Cutaneous manifestations of COVID-19

Authors

  • Shehla Shaukat
  • Ghazala Butt
  • Ijaz Hussain

Keywords:

COVID-19, Cutaneous manifestations

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and the disease it causes, termed coronavirus disease 2019 (COVID‐19), has rapidly swept across the world since its first known human manifestation on December 8, 2019. Confirmed cases are present in over 160 countries. Patients of COVID-19 infection present with diverse cutaneous manifestations seen in 0.2% to 20% of patients. This article summarizes different dermatological manifestations in patients with COVID-19 through literature review using Google Scholar, Sci Hub, PubMed and other online review articles. Case reports, case series and other studies which mentioned cutaneous manifestations in the patients with COVID-19 infection were added. The most common cutaneous manifestation of COVID-19 was found to be maculopapular (morbilliform) exanthem. Papulovesicular rash, urticaria, painful acral red purple papules (COVID toes), livedo reticularis and petechiae were other presentations. Majority of lesions were localized on the trunk; however, involvement of the hands and feet was also noted. Cutaneous involvement usually followed the respiratory symptoms; nonetheless, in a minority, it preceded systemic features. Majority of the studies failed to report any correlation between COVID-19 severity and skin lesions. Cutaneous manifestations may help in early diagnosis of disease and prompt treatment of COVID-19. 

References

https://www.worldometers.info/coronavirus/

Sachdeva M, Gianotti R, Shah M, Lucia B, Tosi D, Veraldi S, et al. Cutaneous manifestations of COVID-19: Report of three cases and a review of literature [published online ahead of print, 2020 Apr 29]. J Dermatol Sci.2020;S0923-1811(20)30149-3. doi:10.1016/j.jdermsci.2020.04.011

de Masson A, Bouaziz J-D, Sulimovic L, Cassius C, Jachiet M, Ionescu M-A, Rybojad M, Bagot M, Duong T-A, on behalf of the SNDV (French Union of Dermatologists-Venereologists), Chilblains are a common cutaneous finding during the COVID-19 pandemic: a retrospective nationwide study from France J Am Acad Dermatol (2020), doi: https://doi.org/10.1016/j.jaad.2020.04.161.

Gianotti R, Zerbi P, Dodiuk-Gad R. Histopathological study of skin dermatoses in patients affected by COVID-19 infection in the Northern part of Italy, J Cosmet Dermatol. Sci. Appl. (2020) In press.

Magro C, Mulvey J, Berlin D, Nuovo G, Salvatore S, Harpe J, et al. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19infection: a report of five cases. Transl Res 2020.https://doi.org/10.1016/j.trsl.2020.04.007.

Suchonwanit P, Leerunyakul K, Kositkuljorn C, Cutaneous manifestations in COVID-19: Lessons learned from current evidence, J Am Acad Dermatol (2020), doi: https://doi.org/10.1016/j.jaad.2020.04.094

Galvan Casas c, Catala A, Carretero Hernandez G, Rodriguez-Jimenez P, Fernandez Nieto D, Rodriguez-Villa Lario A et al. Classification of the cutaneous manifestations of COVID‐19: a rapid prospective nationwide consensus study in Spain with 375 cases. Br J Dermatol. 2020. https://doi.org/10.1111/bjd.19163

Recalcati S, Cutaneous manifestations in COVID-19: a first perspective, J Eur Acad Dermatol Venereol. (March 26) (2020), doi:http://dx.doi.org/10.1111/ jdv.16387 [Epub ahead of print].

M. Hunt, C. Koziatek, A case of COVID-19 pneumonia in a young male with full body rash as a presenting symptom, Clin Pract Cases Emerg Med. 2020. doi:http://dx.doi.org/10.5811/cpcem.2020.3.47349

A. Mahé, E. Birckel, S. Krieger, C. Merklen, L. Bottlaender, A distinctive skin rash associated with Coronavirus Disease 2019? J Eur Acad Dermatol Venereol. 2020.

D.J. Najarian, Morbilliform exanthem associated with COVID-19, JAAD Case Rep. (2020), doi:http://dx.doi.org/10.1016/j.jdcr.2020.04.015.

