Skin disorders associated with the COVID-19 pandemic: A review

Abstract

Introduction: In December 2019, a new coronavirus has emerged out of China, the SARS-CoV-2 virus, causing a disease known as COVID-19, which steadily has progressed into a pandemic. This coronavirus affects many organs, including the skin, whose manifestations are a consequence of the disease itself, as well as the preventative measures taken to avoid the infection. This paper reviews the cutaneous manifestations which currently have been encountered during this pandemic.

Methods: A search was conducted on PubMed, and all relevant articles were included.

Results: The results show the occurrence of many cutaneous findings, ranging from those related to the infection itself and to various dermatitides related to the use of personal protective equipment (PPE) utilized by healthcare workers while attending to infected patients.

Discussion: Recognizing these findings is important for the accurate diagnosis of those infected with COVID-19 as well as the prompt treatment of the side effects caused by PPE that might further impair the effectiveness of healthcare workers.

Keywords: COVID; cutaneous; pandemic; rash; skin.

FIGURE 1

Itchy urticariform rash that appeared in a middle‐aged woman 16 days after COVID symptom onset. SARS‐CoV‐2 infection was confirmed by PCR

FIGURE 2

Itchy urticariform rash appearing in a young man during the first week of COVID infection, confirmed by PCR. Rash spontaneously resolved around a week later. Courtesy of Dr. Omar Zmerli

FIGURE 3

Petechial and purpuric patches and plaques over the bilateral lower extremities, overlying the shins and dorsa of feet, appearing 2 days after onset of fever in a middle‐aged man, found to have COVID, confirmed by PCR. Lesions were asymptomatic. Resolved within 5 days after treatment with systemic corticosteroids (for COVID). Courtesy of Dr. Karam Karam

FIGURE 4

Purpuric patches over the bilateral medial aspects of the feet, overlying the medial malleoli, appearing 2 days after onset of fever in a middle‐aged man with PCR‐confirmed COVID. Courtesy of Dr. Karam Karam

FIGURE 5

Purpuric patches and plaques over right lower extremity, with a reticular pattern, overlying the posterolateral aspect of the calf. The rash appeared 2 days after onset of fever in a middle‐aged man, found to have PCR‐confirmed COVID. Courtesy of Dr. Karam Karam

FIGURE 6

Excoriations secondary to severe pruritus over left lower extremity of a COVID‐positive (confirmed by PCR) young woman. Pruritus started a few days after onset of fever, cough, and myalgias. No new medications had been started prior to onset of pruritus. Courtesy of Dr Maya Habre

FIGURE 7

Excoriations over the right elbow and forearm of a COVID‐positive young woman. Pruritus started a few days after onset of systemic symptoms. Courtesy of Dr Maya Habre

FIGURE 8

Severe pruritus leading to excoriations over the left upper extremity of a young woman with symptomatic, PCR‐confirmed woman. These excoriations are distributed over the arm and forearm. Courtesy of Dr Maya Habre

FIGURE 9

Excoriated papules over the right leg and shin of a young COVID‐positive patient few days after onset of fever, chills, and myalgias. Courtesy of Dr Maya Habre.

FIGURE 10

Excoriations over the medial aspect of the right leg of a COVID‐positive, symptomatic, young woman. Courtesy of Dr Maya Habre