{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T10:14:36Z","timestamp":1771668876909,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Coronavirus disease 2019 (COVID\u201019) primarily affects the respiratory system but extrapulmonary manifestations, including the skin, have been well documented. However, transcriptomic profiles of skin lesions have not been performed thus far. Here, we present a single\u2010cell RNA sequencing analysis in a patient with COVID\u201019 infection with a maculopapular skin rash while on treatment with the interleukin (IL)\u201012\/IL\u201023 blocker ustekinumab for his underlying psoriasis. Results were compared with healthy controls and untreated psoriasis lesions. We found the severe acute respiratory syndrome coronavirus 2 (SARS\u2010CoV\u20102) viral entry receptors <jats:italic>ACE2<\/jats:italic> and <jats:italic>TMPRSS2<\/jats:italic> in keratinocytes of the patient with COVID\u201019, while <jats:italic>ACE2<\/jats:italic> expression was low to undetectable in psoriasis lesions and healthy skin. Among all cell types, <jats:italic>ACE2<\/jats:italic>+ keratinocyte clusters showed the highest levels of transcriptomic dysregulation in COVID\u201019, expressing type 1\u2013associated immune markers such as <jats:italic>CXCL9<\/jats:italic> and <jats:italic>CXCL10<\/jats:italic>. In line with a generally type 1\u2013skewed immune microenvironment, cytotoxic lymphocytes showed increased expression of the <jats:italic>IFNG<\/jats:italic> gene and other T\u2010cell effector genes, while type 2, type 17, or type 22\u2009T\u2010cell activation was largely absent. Conversely, downregulation of several anti\u2010inflammatory mediators was observed. This first transcriptomic description of a COVID\u201019\u2013associated rash identifies <jats:italic>ACE2+<\/jats:italic> keratinocytes displaying profound transcriptional changes, and inflammatory immune cells that might help to improve the understanding of SARS\u2010CoV\u20102\u2013associated skin conditions.<\/jats:p>","DOI":"10.1111\/1346-8138.16793","type":"journal-article","created":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T09:28:52Z","timestamp":1680341332000},"page":"1052-1057","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Single\u2010cell <scp>RNA<\/scp> sequencing analysis of a <scp>COVID<\/scp>\u201019\u2013associated maculopapular rash in a patient with psoriasis treated with ustekinumab"],"prefix":"10.1111","volume":"50","author":[{"given":"Katharina","family":"Rindler","sequence":"first","affiliation":[{"name":"Department of Dermatology Medical University of Vienna  Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Tschandl","sequence":"additional","affiliation":[{"name":"Department of Dermatology Medical University of Vienna  Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasmine P.","family":"Levine","sequence":"additional","affiliation":[{"name":"Department of Dermatology Icahn School of Medicine at Mount Sinai  New York New York USA"},{"name":"New York Medical College  Valhalla New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa E.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Dermatology Medical University of Vienna  Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Weninger","sequence":"additional","affiliation":[{"name":"Department of Dermatology Medical University of Vienna  Vienna 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