A.V. Marzano, G. Genovese, G. Fabbrocini, P. Pigatto, G. Monfrecola, B.M. Piraccini, et al., Varicella- like exanthem as a specific COVID-19-associated skin manifestation: multicenter case series of 22 patients, J. Am. Acad. Dermatol. (April 16) (2020), doi:http://dx.doi.org/10.1016/j.jaad.2020.04.044 pii: S0190- 9622(20)30657-5.

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, doi:http://dx.doi.org/10.1111/jdv.16470 [Epub ahead of print].

Zhang J, Dong X, Cao Y, Yuan y, Yang Y, Yan Y, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China, Allergy (February 19) (2020), doi:http://dx.doi.org/10.1111/all.14238 [Epub ahead of print].

Henry D, Ackerman M, Sancelme E, Finon A, Esteve E, Urticarial eruption in COVID-19 infection, J Eur Acad Dermatol Venereol. 2020. doi: http://dx.doi.org/10.1111/jdv.16472 [Epub ahead of print].

Quintana-Castanedo L, Feito-Rodríguez M, Valero-López I, ChiloechesFernández C, Sendagorta-Cudós E, Herranz-Pinto P, Urticarial exanthem as early diagnostic clue for COVID-19 infection. J Am Acad Dermatol. Case Reports (2020), doi: https://doi.org/10.1016/j.jdcr.2020.04.026.

Kolivras, F. Dehavay, D. Delplace, F. Feoli, I. Meiers, L. Milone, et al., Coronavirus (COVID-19) infection- induced chilblains: a case report with histopathological findings, J Am Acad Dermatol Case Rep. 2020. doi:http://dx.doi. org/10.1016/j.jdcr.2020.04.011.

Mazzotta F, Troccoli T, Acute Acro-Ischemia in the Child at the time of COVID19. Dermatologia Pediatrica, Bari, (2020) In press.

Alramthan A, Aldaraji W, A case of COVID-19 presenting in clinical picture resembling chilblains disease. First report from the Middle East, Clin Exp Dermatol. 2020. doi: https://doi.org/10.1111/ced.14243. [Epub ahead of print]

Ehsani AH, Nasimi M, Bigdelo Z. Pitryasis rosea as a cutaneous manifestation of COVID-19 infection. J Eur Acad Dermatol Venereol. 2020;10.1111/jdv.16579. [Epub ahead of print]

Janah H, Zinebi A, Elbenave J. Atypical erythema multiforme palmar plaques lesions due to Sars-Cov-2. J Eur Dermatol venereal. 2020. https://doi.org/10.1111/jdv.16623. [Epub ahead of print]

Ma J, Xia P, Zhou Y, Liu Z, Zhou X, Wang J 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: https://doi.org/10.1016/j.clim.2020.108408

Young S, Fernandez AP. Skin manifestations of COVID-19. Clev Clin J Med. 2020. doi: 10.3949/ccjm.87a.ccc031.

Suarez-Valle A, Fernandez-Nieto D, Diaz-Guimaraens B, Dominguez-Santas M, Carretero I, Perez-Garcia B. Acro‐ischemia in hospitalized COVID‐19 patients. J Eur Acad Dermatol Venereol. 2020;10.1111/jdv.16592. [Epub ahead of print]

Manalo IF, Smith MK, Cheeley J, Jacobs R. A dermatologic manifestation of COVID-19: Transient livedo reticularis. J Am Acad Dermatol. 2020. https://doi.org/10.1016/j.jaad.2020.04.018.

