Skin manifestations of COVID-19: A worldwide reviewCapsule Summary

• Published in: JAAD international Vol. 2; pp. 119 - 133
• Main Authors: See Wei Tan, MBBS, MRCP, Yew Chong Tam, BSc, Choon Chiat Oh, MBBS, MSc, MCI, FRCP, FAMS
• Format: Journal Article
• Language: English
• Published: Elsevier 01.03.2021
• Subjects: acral ischemia; coagulopathy; COVID-19; pseudo-chilblains; rash containing macules and papules; skin manifestations
• ISSN: 2666-3287; 2666-3287

Objective: Because of the increasing emergence of skin manifestations of COVID-19 worldwide, we investigated the published reports of these lesions. Methods: We conducted a literature search for original and review articles published from November 11, 2019 to September 30, 2020. Results: We identified 5 skin lesions common in patients with COVID-19: pseudo-chilblains, rashes containing macules and papules, and urticarial, vesicular, and vaso-occlusive lesions. These lesions manifested at various times in relation to the COVID-19 symptoms, which may indicate whether the lesions are virus-induced or are delayed immunological responses to the infection. Skin lesions were more prevalent among Europeans and United States residents than among Asians, as was pseudo-chilblain, and the morphology of the skin lesions varied among continents. Pseudo-chilblains were the most common COVID-19 skin manifestation in Europe and the United States, but there was only 1 reported case from Asian populations. Additionally, patients with vaso-occlusive lesions were more likely than those with pseudo-chilblains to be admitted to the intensive care unit and to die. Conclusion: Different cutaneous manifestations in patients with COVID-19 could reflect a wide spectrum of viral interactions with the skin, though reporting bias may play a role as well.