Abstract
After the beginning of the SARS-CoV-2 pandemic, our dermatology department created a multidisciplinary unit to manage patients with cutaneous manifestations associated with COVID-19. With the objective of identifying skin lesions in patients with suspected COVID-19 and evaluating possible associations with systemic involvement, other infectious agents and coagulation disorders, we carried out a prospective observational study that included all patients that attended our COVID-19 dermatology clinic with a multidisciplinary protocol. A total of 63 patients (mean 34.6 years) were enrolled between May 2020 and February 2021. Overall, 27 patients (42.9%) had a positive COVID-19 test, and 74.6% had COVID-19 clinical signs. The most common skin lesion was maculopapular rash (36.5%), predominantly seen in male (54.2%) and older patients (42 vs. 30 years), followed by chilblain-like lesions (20.6%) in younger patients (13.9 vs. 20.9 years) who were predominantly barefoot at home (69.2%); these patients exhibited a tendency towards a negative COVID-19 test. A total of 12 patients (19.1%) had positive serology for herpesvirus 6 (IgM or IgG). We conclude that the COVID-19-associated skin lesions we observed were similar to those previously described. Questions as to the underlying mechanisms remain. Interferon, possibly aided by cold exposure, may cause perniosis-like lesions. Other cutaneous manifestations were similar to those caused by other viruses, suggesting that SARS-CoV-2 may reactivate or facilitate other viral infections.
Highlights
Throughout the recent coronavirus disease 2019 (COVID-19) pandemic, several publications warned of possible cutaneous manifestations associated with this novel coronavirus (SARS-CoV-2)
There are several reports warning about the appearance of similar skin manifestations in relation to COVID-19 vaccination [5]
Our study shows that the maculopapular pattern was the most frequent COVID-19-associated pattern in our cohort, the types of lesions observed varied depending on the wave of infection, sex, age, and certain behavioral factors such as walking barefoot at home
Summary
Throughout the recent coronavirus disease 2019 (COVID-19) pandemic, several publications warned of possible cutaneous manifestations associated with this novel coronavirus (SARS-CoV-2). Galván Casas et al [1] described the following five cutaneous clinical patterns in SARS-CoV-2 patients: acral areas of erythema with vesicles or pustules (pseudochilblain), other vesicular eruptions, urticarial lesions, maculopapular eruptions, and livedo or necrosis. Dermatologists have reported multiple cases of patients with cutaneous clinical signs associated with COVID-19, requiring rapid scheduling of specific consultations carried out in a manner safe for all involved. The main objective of the present study was to investigate epidemiological, clinical, analytical, and microbiological factors associated with the different cutaneous manifestations of COVID-19. The secondary objective was to describe the frequency of the different cutaneous patterns observed in COVID-19 patients throughout the pandemic
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