Recalcati S, Barbagallo T, Frasin LA, Prestinari F, Cogliardi A, Provero MC et al. Acral cutaneous lesions in the time of COVID-19. J Eur Dermatol Venereol. 2020. Doi: 10.1111/jdv.16533. [Epub ahead of print]

Estebanez A, Perez-Santiago L, Silva E, Guillen-Climent S, Garcia-Vazquez A, Ramon MD. Cutaneous manifestations in COVID-19: a new contribution. J Eur Acad

Chaux- Bodard AG, Deneuve S, Desoutter A. Oral manifestation of Covid-19 as an inaugural symptom? J Oral Med oral Surg. 2020;26(2):18. https://doi.org/10.1051/mbcb/2020011

Graeme M. COVID toes and Kawasaki rash: 5 cutaneous signs in COVID-19. Available at: https://www.medscape.com/viewarticle/930180

Pediatric Intensive Care Society. PICS Statement: Increased number of reported cases of novel presentation of multi-system inflammatory disease. April 27, 2020. Available at https://picsociety.uk/wpcontent/uploads/2020/04/PICS-statement-re-novel-KD-C19-presentation-v2-27042020.pdfKawasaki disease

Bouaziz JD, Doung T, Jachiet M, Velter C, Lestang P, Cassius C et al. Vascular skin symptoms in COVID-19: a French observational study. J Eur Acad Dermatol Venereol. 2020;10.1111/jdv.16544. [Epub ahead of print]

Castelnovo L, Capelli F, Tamburello A, Faggioli PM, Mazzone A. Symmetric cutaneous vasculitis in COVID‐19 pneumonia. J Eur Acad Dermatol Venereol. 2020; doi: 10.1111/jdv.16589. [Epub ahead of print]

Sernicola A, Carnicelli G, Fraia MD, Chello C, Furhan C, Muharremi R et al. Toxic erythema and eosinophilia associated to tocilizumab therapy in COVID-19 patient. J Eur Acad Dermatol Venereol. 2020;10.1111/jdv.16620. [Epub ahead of print]

Robustelli Test E, Vezzoli P, Caugno A, Rapuno F, Gianatti A, Rongioletti F et al. Acute Generalized Exanthematous Pustulosis with Erythema Multiforme‐Like lesions in a COVID‐19 woman. J Eur Acad Dermatol Venereol. 2020;10.1111/jdv.16613. [Epub ahead of print]

Pei S, Xue Y, Zhao S, Alexander N, Mohamad G, Chen X et al. Occupational skin conditions on the frontline: A survey among 484 Chinese healthcare professionals caring for Covid-19 patients. J Eur Acad Dermatol Venereol. 2020. https://doi.org/10.1111/jdv.16570. [Epub ahead of print]

Singh M, Pawar M, Bothra A, Maheshwari A, Dubey V, Tiwari A et al. Personal protective equipment induced facial dermatoses in healthcare workers managing COVID-19 cases. J Eur Acad Dermatol Venereol. 2020;10.1111/jdv.16628. [Epub ahead of print]

Lan J, Song Z, Miao X, et al. Skin damage among healthcare workers managing coronavirus disease-2019 [published online ahead of print, 2020 Mar 18]. J Am Acad Dermatol. 2020;S0190-9622(20)30392-3. doi:10.1016/j.jaad.2020.03.014

Yin Z. Covid-19: Countermeasure for N95 mask-induced pressure sore [published online ahead of print, 2020 Apr 17]. J Eur Acad Dermatol Venereol. 2020;10.1111/jdv.16490. doi:10.1111/jdv.16490

Campbell V, Middleton D, Donnelly J, Hunter H. Localised mid-face Miliaria as a consequence of filtering face piece (FFP) respirator use during the COVID-19 pandemic. J Eur Acad Dermatol Venereol. 2020;10.1111/jdv.16624. [Epub ahead of print]

Tang k, Wang Y, Zhang H, Zheng Q, Fang R, Sun Q. Cutaneous manifestations of the Coronavirus Disease 2019 (COVID-19): a brief review. Dermatol Ther. 2020. doi: 10.1111/dth.13528. [Epub ahead of print].

Downloads

Published

2020-08-07

How to Cite

1.
Shaukat S, Butt G, Hussain I. Cutaneous manifestations of COVID-19. J Pak Assoc Dermatol [Internet]. 2020Aug.7 [cited 2024Dec.7];30(1):181-9. Available from: http://www.jpad.com.pk/index.php/jpad/article/view/1560

Issue

Section

Review Articles

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 10 > >>