COVID-19感染症における止血異常に続発する皮膚合併症

Cutaneous Complications Secondary to Haemostasis Abnormalities in COVID-19 Infection.

• Noel Lorenzo-Villalba
• Yasmine Maouche
• Aneska Syrovatkova
• Felix Pham
• Jean-Baptiste Chahbazian
• Pierre Pertoldi
• Emmanuel Andrès
• Abrar-Ahmad Zulfiqar

抄録

標準病棟に急性代償性心不全で入院した患者の症例を報告する。入院中にCOVID-19と診断され，特別病棟に転棟した。臨床経過は呼吸器疾患の悪化，右耳下腺炎の発症，左内頸静脈の血栓症を呈していた．治療的抗凝固療法が開始され，2日後には上肢に存在していた軽度の皮膚病変が，水疱内血栓と解離性血腫を伴う出血性水疱へと進展した．解離性血腫の外科的管理は、止血異常の観点から困難であった。この患者は入院後29日後に死亡した。

We describe the case of a patient hospitalized for acute decompensated heart failure in a standard medical ward. During hospitalization, he was diagnosed with COVID-19 and transferred to a special unit. The clinical course was marked by worsening of the respiratory disease, the development of right parotiditis and thrombosis of the left internal jugular vein. Therapeutic anticoagulation was initiated and 2 days later, the minimal dermatoporosis lesions previously present in the upper extremities evolved to haemorrhagic bullae with intra-bullae blood clots and dissecting haematomas. Surgical management of the dissecting haematomas was difficult in the context of haemostasis abnormalities. The patient died 29 days after hospital admission.

学習ポイント:

COVID-19パンデミック時の標準病棟では、個室宿泊は二人部屋宿泊よりも優先されるべきである.抗凝固療法とループス抗凝固剤の存在は、COVID-19感染時の皮膚合併症を誘発する可能性がある.抗凝固療法の中止は、皮膚病変の管理を改善する助けにはならなかった.

LEARNING POINTS: Single room accommodation should be preferred to double room accommodation in standard wards during the COVID-19 pandemic.Anticoagulation therapy and the presence of lupus anticoagulant may induce cutaneous complications during COVID-19 infection.The discontinuation of anticoagulation therapy did not help improve the management of cutaneous lesions.

© EFIM 2020.