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Carta al Director
Pitiriasis rosada en un paciente pediátrico con diagnóstico confirmado de COVID-19
Pityriasis Rosea in a Confirmed COVID-19 Pediatric Patient
I.N.S. Öncüa,
Corresponding author
oncuisin@gmail.com

Autor para correspondencia.
, D. Gülera, G. Gürela, G.Ş. Yalçınb
a Departamento de Dermatología, Facultad de Medicina, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
b Departamento de Patología, Facultad de Medicina, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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        "titulo" => "Pityriasis Rosea in a Confirmed COVID-19 Pediatric Patient"
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          "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">C&#250;mulos focales de paraqueratosis&#44; exocitosis linfocitaria leve&#44; algunas c&#233;lulas inflamatorias mononucleares perivasculares y cierta extravasaci&#243;n eritocitaria &#40;hematoxilina y eosina&#44; &#215;200&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">El 31 de diciembre de 2019 la Organizaci&#243;n Mundial de la Salud identific&#243; un nuevo coronavirus &#40;SARS-CoV-2&#41; en la ciudad de Wuhan&#44; China&#44; que se propag&#243; con mucha rapidez&#44; y que hasta la fecha ha causado la muerte a miles de personas por la enfermedad que provoca &#40;COVID-19&#41;&#46; Se han reportado diversas manifestaciones dermatol&#243;gicas asociadas a la COVID-19&#46; Entre ellas se han publicado previamente pitiriasis rosada &#40;PR&#41; y erupci&#243;n de tipo PR&#46; Durante la pandemia de la COVID-19 el diagn&#243;stico de PR se ha vuelto m&#225;s com&#250;n<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1&#8211;5</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La PR es una enfermedad cut&#225;nea inflamatoria autolimitada que puede ser inducida por agentes virales&#58; en especial herpesvirus humano 6 y herpesvirus humano 7&#44; autoinmunidad&#44; factores psicog&#233;nicos&#44; vacunas y f&#225;rmacos<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1&#44;2</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Presentamos aqu&#237; un caso de PR en un paciente pedi&#225;trico con diagn&#243;stico confirmado de COVID-19&#46; El paciente y sus familiares han otorgado consentimiento informado escrito para la publicaci&#243;n de los datos de este caso&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Un ni&#241;o de 10 a&#241;os de edad acudi&#243; con historia de 20 d&#237;as de erupci&#243;n cut&#225;nea&#46; Se sab&#237;a que hab&#237;a contra&#237;do infecci&#243;n por COVID-19 un mes atr&#225;s&#44; y que no hab&#237;a recibido medicaci&#243;n alguna&#46; Durante la exploraci&#243;n dermatol&#243;gica se observaron peque&#241;as placas eritematosas y manchas elevadas y escamosas situadas en paralelo a las costillas &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; El recuento sangu&#237;neo completo&#44; las pruebas hep&#225;ticas y renales&#44; los marcadores de hepatitis y los valores de sedimentaci&#243;n y PCR se hallaban dentro de rangos normales&#46; En el examen histopatol&#243;gico de la biopsia de una lesi&#243;n se observaron picos focalizados de paraqueratosis&#44; espongiosis&#44; ves&#237;culas espongi&#243;ticas focalizadas&#44; exocitosis linfoc&#237;tica&#44; acantosis ligeramente irregular con leve homogenizaci&#243;n de col&#225;geno en la dermis&#44; infiltraci&#243;n eritroc&#237;tica de leve a moderada en el plexo vascular superficial y dispersi&#243;n de linfocitos &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46; Se estableci&#243; diagn&#243;stico de PR tras infecci&#243;n por COVID-19&#44; dados los hallazgos cl&#237;nicos e histopatol&#243;gicos&#46; Se trat&#243; al paciente con pomada de betametasona valerato&#44; urea al 10&#37; y cetirizina&#46; Las lesiones se resolvieron un mes m&#225;s tarde&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">No se conoce con claridad la asociaci&#243;n entre PR y la infecci&#243;n por la COVID-19&#46; En la literatura los pacientes con diagn&#243;stico confirmado de COVID-19 desarrollaron PR y erupci&#243;n de tipo PR&#44; algunos de ellos sintom&#225;ticos o asintom&#225;ticos&#44; y otros tras infectarse por la COVID-19<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2&#8211;5</span></a>&#46; Por tanto&#44; en un paciente que se presente con PR y erupci&#243;n de tipo PR es necesario considerar la infecci&#243;n por COVID-19 y aconsejar la realizaci&#243;n de pruebas de SARS-CoV-2 a los pacientes necesarios&#46; La PR podr&#237;a ser directamente dependiente de la infecci&#243;n por la COVID-19&#44; o de la reactivaci&#243;n viral &#40;herpesvirus humano 6&#44; herpesvirus humano 7&#44; virus de Epstein Barr&#41;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1&#8211;5</span></a>&#46; Adem&#225;s&#44; el incremento de estr&#233;s psicol&#243;gico causado por el periodo pand&#233;mico podr&#237;a haber contribuido a desencadenar PR<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>&#46; Debido al n&#250;mero limitado de datos se hace dif&#237;cil probar una relaci&#243;n causal en estos casos&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; los dermat&#243;logos deben ser conscientes de los s&#237;ntomas cut&#225;neos vinculados a la infecci&#243;n por la COVID-19&#46;</p></span>"
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Article information
ISSN: 00017310
Original language: Spanish
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