Cutaneous Vasculopathy in a COVID-19 Critically Ill Patient: A Histologic, Immunohistochemical, and Electron Microscopy Study
We describe a critically ill, SARS-CoV-2 positive patient with respiratory failure and thrombotic/livedoid skin lesions, appearing during the course of the disease. The biopsy of the lesions revealed an occlusive, pauci-inflammatory vasculopathy of the cutaneous small vessels characterized by comple...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Critical Care |
| Online Access: | http://dx.doi.org/10.1155/2021/6644853 |
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| author | Anna Kyriakoudi Konstantinos Pontikis Athanasios Tsaraklis Efthymia Soura Christine Vourlakou Athanasios Kossyvakis Efstathia Potamianou Evangelos Kaniaris Iliana Ioannidou Andreas Mentis Ismini Kloukina Maria Daganou Antonia Koutsoukou |
| author_facet | Anna Kyriakoudi Konstantinos Pontikis Athanasios Tsaraklis Efthymia Soura Christine Vourlakou Athanasios Kossyvakis Efstathia Potamianou Evangelos Kaniaris Iliana Ioannidou Andreas Mentis Ismini Kloukina Maria Daganou Antonia Koutsoukou |
| author_sort | Anna Kyriakoudi |
| collection | DOAJ |
| description | We describe a critically ill, SARS-CoV-2 positive patient with respiratory failure and thrombotic/livedoid skin lesions, appearing during the course of the disease. The biopsy of the lesions revealed an occlusive, pauci-inflammatory vasculopathy of the cutaneous small vessels characterized by complement and fibrinogen deposition on vascular walls, pointing to a thrombotic vasculopathy. Transmission electron microscopy of the affected skin failed to reveal any viral inclusions. Clinical evaluation and laboratory findings ruled out systemic coagulopathies and disseminated intravascular coagulation, drug-induced skin reaction, and common viral rashes. Our hypothesis is that the, herein evidenced, microvascular occlusive injury might constitute a significant pathologic mechanism in COVID-19, being a common denominator between cutaneous and pulmonary manifestations. |
| format | Article |
| id | doaj-art-e5d7ff125aa549b7b6c3e53779dcf72f |
| institution | Kabale University |
| issn | 2090-6420 2090-6439 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| spelling | doaj-art-e5d7ff125aa549b7b6c3e53779dcf72f2025-08-20T03:26:04ZengWileyCase Reports in Critical Care2090-64202090-64392021-01-01202110.1155/2021/66448536644853Cutaneous Vasculopathy in a COVID-19 Critically Ill Patient: A Histologic, Immunohistochemical, and Electron Microscopy StudyAnna Kyriakoudi0Konstantinos Pontikis1Athanasios Tsaraklis2Efthymia Soura3Christine Vourlakou4Athanasios Kossyvakis5Efstathia Potamianou6Evangelos Kaniaris7Iliana Ioannidou8Andreas Mentis9Ismini Kloukina10Maria Daganou11Antonia Koutsoukou12ICU, 1st Department of Respiratory Medicine, National and Kapodistrian University of Athens Medical School, “Sotiria” Hospital, Athens, GreeceICU, 1st Department of Respiratory Medicine, National and Kapodistrian University of Athens Medical School, “Sotiria” Hospital, Athens, GreeceDermatology Department, “Sotiria” Hospital, Athens, Greece1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, GreecePathology Department, Evangelismos General Hospital, Athens, GreecePublic Health Laboratories, Hellenic Pasteur Institute, Athens, GreeceICU, 1st Department of Respiratory Medicine, National and Kapodistrian University of Athens Medical School, “Sotiria” Hospital, Athens, GreeceICU, 1st Department of Respiratory Medicine, National and Kapodistrian University of Athens Medical School, “Sotiria” Hospital, Athens, GreeceICU, 1st Department of Respiratory Medicine, National and Kapodistrian University of Athens Medical School, “Sotiria” Hospital, Athens, GreecePublic Health Laboratories, Hellenic Pasteur Institute, Athens, GreeceCenter of Basic Research, Biomedical Research Foundation Academy of Athens, Athens, GreeceICU, 1st Department of Respiratory Medicine, National and Kapodistrian University of Athens Medical School, “Sotiria” Hospital, Athens, GreeceICU, 1st Department of Respiratory Medicine, National and Kapodistrian University of Athens Medical School, “Sotiria” Hospital, Athens, GreeceWe describe a critically ill, SARS-CoV-2 positive patient with respiratory failure and thrombotic/livedoid skin lesions, appearing during the course of the disease. The biopsy of the lesions revealed an occlusive, pauci-inflammatory vasculopathy of the cutaneous small vessels characterized by complement and fibrinogen deposition on vascular walls, pointing to a thrombotic vasculopathy. Transmission electron microscopy of the affected skin failed to reveal any viral inclusions. Clinical evaluation and laboratory findings ruled out systemic coagulopathies and disseminated intravascular coagulation, drug-induced skin reaction, and common viral rashes. Our hypothesis is that the, herein evidenced, microvascular occlusive injury might constitute a significant pathologic mechanism in COVID-19, being a common denominator between cutaneous and pulmonary manifestations.http://dx.doi.org/10.1155/2021/6644853 |
| spellingShingle | Anna Kyriakoudi Konstantinos Pontikis Athanasios Tsaraklis Efthymia Soura Christine Vourlakou Athanasios Kossyvakis Efstathia Potamianou Evangelos Kaniaris Iliana Ioannidou Andreas Mentis Ismini Kloukina Maria Daganou Antonia Koutsoukou Cutaneous Vasculopathy in a COVID-19 Critically Ill Patient: A Histologic, Immunohistochemical, and Electron Microscopy Study Case Reports in Critical Care |
| title | Cutaneous Vasculopathy in a COVID-19 Critically Ill Patient: A Histologic, Immunohistochemical, and Electron Microscopy Study |
| title_full | Cutaneous Vasculopathy in a COVID-19 Critically Ill Patient: A Histologic, Immunohistochemical, and Electron Microscopy Study |
| title_fullStr | Cutaneous Vasculopathy in a COVID-19 Critically Ill Patient: A Histologic, Immunohistochemical, and Electron Microscopy Study |
| title_full_unstemmed | Cutaneous Vasculopathy in a COVID-19 Critically Ill Patient: A Histologic, Immunohistochemical, and Electron Microscopy Study |
| title_short | Cutaneous Vasculopathy in a COVID-19 Critically Ill Patient: A Histologic, Immunohistochemical, and Electron Microscopy Study |
| title_sort | cutaneous vasculopathy in a covid 19 critically ill patient a histologic immunohistochemical and electron microscopy study |
| url | http://dx.doi.org/10.1155/2021/6644853 |
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