Hamostaseologie 2021; 41(05): 387-396
DOI: 10.1055/a-1581-6899
Review Article

Microvascular Skin Manifestations Caused by COVID-19

Andrea Gawaz
1  Universitätshautklinik Tübingen, Tübingen, Germany
Emmanuella Guenova
2  Department of Dermatology, Lausanne University Hospital, Lausanne, Switzerland
› Author Affiliations


Hypercoagulability and vascular injury, which characterize morbidity in COVID-19 disease, are frequently observed in the skin. Several pathomechanisms, such as inflammation caused by angiotensin-converting enzyme 2–mediated uptake into endothelial cells or SARS-CoV-2-initiated host immune responses, contribute to microthrombus formation and the appearance of vascular skin lesions. Besides pathophysiologic mechanisms observed in the skin, this review describes the clinical appearance of cutaneous vascular lesions and their association with COVID-19 disease, including acro-ischemia, reticular lesions, and cutaneous small vessel vasculitis. Clinicians need to be aware that skin manifestations may be the only symptom in SARS-CoV-2 infection, and that inflammatory and thrombotic SARS-CoV-2-driven processes observed in multiple organs and tissues appear identically in the skin as well.

Publication History

Received: 31 March 2021

Accepted: 09 August 2021

Publication Date:
25 October 2021 (online)

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