Cutaneous Manifestations Of COVID-19 Research Articles

Proposal for Clinical Classification of Cutaneous Manifestations in Covid-19 and in Post Vaccination Against Sars-Cov-2: An Observational Study

Background: This is a clinical evaluation of patients with the incident, acute, or related cutaneous manifestations associated with coronavirus disease 2019 (COVID-19) and/or vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Objectives: We aimed to propose a classification of dermatological manifestations related to either COVID-19 or vaccination against SARS-CoV-2. Methods: In an observational descriptive study, a classification of cutaneous manifestations is proposed based on groups of etiological hypotheses, which came from a systematic characterization and record of the observed skin lesions of patients who were evaluated personally and via teleconsultation from July 2020 to July 2022 in two reference dermatology services located in the state of Mato Grosso, Brazil. Results: A total of 108 patients were included. Eighty-six patients (79.6%) had incident, acute, or COVID-19-related skin manifestations, 15 (13.9%) had dermatological lesions exclusively after vaccination against SARS-CoV-2, and seven (6.5%) %) had cutaneous manifestations related to both COVID-19 and the vaccine. A total of 143 different dermatological manifestations were diagnosed, for which different etiological hypotheses were established based on the clinical and evolutionary characteristics of the lesion, the use of concomitant medications, and the temporal link with COVID-19 and/or the vaccine against SARS-CoV-2. The observed skin manifestations were classified as peri-infectious and post-infectious immune-inflammatory reactions related to COVID-19 (62.2%); exacerbation, by COVID-19, of pre-existing skin diseases in the patient (4.2%); skin manifestations resulting from the socio-sanitary context of the pandemic (2.1%); adverse drug reactions from the treatment of COVID-19 (14%); and adverse skin reactions from SARS-CoV-2 vaccines (17.5%). Conclusions: The proposed clinical classification may assist physicians who are faced with dermatological lesions associated with COVID-19 or after active immunization against SARS-CoV-2.

COVID-19 Dermatologic Manifestations: Issues More Than Skin-deep

Cutaneous manifestations of COVID-19 have become increasingly more reported. These dermatoses can either precede, accompany, or follow respiratory symptoms of COVID-19, and some have also been correlated with COVID-19 severity. Although COVID-19-related skin changes are relatively rare, there is an even greater paucity of such data in skin of colour. While research into the pathophysiology into this phenomenon is in its nascency, it is paramount to recognize the need for diversification, especially considering the racial disparities of COVID-19. The present discussion raises a deeper reflection of teaching and understanding dermatology of skin of colour in the medical profession. 

Update in cutaneous manifestations of COVID-19: Special populations.

Cutaneous abnormalities were among the first clinical findings reported in patients infected with SARS-CoV-2 at the onset of the COVID-19 pandemic, but the significance was initially unclear. Correlations have since been drawn between many of these cutaneous eruptions and their diagnostic or prognostic value. Additionally, COVID-19 vaccines have generated acute and delayed cutaneous reactions with which clinicians should be familiar. In this narrative review, we update the cutaneous abnormalities associated with COVID-19 infection for pediatric and non-White populations, and common cutaneous reactions to COVID-19 vaccines.

Differences in cutaneous manifestations of COVID-19 during the Delta and Omicron waves revealed using the ZOE app.

Abstract Linked Article:  Visconti et al. Br J Dermatol 2022; 187:900–908.

The cutaneous manifestations of COVID-19, personal protective equipment and treatment

Since the beginning of COVID-19 pandemic in late 2019, the symptoms and signs detailed in the medical literature and the media concentrated on the effect of causative virus SARS-COV-2 on the respiratory tract, the coagulopathy associated with severe forms of the disease and the febrile flu like illness in the mild cases. The widespread publicising of the symptoms has been one of the important public health measures in combatting the rapid spread of COVID-19. Less known is the direct or indirect effect of COVID-19 on the skin and underlying soft tissue. Recognising the various cutaneous manifestations may prove a useful tool in early detection and management of COVID-19.

