Cutaneous manifestations of COVID-19

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Coronavirus disease 2019 has several cutaneous manifestations. The American Academy of Dermatology reports that skin lesions like morbilliform rashes (22%), pernio-like rashes(18%), urticaria (16%), macular erythema (13%), vesicular purpura (11%), papulosquamous purpura (9.9%) and retiform purpura (6.4%) are seen in people with COVID-19.[1][2][3] Pernio-like lesions were more common in mild disease while retiform purpura was seen only in critically ill patients.[1] The major dermatologic patterns identified in individuals with COVID-19 are urticarial rash, confluent erythematous/morbilliform rash, papulovesicular exanthem, chilbain-like acral pattern, livedo reticularis and purpuric “vasculitic” pattern.[4] Chilblains and Multisystem inflammatory syndrome in children are also cutaneous manifestations of COVID-19.[5]

Urticarial rash[edit]

Urticarial rash is seen in several bacterial and viral infections, so COVID-19 is no exception. These rashes are more commonly found in the trunk and limbs, relatively sparing the acral sites. Systemic corticosteroids are a therapeutic option for urticarial rash induced by COVID-19.[4]

Confluent erythematous rash[edit]

The erythematous rashes seen in COVID-19 are mostly present on the trunk and limbs, and associated with itching.[4] Exanthems induced by viruses other than COVID-19 and drug reactions should be considered as differential diagnosis in the case of erythematous rashes.[4]

Livedo reticularis[edit]

Livedo reticularis refers to slowing of blood flow, leading to desaturation of blood and bluish discolouration of the skin. This type of skin rashes may be seen in cold-induced vasoconstriction as seen in polycythemia or other causes leading upto focal impairment of blood flow.[4]

References[edit]

  1. ^ a b Freeman, Esther E.; McMahon, Devon E.; Lipoff, Jules B.; Rosenbach, Misha; Kovarik, Carrie; Desai, Seemal R.; Harp, Joanna; Takeshita, Junko; French, Lars E.; Lim, Henry W.; Thiers, Bruce H.; Hruza, George J.; Fox, Lindy P. (1 October 2020). "The spectrum of COVID-19–associated dermatologic manifestations: An international registry of 716 patients from 31 countries". Journal of the American Academy of Dermatology. 83 (4): 1118–1129. doi:10.1016/j.jaad.2020.06.1016. ISSN 0190-9622. Retrieved 1 March 2021.
  2. ^ "COVID-19 dermatology registry". www.aad.org. Retrieved 1 March 2021.
  3. ^ Freeman, Esther E.; McMahon, Devon E.; Hruza, George J.; Irvine, Alan D.; Spuls, Phyllis I.; Smith, Catherine H.; Mahil, Satveer K.; Castelo-Soccio, Leslie; Cordoro, Kelly M.; Lara-Corrales, Irene; Naik, Haley B.; Alhusayen, Raed; Ingram, John R.; Feldman, Steven R.; Balogh, Esther A.; Kappelman, Michael D.; Wall, Dmitri; Meah, Nekma; Sinclair, Rodney; Beylot-Barry, Marie; Fitzgerald, Matthew; French, Lars E.; Lim, Henry W.; Griffiths, Christopher E. M.; Flohr, Carsten (1 September 2020). "International collaboration and rapid harmonization across dermatologic COVID-19 registries". Journal of the American Academy of Dermatology. 83 (3): e261–e266. doi:10.1016/j.jaad.2020.06.050. ISSN 0190-9622. Retrieved 1 March 2021.
  4. ^ a b c d e Genovese, Giovanni; Moltrasio, Chiara; Berti, Emilio; Marzano, Angelo Valerio (2021). "Skin Manifestations Associated with COVID-19: Current Knowledge and Future Perspectives". Dermatology. 237 (1): 1–12. doi:10.1159/000512932. ISSN 1018-8665. Retrieved 1 March 2021.
  5. ^ "UpToDate". www.uptodate.com. Retrieved 1 March 2021.
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