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Cutaneous Manifestations of COVID-19: An Overview
Introduction to COVID-19 Skin Rashes
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, is primarily known for its respiratory symptoms. However, a significant number of patients have also reported various skin manifestations. These dermatologic symptoms can range from mild to severe and may provide clues for diagnosis and prognosis of the disease.
Common Types of COVID-19 Skin Rashes
Acral Lesions (Chilblain-like)
Acral lesions, resembling pseudo-chilblains, are among the most frequently reported skin manifestations in COVID-19 patients. These lesions typically appear in young adults and are often observed after the onset of other COVID-19 symptoms1 2. They are linked to a milder disease course and may serve as an epidemiological marker2.
Erythematous Maculopapular Rashes
Erythematous maculopapular rashes are another common type, affecting around 21.3% of patients. These rashes usually appear concurrently with other COVID-19 symptoms and are more prevalent in middle-aged adults1 2. They are characterized by red, flat, or slightly raised lesions that can cover large areas of the body.
Vesicular Rashes
Vesicular rashes, which resemble chickenpox, affect approximately 13% of COVID-19 patients. These rashes often appear after the onset of other symptoms and are more common in middle-aged adults1 2. There is also a possibility of herpesvirus co-infections in these cases2.
Urticarial Rashes
Urticarial rashes, or hives, affect about 10.9% of COVID-19 patients. These rashes appear as itchy, raised welts and can occur simultaneously with other COVID-19 symptoms1 2. They are seen across various age groups but are more common in adults.
Vascular Rashes
Vascular rashes, including livedo and purpura, are less common but are significant as they often indicate a severe disease course. These rashes are more frequently observed in elderly patients and appear concurrently with other COVID-19 symptoms1 2. They may serve as a prognostic marker for severe disease3.
Erythema Multiforme-like Eruptions
Erythema multiforme-like eruptions are rare, affecting about 3.7% of patients, and are mostly seen in children. These rashes are characterized by target-like lesions and can be associated with a more severe disease course1 2.
Diagnostic and Prognostic Implications
The presence of certain skin manifestations can aid in the early diagnosis of COVID-19, especially in asymptomatic carriers. For instance, vesicular rashes may suggest an initial diagnosis, while acral lesions can be useful for epidemiological tracking. Vascular rashes, on the other hand, may indicate a severe disease prognosis1 2 3.
Treatment and Management
Treatment for COVID-19-related skin rashes varies depending on the type and severity of the lesions. Common treatments include the use of anticoagulants, corticosteroids, and antihistamines. Understanding these dermatologic manifestations is crucial for healthcare professionals to provide personalized care and improve patient outcomes3.
Conclusion
COVID-19 is associated with a wide range of cutaneous manifestations, from mild rashes to severe vascular lesions. Recognizing these skin symptoms can aid in the diagnosis and prognosis of the disease, providing valuable insights for healthcare providers. As the pandemic continues, further research is essential to fully understand the implications of these dermatologic findings.
Sources and full results
Most relevant research papers on this topic
Cutaneous Manifestations of COVID-19: An Evidence-Based Review
COVID-19 cutaneous manifestations include acral lesions, erythematous maculopapular rashes, vesicular rashes, and vascular rashes, which may aid in diagnosis and prognosis.
Systematic Review
Highly CitedCutaneous Manifestations in Confirmed COVID-19 Patients: A Systematic Review
COVID-19 patients with skin rashes may help identify asymptomatic carriers or predict a more severe course of the disease.
Systematic ReviewIdentification, Mechanism, and Treatment of Skin Lesions in COVID-19: A Review
COVID-19 patients often experience common cutaneous manifestations, which can help diagnose the disease and personalize care plans.
Systematic ReviewCutaneous manifestations of SARS‐CoV‐2 infection: a clinical update
SARS-CoV-2 infection can cause various skin manifestations, including exanthema, vascular lesions, urticaria, and acro-papular eruptions, with potential for worsening chronic inflammatory diseases like psoriasis and atopic dermatitis.
Systematic Review
Rigorous JournalHighly CitedSkin Manifestations Associated with COVID-19: Current Knowledge and Future Perspectives
COVID-19-associated cutaneous manifestations can be categorized into six main clinical patterns, with varying clinical features and therapeutic management.
Highly CitedA distinctive skin rash associated with coronavirus disease 2019?
A distinctive skin rash with an original appearance was reported in a woman with Covid-19, suggesting its potential as a diagnostic marker for the disease.
Case ReportRigorous JournalHighly CitedCutaneous manifestations of the Coronavirus Disease 2019 (COVID‐19): A brief review
COVID-19 skin manifestations are highly variable and heterogeneous, with erythematous, urticarial, and vesicular lesions being the most common, but newer eruptions like vascular and peculiar skin lesions also cause concern.
Systematic ReviewHighly CitedCutaneous manifestations in SARS‐CoV‐2 infection (COVID‐19): a French experience and a systematic review of the literature
COVID-19 patients with skin lesions, mainly disseminated maculo-papular exanthema, have a mean delay between respiratory/systemic and dermatological signs of 13 days.
Systematic ReviewRigorous JournalCutaneous manifestations in COVID‐19: a new contribution
COVID-19 patients may experience more skin manifestations than previously reported, with rash observed in 0.2% of cases in China.
Rigorous JournalHighly CitedUrticarial eruption in COVID‐19 infection
Urticaria is a rare skin manifestation in COVID-19 patients, but other symptoms, such as anosmia and ageusia, are emerging.
Rigorous JournalHighly Cited