COVID-19-induced alopecia: a clinical case of diffuse focal alopecia in a patient with generalized pustular psoriasis after a new coronavirus infection
- Authors: Petrova M.S.1, Kartashova M.G.1, Molochkova Y.V.1, Molochkov A.V.1, Varfolomeev A.D.1
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Affiliations:
- Moscow Regional Research and Clinical Institute
- Issue: Vol 24, No 6 (2021)
- Pages: 565-572
- Section: DERMATOLOGY
- URL: https://journals.rcsi.science/1560-9588/article/view/97223
- DOI: https://doi.org/10.17816/dv97223
- ID: 97223
Cite item
Abstract
The clinical picture of dermatological diseases in synergy with the pandemic of coronavirus infection demonstrates various, additional, more striking features of the course of dermatoses. The proposed case of observation illustrates the development of diffuse alopecia in a patient with torpid generalized pustular psoriasis, metabolic syndrome, endocrinopathy against the background of a coronavirus infection complicated by polysegmental pneumonia.
In the presented clinical observation, the severity of the lesion of the skin and skin appendages correlated with the severity of the course of COVID-19, which was the trigger point of the general pathological process ― immune-mediated T-cell inflammation. In the manifestation of psoriasis and its exacerbation, a significant role was played by viral load and a pronounced comorbid background ― autoimmune thyroid disease and metabolic syndrome. Thus, the severe course of COVID-19 with involvement in the pathological process of the microcirculatory bed, coagulopathy, hypoxia of hair follicles as a result, as well as the reduced estrogenic background of the sixty-one-year-old patient contributed not only to the exacerbation of psoriasis, but also led to diffuse hair loss. The degree of hair loss according to SALT criteria was 82%, which corresponded to a severe degree of lesion. The use of prolonged-acting injectable corticosteroids in the complex treatment of various forms of alopecia was an effective method of therapy in this patient, which is associated with the immunosuppressive effect of corticosteroids in autoimmune damage to hair follicles, a decrease in inflammation of the microvascular bed in various infectious and inflammatory conditions. In the presented case, the high efficiency may also have been associated with the mechanisms of reducing the damaging effect of cytokine inflammatory factors, expressed both with the existing background disease psoriasis and with coronavirus complicated infection.
As numerous observations show, COVID-19 is a potential trigger for many dermatological conditions. Examination and treatment of patients with skin pathology infected with COVID-19 requires a systematic integrated approach.
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##article.viewOnOriginalSite##About the authors
Marina S. Petrova
Moscow Regional Research and Clinical Institute
Author for correspondence.
Email: marina.s.petrova@gmail.com
ORCID iD: 0000-0002-1789-2311
MD, Research Associate
Russian Federation, 61/2, Shepkina street, Moscow, 129110Maria G. Kartashova
Moscow Regional Research and Clinical Institute
Email: maxa.ka@mail.ru
MD, Cand. Sci. (Med.), Research Associate
Russian Federation, 61/2, Shepkina street, Moscow, 129110Yulia V. Molochkova
Moscow Regional Research and Clinical Institute
Email: 79265542544@yandex.ru
ORCID iD: 0000-0003-0934-8903
MD, Dr. Sci. (Med.), Assistant Professor
Russian Federation, 61/2, Shepkina street, Moscow, 129110Anton V. Molochkov
Moscow Regional Research and Clinical Institute
Email: anton.molochkov@gmail.com
ORCID iD: 0000-0002-6456-998X
MD, Dr. Sci. (Med.), Professor
Russian Federation, 61/2, Shepkina street, Moscow, 129110Alexandr D. Varfolomeev
Moscow Regional Research and Clinical Institute
Email: doctor.varfolomeev@gmail.com
ORCID iD: 0000-0003-3807-9706
MD
Russian Federation, 61/2, Shepkina street, Moscow, 129110References
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