Dermatological Manifestations of COVID-19: A Brief Review
The emphasis so far during the COVID-19 pandemic has been on the respiratory manifestations with little attention being paid to cutaneous manifestations. The novel coronavirus has a wide spectrum of cutaneous manifestations which are broadly divided into exanthematous and vasculopathic type of lesions. The effects of this novel virus on the integumentary system cannot be underestimated as it can mimic various types of viral skin lesions. Thus, dermatologists should have knowledge about COVID-19 disease presentations and which differential diagnosis to consider if they encounter skin lesions in a patient who is known or suspected to have COVID-19. Patient evaluation and workup also needs to be modified during the time of this pandemic. Immunosuppressive/immunomodulatory drugs which are rampantly used in dermatological practice, must be used only after weighing their risks and benefits during the COVID-19 era. Personal Protective Equipment has to be worn when coming in contact with a suspected or a proven case of COVID-19. However, its use itself is associated with dermatological side effects which should be known to dermatologist practising during the COVID-19 era. Teledermatology can go a long way in circumventing these issues and it should be made more accessible, especially in remote areas. Another future recommendation could be setting up of a national level organization or group for recording dermatological data related to COVID-19.
17 September 2020 (online)
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- 1 Guan WJ, Ni ZY, Hu Y. et al. China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382 (18) 1708-1720
- 2 Recalcati S. Cutaneous manifestations in COVID-19: a first perspective. J Eur Acad Dermatol Venereol 2020; 34 (05) e212-e213
- 3 Suchonwanit P, Leerunyakul K, Kositkuljorn C. Cutaneous manifestations in COVID-19: Lessons learned from current evidence. J Am Acad Dermatol 2020; 83 (01) e57-e60
- 4 Mazzotta F, Troccoli T. Acute acro-ischemia in the child at the time of COVID-19. Eur J Pediat Dermatol 2020; 30 (02) 71-74
- 5 Fernandez-Nieto D, Jimenez-Cauhe J, Suarez-Valle A. et al. Comment on “Characterization of acute acro-ischemic lesions in non-hospitalized patients: a case series of 132 patients during the COVID-19 outbreak”. J Am Acad Dermatol 2020; 83 (03) e241-e241
- 6 Piccolo V, Neri I, Filippeschi C. et al. Chilblain-like lesions during COVID-19 epidemic: a preliminary study on 63 patients. J Eur Acad Venereol 2020; 34 (07) e291-e293
- 7 Bouaziz JD, Duong T, Jachiet M. et al. Vascular skin symptoms in COVID-19: a French observational study. J Eur Acad Dermatol Venereol 2020; DOI: 10.1111/jdv.16544.
- 8 Zhang Y, Cao W, Xiao M. et al. [Clinical and coagulation characteristics of 7 patients with critical COVID-2019 pneumonia and acro-ischemia] (in Chinese). Zhonghua Xue Ye Xue Za Zhi 2020; DOI: 10.3760/cma.j.issn.0253-2727.2020.0006.
- 9 Ma J, Xia P, Zhou Y. et al. Potential effect of blood purification therapy in reducing cytokine storm as a late complication of critically ill COVID-19. Clin Immunol 2020; 214: 108408
- 10 Manalo IF, Smith MK, Cheeley J, Jacobs R. A dermatologic manifestation of COVID-19: Transient livedo reticularis. J Am Acad Dermatol 2020; 83 (02) 700
- 11 Estébanez A, Pérez-Santiago L, Silva E, Guillen-Climent S, García-Vázquez A, Ramón MD. Cutaneous manifestations in COVID-19: a new contribution. J Eur Acad Dermatol Venereol 2020; 34 (06) e250-e251
- 12 Henry D, Ackerman M, Sancelme E, Finon A, Esteve E. Urticarial eruption in COVID-19 infection. J Eur Acad Dermatol Venereol 2020; 34 (06) e244-e245
- 13 van C Damme, Berlingin E, Saussez S, Accaputo O. Acute urticaria with pyrexia as the first manifestations of a COVID-19 infection. J Eur Acad Dermatol Venereol 2020; 34 (07) e300-e301
- 14 Quintana-Castanedo L, Feito-Rodríguez M, Valero-López I, Chiloeches-Fernández C, Sendagorta-Cudós E, Herranz-Pinto P. Urticarial exanthem as early diagnostic clue for COVID-19 infection. JAAD Case Rep 2020; 29 (06) 498-499
- 15 Marzano AV, Genovese G, Fabbrocini G. et al. Varicella-like exanthem as a specific COVID-19-associated skin manifestation: multicenter case series of 22 patients. J Am Acad Dermatol 2020; 83 (01) 280-285
- 16 Tammaro A, Adebanjo GAR, Parisella FR, Pezzuto A, Rello J. Cutaneous manifestations in COVID-19: the experiences of Barcelona and Rome. J Eur Acad Dermatol Venereol 2020; 34 (07) e306-e307
- 17 Hunt M, Koziatek C. A case of COVID -19 pneumonia in a young male with full body rash as a presenting symptom. Clin Pract Cases Emerg Med 2020; 4 (02) 219-221
- 18 Joob B, Wiwanitkit V. COVID-19 can present with a rash and be mistaken for dengue. J Am Acad Dermatol 2020; 82 (05) e177
- 19 Mahé A, Birckel E, Krieger S, Merklen C, Bottlaender L. A distinctive skin rash associated with coronavirus disease 2019?. J Eur Acad Dermatol Venereol 2020; 34 (06) e246-e247
- 20 Jimenez-Cauhe J, Ortega-Quijano D, Prieto-Barrios M, Moreno-Arrones OM, Fernandez-Nieto D. Reply to “COVID-19 can present with a rash and be mistaken for dengue”: Petechial rash in a patient with COVID-19 infection. J Am Acad Dermatol 2020; 83 (02) e141-e142
- 21 Ehsani AH, Nasimi M, Bigdelo Z. Pityriasis rosea as a cutaneous manifestation of COVID-19 infection. J Eur Acad Dermatol Venereol 2020; DOI: 10.1111/jdv.16579.
