When your respirator grows in your face
Doctors also have skin problems, but already because of masks and aggressive antiseptics
Our laboratory has been developing products for the treatment and regeneration of the skin for several decades. And right now there are scientific publications about a new symptom that directly concerns us. And I have something to tell.
Denis Protsenko, chief physician of Kommunarka, reportedthat in most patients of the hospital complex, rashes on the stomach and arms are observed. The Italian doctor, Sebastiano Recalcati, also noted 20.4% of patients with skin manifestations – erythematous rash (14 cases), common urticaria (three cases), chickenpox vesicles (one case).
In addition, the head of the research team of doctors, Ignacio Garcia-Doval, also conducted a studysummarizing the symptoms based on 375 clinical cases. Of the unusual features, the authors noted polymorphism (heterogeneity) of skin manifestations of the disease.
In total, they identified five varieties of skin symptoms.
What happens to the skin
If for most ordinary people, all pathological skin elements are very conditionally divided into peeling, pimples and red spots, then, from the point of view of dermatologists, everything is pretty strictly classified and has its own notation. I hid the pictures under the spoilers, in case someone is psychologically injured by the appearance of skin lesions.
Kovy fingers
“Fingers” reminiscent of the effects of frostbite
Prevalence: 19%
Asymmetric spots resembling a picture of frostbite. As a rule, they are found only in young patients in the late stages of the development of the disease. Due to the specificity of the picture, the phenomenon has already received the unofficial name of “Cow-shaped fingers”.
Focal rashes with small blisters
Prevalence: 9%
They can occur almost anywhere on the torso, arms and legs. Often itchy. Appear before all other symptoms and are found mainly in middle-aged people.
Focal rashes resembling urticaria
Characteristic abdominal rash of a patient with Covid-19
Prevalence: 19%
The structure of this rash is similar to the usual allergic urticaria and is most often found on the torso. Usually itches.
Maculopapular rashes
In fact, this is the stomach with rubella. But the type of rash is very similar
Prevalence: 47%
They look like red small flat or convex papules that rise above the surface of the skin. Most often, this type of rash appears simultaneously with other symptoms and accompanies a severe course of the disease.
Thai researchers also reportthat a coronavirus rash may be confused with manifestations characteristic of Dengue fever. However, mosquito vectors of this fever are almost never found in most regions of our country and are not very relevant for us.
Livedo
Mesh livedo with characteristic vascular pattern
Prevalence: 6%
Livedo is the appearance of a purple mesh pattern of venules on the skin. The color change is caused by venule swelling due to capillary obstruction due to the formation of small blood clots. One of the key points during Covid-19 is the risk of blood clots in both small and large vessels. The mechanisms to this effect are not fully understood, but there are suggestions that this may be due to activation of platelet aggregation, since the vascular endothelium has ACE2 receptors and is a target for the virus.
As a rule, this symptom is characteristic of elderly patients with a severe course of the disease. They are not all right with microcirculation because of their age, and then there is such a viral gift from above.
How will this help us in early diagnosis?
No way.
Firstly, the symptoms most often occur already in patients with moderate to severe disease, when there is no doubt in the diagnosis.
Secondly, they are extremely non-specific. You could be allergic to celery or taken medications, you could be bitten by mosquitoes, or you were unsuccessfully sunbathing on the balcony of your apartment.
Moreover, despite the epidemic, measles, rubella in unvaccinated people and other viral infections have not disappeared from time to time. And also various enteroviruses, including the same Coxsackie and ECHO viruses. They also cause a rash.
Nevertheless, this can help in predicting the course of the disease in people who are already on treatment in hospitals. So, the symptoms of ischemia and microthrombosis on the skin can indicate a deterioration in the condition and the need for the appointment of anticoagulants.
Why haven’t you noticed before?
Phylogenetic distribution map of strains of SARS-nCoV-2. Early March
The American CDC also did not currently include skin manifestations in list of typical manifestations of the disease. In previously developed statistics collection applications, such as COVID Symptom Tracker from King’s College London, there are also no questions about skin rashes.
Perhaps in the near future they will be added to the diagnostic checklists, as in due time happened with loss of taste and smell.
I have several hypotheses why reports of skin symptoms have appeared just now. The least likely option, in my opinion, is that they were not noticed or were not considered significant. This is rather strange, considering that the same diarrhea and headache were taken into account.
The second hypothesis is, in my opinion, more likely to change the properties of the virus itself and its clinical manifestations.
Judging by the genetic data, which are carefully accumulated and visualized on nextstrain.org, genetically, strains identified in Russia were brought from Europe and the USA. Moreover, the bulk of the US strains also comes from Europe (Italy and Spain). The initial “zero” strain from China, apparently, is not detected among our population.