Cutaneous manifestations of COVID-19: a case report and review of the literature

<p>Since the onset of the SARS-Cov2 pandemic, new data and peculiarities have emerged within the range of manifestations caused by this virus. Multisystem inflammatory syndrome in children (MIS-C) affects a small percentage of pediatric patients infected with SARS CoV 2 and characterized by fever, lab evidence of inflammation, multisystem involvement, and severe illness requiring hospitalization. Cutaneous findings are often present in these patients and are notable for their heterogeneity and poor characterization. We present case of pediatric patient with COVID-19 and cutaneous manifestations consistent with a multisystem inflammatory syndrome.</p>

Cutaneous manifestations Of COVID-19

The coronavirus 2019(COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2), has had enormous health, economic, and social consequences. Cutaneous manifestations associated with COVID-19 probably reflect the activation of pathogenic pathways by the virus or a response to inflammatory processes, vascular or systemic complications, or even treatments. There is no previous detailed classification or description of the cutaneous manifestations of COVID‐19. This information may prove useful to manage patients and to recognize paucisymptomatic patients and might provide prognostic information. The recognition of paucisymptomatic patients could also be helpful for epidemiological control, especially in areas where diagnostic tests are scarce. This is a cross-sectional study among the COVID positive patients admitted in Index Medical College Hospital and Research Centre (Tertiary Care Centre) Indore from 1st May 2020 – 30th November 2020. Considered initially as of little relevance, the dermatological manifestations observed in patients with COVID-19 are both heterogeneous and complex. 5 main categories of lesions identified; vesicular rashes, urticarial rashes, acral lesions, maculopapular rashes and livedoid & necrotic lesions.

Cutaneous Manifestations of COVID-19 in the Lower Limbs: A Narrative Review.

In 2020, the World Health Organization declared the COVID-19 pandemic. This infectious pathology can be associated with different manifestations in different body systems, among which are dermatological lesions. The purpose of this work is to determine the most frequent dermatological signs, in the lower limbs, produced by SARS-CoV-2. To carry this out, a bibliographic search was performed in the following databases: PubMed, SciELO, ScienceDirect, Cochrane Database of Systematic Reviews, and the Google Scholar literature. The inclusion criteria were articles that included confirmed subjects or those with a clinical suspicion of COVID-19, written in the Spanish or English languages, and the results presented clinical manifestations in the lower extremities. Initially, 128 scientific documents were identified and, after reading the title and abstract, 18 articles were selected. The most frequent skin lesions on the lower limbs are acral lesions such as pernio erythema or ischemic lesions, maculopapular rash, petechiae, and erythematous plaques.

Retrospective Study of Covid Related Hair Loss.

The Novel Coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome coronavirus two and primarily affects the epithelium of the airways. Multiple cutaneous manifestations of COVID-19 have been reported in the literature. Case reports citing many different types of exanthems and enanthems have been reported to correspond with the initial presentation and diagnosis of COVID-19. Some researchers have even described cutaneous symptoms linked to COVID-19 as an important presenting sign of the infection with COVID-19 in otherwise asymptomatic or minimally symptomatic patients. Hair loss has emerged as a frequently noted side effect of infection with COVID-19 and has been observed in many patients who have recovered from a documented COVID-19 illness. Given the prevalence of the onset of hair loss in patients who have overcome COVID-19, we designed this retrospective study in order to evaluate the prevalence of hair loss, along with histological findings if hair loss was present and response to treatment in 100 patients who presented to our outpatient dermatology clinic for various dermatological conditions and reported a history of having recovered from COVID-19. J Drugs Dermatol. 2022;21(7):724-727. doi:10.36849/JDD.6661.

Cutaneous manifestations of COVID-19: diagnosis and management.

Cutaneous manifestations of COVID-19: diagnosis and management.

A curious case of ‘COVID toes’ in pregnancy

The novel coronavirus of 2019 (COVID-19) can affect multiple organ systems with a wide spectrum of illness severity. Its effect on the respiratory tract is well-documented and has resulted in considerable excess mortality worldwide. However, observed cutaneous manifestations of COVID-19 are rising, ranging from short-lived viral exanthems to vesicular eruptions and urticaria. An unusual subgroup of these manifestations – pseudo-chilblains, also referred to as pernio-like lesions or ‘COVID toes’ – describes the acral areas of erythema and oedema that can affect young individuals following COVID-19. We present a case associated with pustule and vesicle formation occurring in the context of pregnancy.

Cutaneous Anomalies of the Critically Ill Patient.

