Livedo reticularis and acrocyanosis as late manifestations of COVID‐19 in two cases with familial aggregation. Potential pathogenic role of complement (C4c)

• Published in: International Journal of Dermatology 2020-12, Vol.59 (12), p.1549-1551
• Main Authors: García‐Gil, Miguel Fernando, Monte Serrano, Juan, Lapeña‐Casado, Alejandro, García García, Mar, Matovelle Ochoa, Cristina, Ara‐Martín, Mariano
• Format: Article
• Language: English
• Subjects: Adolescent; Betacoronavirus - immunology; Betacoronavirus - isolation & purification; Biopsy; Child; Complement C4b - analysis; Complement C4b - immunology; Coronavirus Infections - complications; Coronavirus Infections - immunology; Coronavirus Infections - virology; Correspondence; COVID-19; Female; Humans; Livedo Reticularis - diagnosis; Livedo Reticularis - immunology; Male; Pandemics; Peptide Fragments - analysis; Peptide Fragments - immunology; Pneumonia, Viral - complications; Pneumonia, Viral - immunology; Pneumonia, Viral - virology; SARS-CoV-2; Siblings; Skin - immunology; Skin - pathology; Time Factors
• ISSN: 0011-9059; 1365-4632
• DOI: 10.1111/ijd.15233

Dear Editor, Livedo or necrotic‐type manifest different levels of occlusive vascular disease and are more frequent in patients of advanced age and severe COVID‐19.1 However, transient manifestations, such as livedo reticularis, have been described in other cases.2 We present two cases with familial aggregation of transient livedo reticularis as a late manifestation of COVID‐19. Serologies were also requested for cytomegalovirus, Epstein–Barr virus, parvovirus B19, Mycoplasma pneumoniae, herpes simplex virus, varicella zoster virus, hepatitis B and C, and HIV, as well as SARS‐CoV‐2‐specific IgA + IgM and IgG antibodies, all of which were negative. [...]we present two cases of livedo reticularis that emerged after presenting with symptoms compatible with COVID‐19.