Phylogenetic tree of strains SARS-nCoV-2. China, Asia and Australia are purple, we are blue-green, Europe is yellow, and the USA is red
As has been written more than once, betacoronaviruses belong to the group of relatively genetically resistant viruses and slowly mutate. The strains farthest from the original have no more than 18 different nucleotides. This is relatively small, given the fact that the entire genome of the virus has in the region of 29,000 nucleotides. However, individual nucleotide substitutions may introduce new clinical manifestations and symptoms.
Themselves researchers suggestthat such symptoms may be due to interactions with other chronic viral infections, such as Herpes Zoster.
What to do if you are sprinkled
To start, do not panic. The risk that you will still get infected will not go anywhere, but with a high probability you will transfer it in a mild form. Exclude any contact with other people. Even if it is not Covid-19, but rubella, for example, it will not be a gift for the rest, especially for unvaccinated pregnant women.
If you have any more general symptoms, no need to run headlong into the clinic and cough on all passers-by. Call the hotline 8-800-2000-112 and wait people with flamethrowers a doctor. If it became really bad – immediately call an ambulance. In any case, most likely, you just sit at home with a temperature, and that’s all.
As you know, in a global pandemic, no one will bother with a rash or accelerate the regeneration of skin lesions. Do you breathe? Well done. Moreover, the majority will be ill in a mild form. Tolerate itching, itching, and walking spotty, of course, is not necessary. Typically, these dermatitis respond fairly well to treatment. Now I will tell you what can be done.
If you’re out of luck and this is Covid-19
In medicine, there are several typical pathological processes. For example, inflammation. Not so important, heel abscess is an exacerbation of tonsillitis or dermatitis. The general principles of damage and body response are very similar. The key mechanisms always come down to the fact that locally the tissues begin to suffer from a lack of oxygen, acidosis develops – a pH shift to the acidic side. Plus, the vessels expand and their permeability increases. As a result, fluid from the vascular bed rushes into the surrounding tissues and forms edema, which further impairs blood circulation. As a bonus, free radical defense mechanisms such as superoxide dismutase no longer work. As a result, oxygen radicals begin to damage cell membranes.
Various dermatitis, including cobiform, are no exception. Therefore, in order to maintain tissue in conditions of hypoxia, it will be justified to use a combination of vitamins C and P. Vitamins of group P belong to quercetin derivatives of flavonoid. They work as antioxidants, reducing vascular fragility and permeability due to lipid peroxidation of endothelial cells in hypoxia zones. In particular, they are indicated for varicose veins, allergic diseases and diseases that cause a rash (typhus, measles, scarlet fever).
This group of components works especially well when applied locally. Our laboratory at one time developed an extremely effective Neo gel. Do not pay attention to the fact that it is “anti-aging”. In this case, it will be very appropriate in terms of the pathogenesis of a process that impairs microcirculation and damages the vascular wall. This gel also contains vitamin C, and the quercetin derivative is represented by dihydroquercetin, which is similar in effect to rutoside. In addition, its structure is implemented on a complex phospholipid complex, which allows you to deliver all the active components through the protective lipid layer of the skin. If the rash itches, you can additionally look in the direction of gels with Dimetinden in the composition. This is a very good local antihistamine that relieves itching.
As a result, we will reduce inflammation and help the skin return to normal.
If it’s not Covid-19
If the tests are negative and you do not have Covid-19, then for a start we are happy.
Remember what you ate soon. At one time, I went to surrender to doctors at a local dermatovenerological dispensary with suspicion of a terrible and insidious disease. It turned out that this is a banal urticaria caused by the recently drunk new tea “Mountain herbs”. It’s hard to say what they got in there, but my body was outraged. Doctors injected a life-giving dose of glucorticoid hormone into the muscle and released it back.
If there are no other problems, you can take antihistamines in the usual dose that your doctor prescribed for allergies. Usually this will be enough to relieve the itching and remove the allergic rash.
Better just wash your hands
Alcohol and other antiseptics damage the skin
Do not forget that in addition to viral diseases, the skin is also damaged by the continuous washing of hands with antiseptics and soap. Use them only when it is really necessary. No need to kill the natural microbiome of your skin, pouring it with aggressive substances every few minutes.
Use alcohol when you cannot reach the nearest sink and soap. Although washing the hands with the virus does not kill, it completely rinses it off the skin. Alcohol is able to dissolve the protective lipid layer of the skin, which allows us to resist bacteria and mold, which are trying to continuously devour us. As a result, you kill a certain amount of viruses and bacteria that got on the skin, but leave it defenseless. The next portion of bacteria from the door handle will come already on the damaged skin and with great pleasure will begin to colonize it.
If you are constantly forced to treat your hands with disinfectant solutions, especially alcohol-based, I can advise our series Hydration. It should help cover up from continuous chemical damage. The key component there is high molecular weight hyaluronic acid, which helps restore the protective layer and saturate the skin with moisture.
