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Tratamiento de las lesiones cutáneas secundarias a la infección por COVID-19.

BACKGROUND: COVID-19 produces dermatological lesions in around 20% of those infected; these lesions include erythema, papules, vesicles, urticaria, chilblains and forms of vasculitis. Its severity depends on the age and degree of immune and inflammatory compromise of the patient, so there is no unif...

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Published in:Dermatología Revista Mexicana Vol. 69; no. 1; pp. 22 - 32
Main Authors: Galván Bañuelos, Guillermo, Gamboa Esquivel, Jorge Edmundo
Format: Article
Published: Edicion y Farmacia S.A. de C.V. Jan/Feb2025
Online Access:View this record in EBSCOhost
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      dt: Jan/Feb2025
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        10.24245/dermatolrevmex.v69i1.10309
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          Galván Bañuelos, Guillermo
          Gamboa Esquivel, Jorge Edmundo
        affil:
          Hospital General de Zona 3 San Juan del Río, Instituto Mexicano del Seguro Social, Querétaro, México
          Hospital Tercer Milenio, Secretaría de Salud, Aguascalientes, México
      sug:
      keyword:
        Chilblains
        Review
        Urticaria
        Vasculitis
        Chilblains
        COVID-19
        Review
        revisión
        sabañones
        Urticaria
        vasculitis
      ab:
        BACKGROUND: COVID-19 produces dermatological lesions in around 20% of those infected; these lesions include erythema, papules, vesicles, urticaria, chilblains and forms of vasculitis. Its severity depends on the age and degree of immune and inflammatory compromise of the patient, so there is no unified treatment that guides the most effective therapeutic scheme for its resolution. OBJECTIVE: To describe the most effective treatments against dermatological manifestations of COVID-19 infection. METHODOLOGY: A review of studies that described the treatment implemented in patients with dermatological manifestations of COVID-19, published from January 2020 to January 2024 in the PubMed, Scopus, Embase and Google Scholar repositories, was made. RESULTS: A total of 14 articles were included, the skin lesions reported were mainly pruritic rash, exanthematous, thrombocytopenic purpura and vasculitis. In two studies, poor therapeutic efficacy was reported after the use of human immunoglobulin in combination with low doses of prednisolone, the remaining 12 studies used combinations of immunomodulators (monoclonal antibodies) and/or corticosteroids (prednisolone, methylprednisolone, dexamethasone) with adequate therapeutic efficacy. CONCLUSIONS: Corticosteroids are the most promising option in the treatment of dermatological symptoms of COVID-19, as they do not compromise the course of active infection (as with the use of monoclonal antibodies), while maintaining therapeutic efficacy.
        ANTECEDENTES: La COVID-19 produce lesiones dermatológicas en, incluso, el 20% de los infectados; estas lesiones incluyen eritema, pápulas, vesículas, urticaria, sabañones y formas de vasculitis. Su gravedad depende de la edad y el grado de afectación inmunitaria e inflamatoria del paciente, por lo que no existe un tratamiento unificado que oriente sobre el esquema terapéutico más efectivo. OBJETIVO: Describir los tratamientos más eficaces para combatir las manifestaciones dermatológicas de la infección por COVID-19. METODOLOGÍA: Revisión en la que se incluyeron estudios que describieran el tratamiento implementado en pacientes con manifestaciones dermatológicas de COVID-19, publicados de enero de 2020 a enero de 2024 en los repositorios de PubMed, Scopus, Embase y Google Scholar. RESULTADOS: Se incluyeron 14 artículos. Las lesiones cutáneas reportadas fueron principalmente: exantema pruriginoso, púrpura trombocitopénica y vasculitis. En dos estudios se reportó escasa eficacia terapéutica tras la administración de inmunoglobulina humana en combinación con dosis bajas de prednisolona. Los 12 estudios restantes utilizaron combinaciones de inmunomoduladores (anticuerpos monoclonales), corticosteroides (prednisolona, metilprednisolona, dexametasona) o ambos y mostraron eficacia terapéutica adecuada. CONCLUSIONES: Los corticosteroides son la opción más prometedora en el tratamiento de los síntomas dermatológicos de COVID-19, al no afectar el curso de la infección activa (como con los anticuerpos monoclonales), mientras mantienen la eficacia terapéutica.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: Spanish
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      custom: Copyright of Dermatología Revista Mexicana is the property of Edicion y Farmacia S.A. de C.V. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use.
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