key: cord-0796530-ime2cjby authors: Kutlu, Ömer; Öğüt, Neslihan Demirel; Erbağcı, Ece; Metin, Ahmet title: Dermatologic comorbidities of the patients with severe COVID‐19: A case‐control study date: 2021-01-10 journal: Dermatol Ther DOI: 10.1111/dth.14731 sha: ead3cade66cedc61d9236c98b7563ee07b7491e2 doc_id: 796530 cord_uid: ime2cjby The current studies focus on the association between COVID‐19 and certain comorbidities. To the best of our knowledge, the association between severe COVID‐19 and dermatologic comorbidities has not been reported yet. In this study, we aimed to describe the dermatologic comorbidities of patients with severe COVID‐19 and compare it with the control group. Patients who have died at Uşak Training and Research Hospital due to COVID‐19 and other diseases in the COVID‐19 Intensive Care Units and Internal Medicine Intensive Care Units were recruited into the study. Two groups were compared with each other regarding the most common dermatologic comorbidities. A total of 198 patients including 111 patients with COVID‐19 and 87 age and sex‐matched patients with other diseases were enrolled in the study. The most common dermatologic comorbidities were pruritus (8.1%), eczema (6.3%), skin infections (3.6%), leukocytoclastic vasculitis (1.8%), and urticaria (0.9%) in the COVID‐19 group while they were skin infections (9.2%), eczema (3.4%), pruritus (2.3%), and urticaria (1.1%) in the control group. None of patients in the control group had leukocytoclastic vasculitis. There were no significant differences between COVID‐19 and control groups in terms of pruritus, eczema, skin infections, and urticaria (P values were .117, .517, .181, .505, and 1.000, respectively). In conclusion, although it is not statistically significant, it appears that pruritus and leukocytoclastic vasculitis are more common in severe COVID‐19 patients. These cytokines‐related diseases in the immuno‐cutaneous systems may give some clues on the COVID‐19 severity. Further studies are required to elucidate the relationship between the immuno‐cutaneous system and COVID‐19 severity. main factors for the severity and fatality of the disease. 4 There are numerous dermatologic diseases that have an immunological infrastructure that includes cytokine releases. 5, 6 Therefore, certain dermatologic comorbidities may give hints about the COVID-19 severity. To the best of our knowledge, the association between severe COVID- 19 and dermatologic comorbidities has not been reported yet. In this study, we aimed to describe the dermatologic comorbidities of patients with severe COVID-19 and compare it with the control group. Severe COVID-19 is mainly associated with increased certain inflammatory cytokines and mediators. It shares many common aspects regarding cytokine storms with other infectious and non-infectious diseases including dengue viruses, Ebola virus infection, multiple sclerosis, pancreatitis, graft-vs-host disease, or multiple organ dysfunction syndromes. [9] [10] [11] [12] [13] Siddiqia et al reported there is a significant increasing number of inflammatory cytokines along with biomarkers including IL6, IL-7, macrophage inflammatory protein 1-α, TNF-α, CRP, D-dimer, ferritin, and procalcitonin in the hyperinflammation stage of COVID-19. 14, 15 In our study, inflammatory markers such as CRP, D-dimer, procalcitonin levels increased in patients with COVID-19. There are many dermatologic diseases that are associated with increased certain inflammatory cytokines and mediators. These cytokines and mediators may lead to an increased risk of getting and severity of certain systemic diseases. The relationship between psoriasis and cardiovascular diseases, atopic dermatitis and asthma, or pityriasis versicolor and Helicobacter pylori infection can be discussed in this context. 16 In conclusion, although it is not statistically significant, it appears that pruritus and leukocytoclastic vasculitis are more common in severe COVID-19 patients. These cytokines-related diseases in the immuno-cutaneous systems may give some clues on the COVID-19 severity. Further studies are required to elucidate the relationship between the immuno-cutaneous system and COVID-19 severity. The authors declare no conflict of interest. The datasets generated during and/or analyzed during the current study are not publicly available due to privacy and ethical restrictions but are available from the corresponding author on reasonable request. Dermatological diseases presented before COVID-19: are patients with psoriasis and superficial fungal infections more vulnerable to the COVID-19? 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