No antibody response in cutaneous manifestations associated with COVID-19: An observational study of 64 cases with microbiological and clinical characterization

García-Gil, Miguel Fernando ; Monte-Serrano, Juan ; Lapeña-Casado, Alejandro ; Villagrasa-Boli, Pablo ; Ramírez-Lluch, Mar ; Martínez-Pallás, Isabel ; Bularca, Aura ; Aldea-Manrique, Beatriz ; Benito-Ruesca, Rafael (Universidad de Zaragoza) ; Ventura-Faci, María Purificación (Universidad de Zaragoza) ; Ara-Martín, Mariano (Universidad de Zaragoza)

Resumen: Background: The microbiological diagnosis of skin lesions related to COVID-19 is not well known. Objective: Perform a microbiological diagnosis in COVID19-related cutaneous manifestations. Methods: A cross-sectional study was performed with 64 patients with cutaneous manifestations associated with COVID-19 who under- went serological and nasopharyngeal reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2. Results: Out of the 64 patients, 6 patients had positive RT-PCR, with all of them developing SARS-CoV-2 IgG and 4 of them had positive IgM + IgA. Of the 58 patients with negative RT-PCR, 8 cases had positive IgM + IgA and only one of them had IgG seroconversion. Therefore, the infection was demon- strated in 7 cases (10.9%) and was doubtful in 7 other cases (10.9%) who presented negative RT-PCR and presence of IgA + IgM without subsequent seroconversion of IgG. Fifty patients (78.1%) had negative serological tests. The most frequent cutane- ous pattern was pseudo-chilblain (48.4%) followed by maculo-papular pattern (26.6%), urticarial lesions (10.9%), vesicular eruptions (6.3%) and livedoid pattern (4.7%). The maculo-papular pattern showed the highest positivity in RT-PCR (3 cases; 17.6%) and serologies (4 cases; 23.5%). Skin lesions developed after the systemic symptoms in most patients (19 cases; 61.3%). Conclusions: Microbiological confirma- tion tests may not be an effective diagnostic technique for COVID-related cutaneous manifestations or that attributed lesions are not related to COVID-19. Confounding fac- tors such as adverse drug reaction, serological cross-reactions with other viruses, the low production of antibodies in asymptomatic or mild forms of COVID-19 or its rapid disap- pearance, increase diagnostic uncertainty.

Idioma: Inglés

DOI: 10.1111/dth.15142

Año: 2021

Publicado en: Dermatologic Therapy 34, 6 (2021), e15142 [5 pp.]
ISSN: 1396-0296

Factor impacto JCR: 3.858 (2021)

Categ. JCR: DERMATOLOGY rank: 19 / 69 = 0.275 (2021) - Q2 - T1

Factor impacto CITESCORE: 3.1 - Medicine (Q2)

Factor impacto SCIMAGO: 0.598 - Medicine (miscellaneous) (Q2) - Dermatology (Q2)

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Microbiología (Dpto. Microb.Ped.Radio.Sal.Pú.)
Área (Departamento): Área Dermatología (Dpto. Medicina, Psiqu. y Derm.)
Área (Departamento): Área Pediatría (Dpto. Microb.Ped.Radio.Sal.Pú.)