Review Article of American Journal of Dermatological Research and Reviews
The Cutaneous Manifestations Associated with COVID-19: A review
Ahmed, H MD, Yusuf, N PhD, MSPH
University of Alabama at Birmingham, Department of Dermatology
Importance: As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic spreads, increasing cases of dermatologic manifestations of the disease continue to be reported.
Observations: In this general review of the case reports, case series, and other systematic reviews on this subject, several patterns of cutaneous lesions have been compiled. These include viral exanthems, papulovesicular, pernio-like, vasculopathy-related, and other miscellaneous rashes.
Conclusions and Relevance: While clinical observations and subjective cases of rashes associated with SARS-CoV-2 are important to furthering our research and study of this viral disease, we as clinicians must be cautious in attributing causation with correlation. Continued research and study are needed before we can attribute a source for these dermatologic manifestations.
Funding: This research was partially support by IMPACT funds to NY from the School of Medicine, University of Alabama at Birmingham.
Keywords: Dermatology, Rash, Cutaneous, morbilliform, viral exanthem, pernio, chilblains, urticaria, varicelliform, SARS-CoV-2, COVID-19, Coronavirus Disease 19
How to cite this article:
Ahmed, H, Yusuf, N. The Cutaneous Manifestations Associated with COVID-19: A review. American Journal of Dermatological Research and Reviews, 2020, 3:31. DOI: 10.28933/ajodrr-2020-07-1005
1. Fauci AS, Lane HC, Redfield RR. Covid-19 – Navigating the Uncharted. N Engl J Med. 2020;382(13):1268-1269.
2. Sardu C, Gambardella J, Morelli MB, Wang X, Marfella R, Santulli G. Hypertension, Thrombosis, Kidney Failure, and Diabetes: Is COVID-19 an Endothelial Disease? A Comprehensive Evaluation of Clinical and Basic Evidence. J Clin Med. 2020;9(5).
3. de Masson A, Bouaziz JD, Sulimovic L, et al. Chilblains are a common cutaneous finding during the COVID-19 pandemic: a retrospective nationwide study from France. J Am Acad Dermatol. 2020.
4. Fernandez-Nieto D, Jimenez-Cauhe J, Suarez-Valle A, et al. 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.
5. Galván Casas C, Català A, Carretero Hernández G, 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.
6. Recalcati S. Cutaneous manifestations in COVID-19: a first perspective. J Eur Acad Dermatol Venereol. 2020.
7. Sachdeva M, Gianotti R, Shah M, et al. Cutaneous manifestations of COVID-19: Report of three cases and a review of literature. J Dermatol Sci. 2020.
8. Suchonwanit P, Leerunyakul K, Kositkuljorn C. Cutaneous manifestations in COVID-19: Lessons learned from current evidence. J Am Acad Dermatol. 2020.
9. Avellana Moreno R, Villa E, Avellana Moreno V, Estela Villa C, Aparicio M, Fontanella A. Cutaneous manifestation of COVID-19 in images: A case report. Journal of the European Academy of Dermatology and Venereology.n/a(n/a).
10. Gianotti R, Veraldi S, Recalcati S, et al. Cutaneous Clinico-Pathological Findings in three COVID-19-Positive Patients Observed in the Metropolitan Area of Milan, Italy. Acta Derm Venereol. 2020;100(8):adv00124.
11. 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.
12. Najarian DJ. Morbilliform Exanthem Associated with COVID-19. JAAD Case Rep. 2020.
13. Zengarini C, Orioni G, Cascavilla A, et al. Histological pattern in Covid-19 induced viral rash. J Eur Acad Dermatol Venereol. 2020.
14. Rivera-Oyola R, Koschitzky M, Printy R, et al. Dermatologic findings in two patients with COVID-19. JAAD Case Rep. 2020.
15. Amatore F, Macagno N, Mailhe M, et al. SARS-CoV-2 infection presenting as a febrile rash. J Eur Acad Dermatol Venereol. 2020.
16. Paolino G, Canti V, Raffaele Mercuri S, Rovere Querini P, Candiani M, Pasi F. Diffuse cutaneous manifestation in a new mother with COVID-19 (SARS-Cov-2). Int J Dermatol. 2020.
17. Sanchez A, Sohier P, Benghanem S, et al. Digitate Papulosquamous Eruption Associated With Severe Acute Respiratory Syndrome Coronavirus 2 Infection. JAMA Dermatol. 2020.
