<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2072-8174</journal-id>
<journal-title><![CDATA[Revista del Nacional (Itauguá)]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Nac. (Itauguá)]]></abbrev-journal-title>
<issn>2072-8174</issn>
<publisher>
<publisher-name><![CDATA[Hospital Nacional (Itauguá)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2072-81742021000200064</article-id>
<article-id pub-id-type="doi">10.18004/rdn2021.dic.02.064.075</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Lesiones acroisquémicas severas en contexto de covid-19: casuística]]></article-title>
<article-title xml:lang="en"><![CDATA[Severe acroischemic injuries in the context of covid-19: casuistry]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Elli]]></surname>
<given-names><![CDATA[María Melissa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Paredes Benítez]]></surname>
<given-names><![CDATA[Andrea Rosalía]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mafei Aguilera]]></surname>
<given-names><![CDATA[Gabriela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rivelli]]></surname>
<given-names><![CDATA[Victoria]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aldama Caballero]]></surname>
<given-names><![CDATA[Arnaldo Benjamín Feliciano]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Ministerio de Salud Pública y Bienestar Social Centro Médico Nacional, Hospital Nacional Departamento Medicina Interna, Servicio de Dermatología]]></institution>
<addr-line><![CDATA[Itauguá ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>01</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>01</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>13</volume>
<numero>2</numero>
<fpage>64</fpage>
<lpage>75</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2072-81742021000200064&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2072-81742021000200064&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2072-81742021000200064&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción: desde el inicio de la pandemia declarada en marzo del 2020 por la Organización Mundial de la Salud, la piel no se ve excluida de esta afectación, al inicio descripta como hallazgo poco frecuente, actualmente se estima que un 20 % de los pacientes con COVID-19 presentan algún tipo de manifestación dermatológica que se presenta durante la fase aguda de la enfermedad o durante la convalecencia. Las lesiones cutáneas son diversas, entre ellas llama la atención por su importancia y severidad las acroisquémicas.  Objetivo: describir las características demográficas, clínicas, laboratoriales y evolutivas de 6 casos de COVID-19 con lesiones acroisquémicas severas.  Metodología: estudio retrospectivo, descriptivo y observacional de casos de COVID-19 confirmados por pruebas laboratoriales con lesiones acroisquémicas severas interconsultados en el Servicio de Dermatología del Hospital Nacional o de la consulta privada en el periodo julio 2020 a julio 2021.  Resultados: se analizaron 6 casos, 3 mujeres y 3 varones, con promedio de edad de 61,6 años, todos con diagnóstico confirmado de COVID-19. Los patrones clínicos de lesiones acroisquémicas observados fueron 2 isquemias microcirculatorias severas y 4 gangrenas secas. Todos los pacientes presentaron alguna comorbilidad y dímero D elevado. Uno recibió tratamiento ambulatorio, 4 en sala de internados y 1 en unidad de cuidados intensivos. Todos recibieron anticoagulación. La evolución fue satisfactoria en 2 de ellos, en 2 fue necesaria la amputación parcial o total de los miembros afectados y 1 obitó.  Conclusión: las lesiones cutáneas acroisquémicas en pacientes que cursan o han cursado con COVID-19 son poco frecuentes, se presentan por lo general en personas mayores y están asociados a un peor pronóstico en cuanto a morbimortalidad.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction: since the beginning of the pandemic declared in March 2020 by the World Health Organization, the skin is not excluded from this affectation, initially described as a rare finding, currently it is estimated that 20% of patients with COVID-19 present some type of dermatological manifestation that manifests itself during the acute phase of the disease or during convalescence. Skin lesions are diverse, among them acroischemic ones are striking for their importance and severity.  Objective: to describe the demographic, clinical, laboratory and evolutionary characteristics of 6 cases of COVID-19 with severe acroischemic lesions.  Methodology: Retrospective, descriptive and observational study of COVID-19 cases confirmed by laboratory tests with severe acroischemic lesions consulted in the &#8220;Servicio de Dermatología&#8221; del &#8220;Hospital Nacional&#8221; or the private practice in the period July 2020 to July 2021.  Results: 6 cases were analyzed, 3 women and 3 men, with an average age of 61,6 years, all with a confirmed diagnosis of COVID-19. The clinical patterns of acroischemic lesions observed were 2 severe microcirculatory ischemia and 4 dry gangrene. All patients had some comorbidity and elevated D-dimer. One received outpatient treatment, 4 in the inpatient ward and 1 in the intensive care unit. All received anticoagulation. The evolution was satisfactory in 2 of them, in 2 it was necessary the partial or total amputation of the affected limbs and 1 died.  Conclusion: acroischemic skin lesions in patients with or who have had COVID-19 are rare, generally occur in older people, and are associated with a worse prognosis in terms of morbidity and mortality.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[COVID-19]]></kwd>
<kwd lng="es"><![CDATA[piel]]></kwd>
<kwd lng="es"><![CDATA[dermopatías vasculares]]></kwd>
<kwd lng="es"><![CDATA[isquemia.]]></kwd>
<kwd lng="en"><![CDATA[COVID-19]]></kwd>
<kwd lng="en"><![CDATA[skin]]></kwd>
<kwd lng="en"><![CDATA[vascular dermopathies]]></kwd>
<kwd lng="en"><![CDATA[ischemia]]></kwd>
</kwd-group>
</article-meta>
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