Critically ill patients are at high risk for organ failure, including that of the integumentary system. Nurses working in intensive care are adept at performing comprehensive assessments that include the skin. Although pressure injury is a well-known complication associated with critical illness, patients may also have debilitating and life-threatening dermatoses. Conditions such as skin failure and medical adhesive-related skin damage are commonly seen in the critically ill. Infectious processes, such as Fournier gangrene, invasive candidiasis, mucormycosis, and herpetic lesions, can result in severe or superimposed critical illness and elude detection. Similarly, cutaneous manifestations of COVID-19 may develop prior to commonly recognized symptoms of infection. Nurses and providers caring for critically ill patients should be aware of common, but less widely known, skin conditions to facilitate early detection and treatment.

Cutaneous Manifestations of COVID-19 in Critical Care.

SARS-CoV-2 infection can cause virus-mediated endothelial dysfunction, which in turn may lead to coagulopathy and ischemic microangiopathy. In the critical care population, cutaneous skin manifestations related to vascular compromise due to COVID-19 include livedo and purpura. These lesions can be difficult to differentiate from other dermatologic conditions seen in this population, including skin failure and deep-tissue pressure injuries. In addition, similarities in underlying pathophysiological mechanisms of these skin conditions can cause diagnostic overlap. Skin failure is known to occur in critical care patients owing to disease severity and shunting of blood to vital organs. COVID-19-related ischemic lesions can mimic the clinical course of deep-tissue pressure injury. The viral endothelial dysfunction present in patients with COVID-19 decreases tissue tolerance, which can result in an increased risk of hospital-acquired pressure injury. Extrinsic factors can also complicate diagnosis of cutaneous lesions in patients with COVID-19.

Cutaneous manifestations of covid-19 in pediatric population: A web based comparative study between the perspectives of dermatologists and pediatricians

Objectives: To compare the perspectives of dermatologists and pediatricians regarding cutaneous manifestations of covid-19 in the pediatric age group. Material and methods: An online semi-structured English questionnaire was circulated among the doctors (snowball sampling). Items of the questionnaire with a content validity ratio ≥0.49 were retained. Content validity index (CVI) was estimated, and those with a CVI score of >0.79, were accepted. Appropriate statistical tests were carried out for data analysis. Results: Among 305 responders, majority were dermatologists (n = 139; 45.57%) followed by pediatricians (n = 106; 34.75%) and other specialties (n = 60; 19.6%). Nearly 46.55% of all responders (n = 142) observed cutaneous manifestations among pediatric covid patients (40/139 dermatologists, 28.77%, and 94/106 pediatricians, 88.67%). Nearly 54.22% of pediatricians and 10% of dermatologists reported the infection to be moderate to severe. About 15% of dermatologists and 5.3% of pediatricians came across cutaneous manifestations as the sole manifestation. The commonest manifestation was urticarial (61.26%) followed by a morbilliform rash (52.81%). Multisystem inflammatory syndrome in covid (MISC) was observed almost exclusively by 63.82% of pediatricians. Vascular manifestations were seen by 11.97% responders (n = 17). Chilblains were reported by 4.5% of pediatricians. Nearly 78.04% of pediatricians and 35% of dermatologists observed mucosal manifestations. Conclusion: Pediatricians are more commonly observing cutaneous manifestations. MISC is exclusively reported by pediatricians, highlighting the fact that severe disease is usually not seen by dermatologists. Vascular manifestations are uncommon in the skin of color. Dermatologists encounter asymptomatic covid patients with cutaneous manifestation more often, reiterating the fact that children presenting with urticarial and morbilliform rashes should be tested for covid-19, considering the present scenario.

Expanding literature regarding cutaneous manifestations of COVID-19: A bibliometric analysis

To the Editor: Although SARS-CoV-2 is categorized as a respiratory virus, a significant body of literature is emerging regarding the effects of COVID-19 across multiple organ systems, encompassing neurologic, cardiac, renal, gastrointestinal, and dermatologic symptoms.1 Specifically, research on cutaneous manifestations of COVID-19 has increased, and as these sequelae are further explored, more highly cited articles will have an increasing impact on shaping public discourse and driving future research directions.

Cutaneous Manifestations of Covid-19 in Nepal: A Series of Case Reports

Coronavirus Disease 2019 (COVID-19) is an illness caused by SARS-CoV-2. Case series of large population on cutaneous manifestations of COVID-19 are yet to be reported from Nepal. Among the cases in our study, onset of urticarial rash prior to onset of fever and systemic symptoms can be very important in preventing the chain of transmission of COVID-19 infection. Knowledge among medical practitioners of varied cutaneous features of COVID-19 can lead to testing COVID-19 in these cases and an early diagnosis.

