Lessons From the First Wave of the Pandemic: Skin Features of COVID-19 Can Be Divided Into Inflammatory and Vascular Patterns

• Published in: Journal of Cutaneous Medicine and Surgery 2021-03, Vol.25 (2), p.169-176
• Main Authors: Naderi-Azad, Sheida, Vender, Ron
• Format: Article
• Language: English
• Subjects: Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - epidemiology; Disease transmission; Early Diagnosis; Humans; Pandemics; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Skin Diseases, Vascular - diagnosis; Skin Diseases, Vascular - etiology
• ISSN: 1203-4754; 1615-7109
• DOI: 10.1177/1203475420972343

This review examines the clinical, morphological, and systemic factors related to coronavirus disease 2019 (COVID-19) cutaneous manifestations. The EMBASE, Medline, and Pubmed Central databases were searched from February 1, 2020 until April 25, 2020, using the search words “(COVID-19 OR SARS-CoV-2 OR coronavirus-19) AND (skin OR cutaneous OR dermatologic)”. Cutaneous manifestations of COVID-19 were included. The cutaneous manifestations can be classified into 2 types. Patients with inflammatory reactions consisted of morbilliform, varicella-like, urticarial eruptions, and vesiculobullous manifestations. These manifestations were mainly found on the trunk, limbs, and faces of patients and had mainly positive COVID-19 polymerase chain reaction findings (97.7%). Furthermore, there were 516 patients with acral vascular lesions: chilblains, livedo lesions, cutaneous small-vessel vasculitis, and other noninflammatory purpura. These were often nonpruritic (88%) and not seen in severe disease (88.7%). The cutaneous lesions have potential for early diagnosis of COVID-19 and prevention of disease transmission. The implications of COVID-19 in the field of dermatology continue to evolve as more clinical data becomes available.