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Skin and sepsis: contribution of dermatology to a rapid diagnosis

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Abstract

In patients who develop sepsis, whether due to primary, secondary or metastatic lesions, the skin is frequently affected. However, there are unresolved aspects regarding the general clinical manifestations in the skin or the prognosis and/or therapeutic implications. The main challenge in the approach to sepsis is its early diagnosis and management. In this review, we address the sepsis–skin relationship and the potential impact of early dermatological intervention on the septic patient through ten basic questions. We found little evidence of the participation of the dermatologist in sepsis alert programs. There are early skin changes that may alert clinicians on a possible sepsis, such as skin mottling or variations in acral skin temperature. In addition, the skin is an accessible and highly cost-effective tissue for etiological studies of some forms of sepsis (e.g., meningococcal purpura) and its involvement defines the prognosis of certain patients (e.g., infective endocarditis).

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Author notes

  1. Ana Pulido-Perez and Emilio Bouza contributed equally to this study

Authors and Affiliations

  1. Department of Dermatology, Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo 46, 28007, Madrid, Spain

    A. Pulido-Pérez, M. Bergón-Sendín & R. Suárez-Fernández

  2. CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain

    P. Muñoz-Martín & E. Bouza

  3. Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain

    P. Muñoz-Martín & E. Bouza

  4. Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain

    A. Pulido-Pérez, M. Bergón-Sendín, R. Suárez-Fernández, P. Muñoz-Martín & E. Bouza

  5. Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain

    M. Bergón-Sendín, R. Suárez-Fernández, P. Muñoz-Martín & E. Bouza

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  1. A. Pulido-Pérez
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not include studies carried out with animals.

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Pulido-Pérez, A., Bergón-Sendín, M., Suárez-Fernández, R. et al. Skin and sepsis: contribution of dermatology to a rapid diagnosis. Infection 49, 617–629 (2021). https://doi.org/10.1007/s15010-021-01608-7

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