resumen

Se realiza una revisión bibliográfica de las manifestaciones cutáneas en pacientes infectados con el coronavirus tipo 2 del síndrome respiratorio agudo severo (SARS-CoV-2), con el objetivo de ayudar al personal sanitario a reconocer los patrones emergentes de erupciones en este grupo de pacientes. Existen consideraciones importantes en la interpretación al momento de evaluar estos primeros informes desde una perspectiva dermatológica, es decir, si estas erupciones son manifestaciones específicas de la infección por SARS-CoV-2 que involucra la piel o representan patrones de reacción en asociación con covid-19. Se recomienda precaución al atribuir las erupciones cutáneas observadas en pacientes por efecto directo del SARS-CoV-2, debido a que podrían obedecer a variables como la coinfección con SARS-CoV-2 y otra infección respiratoria, complicaciones médicas que surgen en un paciente crítico (fiebre o coagulación intravascular diseminada) u otros medicamentos de apoyo o tratamientos empíricos para la infección. La disponibilidad limitada de las pruebas de SARS-CoV-2, especialmente al comienzo de la pandemia, complica aún más la interpretación de las erupciones cutáneas observadas en casos sin diagnóstico. Se necesitará un estudio prospectivo cuidadoso y detallado, que incluya la realización de pruebas específicas de SARS-CoV-2 en muestras de biopsia de piel, para aclarar la patogénesis de estas erupciones.

Palabras claves

Covid-19, infección SARS-CoV-2, enfermedad cutánea, exantema viral, exantema, manifestaciones cutáneas.

Abstract

A bibliographic review of the cutaneous manifestations in patients infected with the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is performed. The intention is to help healthcare personnel recognize emerging rash patterns in this group of patients. There are important interpretative considerations when evaluating these early reports from a dermatological perspective, whether these rashes are specific manifestations of SARS-CoV-2 infection involving the skin or represent reaction patterns in association with COVID-19. Therefore, caution is recommended when attributing all skin eruptions observed in patients to the direct effects of SARS-CoV-2; Due to the fact that they could be due to variables such as coinfection with SARS-CoV-2 and other respiratory infection, medical complications that arise in a critically ill patient (fever or disseminated intravascular coagulation) or other supportive drugs or empirical treatments for the infection. The limited availability of SARS-CoV-2 tests, especially at the start of the pandemic, further complicates the interpretation of observed skin rashes in undiagnosed cases. A careful and detailed prospective study, including the performance of specific SARS-CoV-2 tests on skin biopsy specimens, will be required to clarify the pathogenesis of these eruptions.

Keywords

COVID-19, SARS-CoV-2 infection, Skin Disease, Viral, exanthema, skin manifestations.

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