Abstract
A wide range of extrapulmonary manifestations in patients with COVID-19 has been reported during the ongoing pandemic, thus making the clinical spectrum of this new disease very heterogeneous. While COVID-19–associated vasculitis and vasculopathy have been described, cutaneous leukocytoclastic vasculitis (cLcV) due to SARS-CoV-2 has rarely been reported, and if it has, with relatively mild courses. We present the case of a 93-year-old man who, after having survived classic COVID-19 infection, developed a fulminant cLcV leading to extensive skin necrosis and tissue damage that resulted in his death. Considering the negative workup for other triggers of vasculitis, we find that cLcV is a secondary manifestation of COVID-19, even though SARS-CoV-2 polymerase chain reaction in the skin biopsy was not present in the tissue. We hypothesize this by providing a pathophysiologic rationale (eg, SARS-CoV-2–induced endotheliitis, complement activation, and interleukin 6 dominant intra- and perivascular inflammation).
【초록키워드】 COVID-19, SARS-CoV-2, Necrosis, pandemic, complement, Endotheliitis, COVID-19 infection, death, Mild, Vasculitis, disease, Trigger, manifestation, Activation, tissue, tissue damage, heterogeneous, while, courses, perivascular inflammation, dominant, polymerase chain, described, reported, survived, pathophysiologic, patients with COVID-19, 【제목키워드】 Necrosis, COVID-19 infection, Vasculitis, Cutaneous,