A Spanish paper with prospective data!
19% covid toes
9% vesicular (small monomorphic)
6% livedo or necrosis
also - sickest patients had livedo, & most mild cases were pseudochilblains. maculopapules in btw.
Skin bx was performed in 6 pts. all 6 had a pauci-inflammatory thrombogenic vasculopathy.
4/6 had arterial thrombosis!
3 of 4 died from thrombosis! (Stroke, PE)
- ?complement activation and deposition
- ?endothelial cell infection and endotheliitis
- severity of underlying condition
- potential need for emergency care increasing risk of exposure if stopping immunosuppression.
- job exposures
- need for lab monitoring
- relative level of immunosuppression