investigate further. First, the analysis did not include patients with similar clinical symptoms, i.e. cough or fever, but were tested negative. Since COVID-19 negative patients, likely with other viral infections, may also have similar skin manifestation as COVID-19 positive patients do, the difference in the prevalence and morphology of skin rash between COVID-19 positive and negative patients warrants comparisons. This would address whether the skin rashes of the three patterns described in the study (erythematous, urticarial and varicelliform) are specific to the COVID-10. Second, it is crucial to measure the viral load in different time points before, during and after the skin rashes in future studies. Viraemia and the skin exanthem may have different time kinetics in different viral infections. For example, viraemia of the measles peaks at the onset of skin rash, 7 whereas viraemia of the parvovirus B19 ends before the onset of skin rash. 8 Hence, the dynamic viral load and its reference to skin rash can become a vital clinical clue for the clinicians to determine the optimal timing (before, during or after the skin rash) to collect the samples for molecular identification. As we have observed the heavy burden of triage and shortage of essential medical goods posed by the outspread of COVID-19, the introduction of an easy clinical assessment tool like classic COVID-19 skin manifestation is a novel path to cope with the challenge that we are facing during the pandemic. However, this will take more studies to build up the validity and reliability. Dermatology's outlook in the COVID-19 is multidimensional, starting from the pathogenesis, public health issues to applying new technologies in clinical practice, the opportunities are infinite. Most importantly, we dermatologists as part of the medical community should contribute our unique perspective in the battle against this formidable pandemic.

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website.Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre -including this research content -immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. Fig 1. Purpuric skin rash in a patient with COVID-19 bilateral pneumonia, revealing purpuric, coalescing macules on (A) left and (B) right periaxillary regions.

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Fifty-three children who attended the emergency department with community-associated (CA) Staphylococcus aureus skin and soft tissue infections (SSTIs) were enrolled in the study. Seven cases of infection (13.2%) were due to methicillin-resistant S. aureus (MRSA). Twelve of 46 available isolates (26.1%) were Panton-Valentine leukocidin (PVL)-positive. PVL-positive S. aureus SSTIs were more frequently associated with abscesses and cellulitis (75% vs. 38%, p 0.028), and more commonly required incision and drainage (75% vs. 21%, p 0.001). Most PVL-positive CA-MRSA isolates belonged to a single multilocus sequence type (ST8). In contrast, PVL-positive methicillin-susceptible S. aureus isolates belonged to four different sequence types (ST8, ST30, ST80, ST120).