Hi, as an skin biologist and dermatology researcher, I have been quite intrigued by the few cases reported regarding patience with SARS-cov-2 infections and skin manifestations. Earlier this year Qi et al made a nice expression analysis of the ACE2 receptor variance in different tissues which showed a minor expression of ACE2 in skin, even though it connected other co-receptors as well. is anyone working on seeing the effects of dead viral content on human keratinocytes and fibroblasts? Just to see what the receptor response is.
The Covid-19 affect the health of skin such as lesions, erythematous rashes, urticaria, and chicken pox-like vesicles are reported in few patients (20%) with COVID-19. In few cases, lesions involved the acral sites, especially the dorsum of the digits of the feet, beginning as erythematous-violaceous patches that slowly evolved to purpuric lesions and then to blisters and ulceronecrotic lesions, with final complete return to normal. Burning and itching are also present with some of the lesions in covid-19 patients.
For more detail please see highly reputed journal "The Lancet" recent publication entitled "Silent COVID-19: what your skin can reveal"
Published:May 18, 2020DOI:https://doi.org/10.1016/S1473-3099(20)30402-3
The skin lesion seems to be like the one observed in Kawasaki disease with non-specific, polymorphous skin rash. Most probably, this clinical finding in SARS-Cov-2 might be due to a cutaneous vascultiis as ecently reported, particularly in childhood. The fact that skin has a poor expression of ACE2r does not mean that a co-receptor has to act in order to provide a biologic door for the virus. The nHLH syndrome may create the conditions leading to a series of immune-phenotypes including Kawasaki-like disease in adults even.
Verdoni L, Mazza A, Gervasoni A, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study [published online ahead of print, 2020 May 13]. Lancet. 2020;10.1016/S0140-6736(20)31103-X. doi:10.1016/S0140-6736(20)31103-X
Numerous reports of skin rashes in patients with COVID-19 are cropping up around the world.
The rashes can take many forms — some appear as tiny red spots, while others appear as larger flat or raised lesions. Some have a hive-like appearance, while others look like frostbitten toes.However, it's too early to say whether these rashes are indeed caused by the new coronavirus, or whether they are related to other factors. "It's unclear whether the skin lesions we see in COVID are actually a direct manifestation of the virus" in the skin, or whether they are a "reaction pattern" due to a generally ramped-up immune system.
Thanks for your answers! The symptoms show signs of an immunological response. It would be interested to do proper histology and immunofluorescence on patient material.