Cutaneous manifestations of COVID-19 in children: Four case presentations

The dermatological signs of Coronavirus disease 2019 (COVID19) in children are uncommon and different from adults. The majority of infected children were asymptomatic, and cutaneous symptoms of infection in children usually appear several weeks after the disease. This article describes four different cutaneous manifestations of COVID-19 in children, including chilblains, erythema multiforme-like lesions (EM), urticaria, and vesicular rash in terms of recalling to mind COVID-19 infection.

Cutaneous manifestations of COVID‐19 among healthcare workers: A Case report and literature review

Common clinical features of COVID‐19 are increasingly known but cutaneous manifestations are rarely described among healthcare workers. A review of cutaneous manifestations of COVID‐19 especially among healthcare workers (HCW) is thus required. The aim of our current study was to provide a comprehensive review of cutaneous manifestations of COVID‐19 among HCW through six case reports and a literature review. We conducted a literature search for cases reports, original and review articles using PubMed and the Google search engines. We included the written English studies that mentioned cutaneous symptoms during COVID‐19 infection. In addition to the review, 6 cases were collected among the HCW working at the Charles Nicolle Hospital of Tunis from September 2020 to January 2021. In our review, we included 17 articles in addition to our six cases. The type of papers was case series and case reports in respectively 8 and 9 studies. Skin manifestations were reported in two studies including two HCW, in addition to our series of six HCW. Skin manifestations were chilblain‐like lesions (44.5%), a generalized macular or maculopapular exanthem (32.1%), a papulovesicular rash and chicken pox‐like vesicles (11.5%), painful acral red–purple papules (4.6%), urticaria (2.8%), purpuric or petechial lesions (2.3%), and livedo reticularis lesions (0.45%). Of the 218 cases, 203 cases have reported the location of lesions. The very great majority of lesions were found on the trunk, hands, and feet. Fifty‐one patients (23.4%) experienced lesions on the trunk. The time of onset of cutaneous lesions was variable. At the diagnosis or the onset of COVID‐19 symptoms, 8.3% (18/218) of patients presented with cutaneous lesions. After the onset of respiratory symptoms or COVID‐19 diagnosis, 36.7% (80/218) of patients presented with cutaneous lesions. Of the 197 cases with reported healing times, healing times were up to 24 days. COVID‐19 has been associated with different cutaneous manifestations, likely of varying pathophysiology and severity, some preceding COVID‐19 symptomatology and others occurring during active disease or later in the course. Thus, heightened awareness and timely recognition of cutaneous manifestations in COVID‐19 are important for occupational physicians treating HCW with COVID‐19.

Cutaneous manifestation of COVID-19: A case report

COVID-19 disease caused by the novel coronavirus (SARS-CoV-2) results in several manifestations
 involving the lungs, upper respiratory tract, gastrointestinal tract, and hematological system.
 During the ongoing COVID-19 pandemic, skin lesions were observed. These lesions resolve
 rapidly on treatment with corticoid creams and antihistamines. In this report, we present a case
 of COVID-19 with cutaneous manifestations.

Cutaneous manifestations of COVID-19 in a tertiary COVID-19 referral hospital in the Philippines

BackgroundReports on COVID-19 skin manifestations and associated clinical outcomes are limited. Like viral diseases, cutaneous findings may be present and can help in confirmation and prognostication among those suspected or diagnosed with COVID-19.ObjectiveTo determine COVID-19 cutaneous manifestations and their association with disease severity and course.MethodsThis study was conducted in a designated COVID-19 referral hospital from January 1 to March 31, 2021. Skin manifestations recorded from January 1 to February 17 were retrospectively gathered. Reports from February 18 to March 31 were prospectively collected using a dermatologic checklist which was incorporated into all official medical records.ResultsA total of 507 confirmed patients with COVID-19 were included. COVID-19 skin signs were detected in 39 patients (7.7%). Morbilliform lesions were most common. Skin signs were significantly associated with severe or critical cases (odds ratio, 3.4; 95% CI, 1.3-8.7) and mortality (relative risk, 2.9; 95% CI, 2.0-4.2).LimitationsUnderestimation of prevalence of COVID-19 skin signs due to exclusion of outpatient and discharged patients and the subjective assessment in the retrospective part.ConclusionCutaneous signs were significantly associated with severe/critical COVID-19 as well as death among 507 hospitalized patients in a Philippine COVID-19 referral hospital.