key: cord-0843505-koeoh94d
authors: Fatima, Farhat; Kumar, Piyush; Ghosh, Shouvik; Das, Anupam
title: Post‐Covid cutaneous small‐vessel vasculitis with features of Koebnerization
date: 2021-09-14
journal: J Cosmet Dermatol
DOI: 10.1111/jocd.14443
sha: 9ad23f27b40d2ea495536269db5aa5555b0dd891
doc_id: 843505
cord_uid: koeoh94d

nan

To The Editor, COVID-19 has been associated with a wide gamut of cutaneous manifestations, some of which are found to develop during the course of the disease, and some of them become clinically apparent, Systemic examination was unremarkable. Routine blood tests and urine workup revealed no abnormalities. He was prescribed a topical corticosteroid and an oral antihistamine. Biopsy from the lesions followed by histopathological examination showed features of perivascular neutrophilic infiltrate and fibrinoid degeneration (Figure 1c) .

A diagnosis of cutaneous small-vessel vasculitis was done, and the patient was prescribed topical corticosteroids.

The purpuric "vasculitic" pattern of skin lesions with histological findings of leukocytoclastic vasculitis has been described in COVID-19 cases along with other patterns of cutaneous manifestations. [1] [2] [3] The underlying mechanism is thought to be direct endothelial injury by the pathogen or by the dysregulated host immune response in response to COVID-19. 4 The Koebner's phenomenon is rare in vasculitis. The underlying mechanism of KP in CSVV is poorly understood. One of them is that immune complexes aggregate in vessels due to local inflammation in response to scratching or local trauma, leading to recurring lesions. 5 Besides, it has been hypothesized that elevated levels of tryptase following a trauma may be responsible.

Few authors also believe that microcirculatory stasis leading to prolonged pressure, mast cell activation due to scratching could be possible reasons behind KP in vasculitis. In our case, the patient had an underlying COVID-19 infection, which could be responsible for this 

A generalized purpuric eruption with histopathologic features of leucocytoclastic vasculitis in a patient severely ill with COVID-19

An unusual case of bullous haemorrhagic vasculitis in a COVID-19 patient

Acral purpuric lesions associated with coagulation disorders

during the COVID-19 pandemic

Dermatological manifestations associated with COVID-19 infection

Isomorphic response of Koebner in a patient with cutaneous small vessel vasculitis

Koebner phenomenon in leukocytoclastic vasculitis: A case report and an updated review of the literature

Koebner's phenomenon in childhood Henoch-Schonlein purpura: a report of two cases

Henoch-Schonlein purpura: yet another disease manifesting the Koebner phenomenon

https://orcid.org/0000-0003-0841-9597