18. Joob B, Wiwanitkit V. COVID-19 can present with a rash and be mistaken for dengue. J Am Acad Dermatol. 2020;82(5):e177.
19. Diaz-Guimaraens B, Dominguez-Santas M, Suarez-Valle A, et al. Petechial Skin Rash Associated With Severe Acute Respiratory Syndrome Coronavirus 2 Infection. JAMA Dermatol. 2020.
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.
21. 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.
22. Ehsani AH, Nasimi M, Bigdelo Z. Pityriasis rosea as a cutaneous manifestation of COVID-19 infection. J Eur Acad Dermatol Venereol. 2020.
23. van Damme C, 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.
24. Henry D, Ackerman M, Sancelme E, Finon A, Esteve E. Urticarial eruption in COVID-19 infection. J Eur Acad Dermatol Venereol. 2020.
25. 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.
26. 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.
27. 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.
28. 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.
29. Bolognia J, Jorizzo JL, Schaffer JV. Dermatology. 3rd ed. ed. [Philadelphia] ; London: Elsevier Saunders; 2012.
30. 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.
31. Cordoro KM, Reynolds SD, Wattier R, McCalmont TH. Clustered Cases of Acral Perniosis: Clinical Features, Histopathology and Relationship to COVID-19. Pediatr Dermatol. 2020.
32. Andina D, Noguera-Morel L, Bascuas-Arribas M, et al. Chilblains in children in the setting of COVID-19 pandemic. Pediatr Dermatol. 2020.
33. Colonna C, Monzani NA, Rocchi A, Gianotti R, Boggio F, Gelmetti C. Chilblains-like lesions in children following suspected Covid-19 infection. Pediatr Dermatol. 2020.
34. Landa N, Mendieta-Eckert M, Fonda-Pascual P, Aguirre T. Chilblain-like lesions on feet and hands during the COVID-19 Pandemic. Int J Dermatol. 2020.
35. Tosti G, Barisani A, Queirolo P, et al. Skin signs resembling vascular acrosyndromes during the COVID-19 outbreak in Italy. Clin Exp Dermatol. 2020.
36. Torres-Navarro I, Abril-Pérez C, Roca-Ginés J, Sánchez-Arráez J, Botella-Estrada R, Évole-Buselli M. Comment on ‘Two cases of COVID-19 presenting with a clinical picture resembling chilblains: first report from the Middle East’: pernio unrelated to COVID-19. Clin Exp Dermatol. 2020.
37. 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.
38. Kolivras A, Dehavay F, Delplace D, et al. Coronavirus (COVID-19) infection-induced chilblains: A case report with histopathologic findings. JAAD Case Rep. 2020.
39. Bouaziz JD, Duong T, Jachiet M, et al. Vascular skin symptoms in COVID-19: a french observational study. J Eur Acad Dermatol Venereol. 2020.
40. Schultz K, Wolf JM. Digital Ischemia in COVID-19 Patients: Case Report. J Hand Surg Am. 2020.
41. 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.
42. Zhang Y, Cao W, Xiao M, et al. [Clinical and coagulation characteristics of 7 patients with critical COVID-2019 pneumonia and acro-ischemia]. Zhonghua Xue Ye Xue Za Zhi. 2020;41(0):E006.
43. Thomas C. Reply to: “A Dermatologic Manifestation of COVID-19: Transient Livedo Reticularis”. J Am Acad Dermatol. 2020.
44. 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.
45. Jones VG, Mills M, Suarez D, et al. COVID-19 and Kawasaki Disease: Novel Virus and Novel Case. Hosp Pediatr. 2020.
46. Loomba RS, Villarreal E, Flores S. Covid-19 and Kawasaki syndrome: should we really be surprised? Cardiol Young. 2020:1-5.
47. Jimenez-Cauhe J, Ortega-Quijano D, Carretero-Barrio I, et al. Erythema multiforme-like eruption in patients with COVID-19 infection: clinical and histological findings. Clin Exp Dermatol. 2020.
48. Duong TA, Velter C, Rybojad M, et al. Did Whatsapp. J Eur Acad Dermatol Venereol. 2020.
49. Freeman EE, McMahon DE, Fitzgerald ME, et al. The AAD COVID-19 Registry: Crowdsourcing Dermatology in the Age of COVID-19. J Am Acad Dermatol. 2020.
50. Madigan LM, Micheletti RG, Shinkai K. How Dermatologists Can Learn and Contribute at the Leading Edge of the COVID-19 Global Pandemic. JAMA Dermatol. 2020.
This work and its PDF file(s) are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.