- 22 Amatore F, Macagno N, Mailhe M. et al. SARS-CoV-2 infection presenting as a febrile rash. J Eur Acad Dermatol Venereol 2020; 34 (07) e304-e306
- 23 Sanchez A, Sohier P, Benghanem S. et al. Digitate papulosquamous eruption associated with severe acute respiratory syndrome coronavirus 2 infection. JAMA Dermatol 2020; DOI: 10.1001/jamadermatol.2020.1704.
- 24 Jones VG, Mills M, Suarez D. et al. COVID-19 and Kawasaki disease: novel virus and novel case. Hosp Pediatr 2020; 10 (06) 537-540
- 25 Paolino G, Canti V, Mercuri SR. Rovere Querini P, Candiani M, Pasi F. Diffuse cutaneous manifestation in a new mother with COVID-19 (SARS-Cov-2). Int J Dermatol 2020; 59 (07) 874-875
- 26 Goren A, Vaño-Galván S, Wambier CG. et al. A preliminary observation: Male pattern hair loss among hospitalized COVID-19 patients in Spain - A potential clue to the role of androgens in COVID-19 severity. J Cosmet Dermatol 2020; 19 (07) 1545-1547
- 27 Lin P, Zhu S, Huang Y. et al. Adverse skin reactions among healthcare workers during the coronavirus disease 2019 outbreak: a survey in Wuhan and its surrounding regions. Br J Dermatol 2020; 183 (01) 190-192
- 28 Singh M, Pawar M, Bothra A, Choudhary N. Overzealous hand hygiene during the COVID 19 pandemic causing an increased incidence of hand eczema among general population. J Am Acad Dermatol 2020; 83 (01) e37-e41
- 29 Magro C, Mulvey JJ, Berlin D. et al. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases. Transl Res 2020; 220: 1-13
- 30 Xiong M, Liang X, Wei Y-D. Changes in blood coagulation in patients with severe coronavirus disease 2019 (COVID-19): a meta-analysis. Br J Haematol 2020; 189 (06) 1050-1052
- 31 Zengarini C, Orioni G, Cascavilla A. et al. Histological pattern in COVID-19-induced viral rash. J Eur Acad Dermatol Venereol 2020; DOI: 10.1111/jdv.16569.
- 32 Price KN, Frew JW, Hsiao JL, Shi VY. COVID-19 and immunomodulator/immunosuppressant use in dermatology. J Am Acad Dermatol 2020; 82 (05) e173-e175
- 33 Fernandez-Nieto D, Ortega-Quijano D, Segurado-Miravalles G, Pindado-Ortega C, Prieto-Barrios M, Jimenez-Cauhe J. Comment on: cutaneous manifestations in COVID-19: a first perspective. Safety concerns of clinical images and skin biopsies. J Eur Acad Dermatol Venereol 2020; 34 (06) e252-e254
- 34 Lim HW, Feldman SR, Van Voorhees AS, Gelfand JM. Recommendations for phototherapy during the COVID-19 pandemic. J Am Acad Dermatol 2020; 83 (01) 287-288
- 35 Freeman EE, McMahon DE, Fitzgerald ME. et al. The American Academy of Dermatology COVID-19 registry: Crowdsourcing dermatology in the age of COVID-19. J Am Acad Dermatol 2020; 83 (02) 509-510