A Working Hypothesis on Vesicular Lesions Related to COVID-19 Infection, Koebner Phenomena Type V, and a Short Review of Related Data

Alin Laurentiu Tatu; Liliana Baroiu; Silvia Fotea; Lucretia Anghel; Eduard Drima Polea; Thomas Nadasdy; Valentin Chioncel; Lawrence Chukwudi Nwabudike

doi:10.2147/CCID.S307846

A Working Hypothesis on Vesicular Lesions Related to COVID-19 Infection, Koebner Phenomena Type V, and a Short Review of Related Data

Clin Cosmet Investig Dermatol. 2021 Apr 30:14:419-423. doi: 10.2147/CCID.S307846. eCollection 2021.

Authors

Alin Laurentiu Tatu^#^{1

2}, Liliana Baroiu^#^{3

4}, Silvia Fotea^#^{4

5}, Lucretia Anghel^#^{6

7}, Eduard Drima Polea^#^{6

8}, Thomas Nadasdy¹, Valentin Chioncel^#⁹, Lawrence Chukwudi Nwabudike¹⁰

Affiliations

¹ Dermatology Department, "St. Parascheva" Clinical Hospital of Infectious Diseases, Galati, Romania.
² Faculty of Medicine and Pharmacy, Clinical Medical Department, Dermatology, Medical and Pharmaceutical Research Unit, Competitive, Interdisciplinary Research Integrated Platform, ReForm-UDJG "Dunărea de Jos" University, Galati, Romania.
³ Infectious Diseases Department, "St. Parascheva" Clinical Hospital of Infectious Diseases, Galati, Romania.
⁴ Faculty of Medicine and Pharmacy, Clinical Medical Department, "Dunărea de Jos" University, Galati, 800010, Romania.
⁵ Sf Ioan Clinical Hospital of Pediatrics, Galati, Romania.
⁶ Department of Clinical Medicine, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, 800010, Romania.
⁷ Internal Medicine Department, Sf Andrei Clinical Emergency Hospital, Galati, Romania.
⁸ Elisabeta Doamna Clinical Hospital of Psychiatry, Galati, Romania.
⁹ Department of Cardio-Thoracic Pathology, Faculty of Medicine, 'Carol Davila' University of Medicine and Phamacy, Bucharest, 050474, Romania.
¹⁰ N. Paulescu National Institute of Diabetes, Bucharest, Romania.

^# Contributed equally.

Abstract

SARS-CoV-2 has recently been associated with the reactivation of varicella zoster virus in patients. This is potentially an observation of a local susceptibility of the skin in areas of vesicle formation. This article explores the dermatologic manifestations that have been linked to the SARS-CoV-2 virus, their infectious risk, as well as potential confounding factors. An isotopic response may be occurring due to the occurrence of an immunocompromised district incited by sustained inflammation mediated by inflammatory cytokines.

Keywords: COVID-19; Koebner phenomenon; SARS-CoV-2; locus minoris resistentiae; vesicular rash; wolf isotopic response.

Grants and funding

This article has no funding source.