Cutaneous Manifestations of SARS-CoV-2 Infection

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the coronavirus disease 2019 (COVID-19) pandemic, affecting people worldwide. SARS-CoV-2 infection is a multisystem disease with potential for detrimental effects on various systemic organs. It affects people of all ages with varying degrees of disease severity. Patients with SARS-CoV-2 infection commonly present with dry cough, fever, and fatigue. A clinical spectrum of skin findings secondary to SARS-CoV-2 has also been reported. The most common cutaneous patterns associated with COVID-19 are chilblain-like lesions (CBLL), maculopapular lesions, urticarial lesions, vesicular lesions, and livedoid lesions. Other skin findings secondary to SARS-COV-2 infection are erythema multiforme (EM)-like lesions and skin findings associated with multisystem inflammatory syndrome in children (MIS-C) and rarely multisystem inflammatory syndrome in adults (MIS-A). Physician awareness of skin manifestations of SARS-CoV-2 infection can help with early identification and treatment. This narrative review provides an update of various skin manifestations reported with SARS-CoV-2 infection, including clinical presentation, proposed pathogenesis, histopathology, prognosis, and treatment options.

Granuloma annulare after SARS-CoV-2 vaccination: A case report and a literature review

“…During the Cov-19 pandemic, many studies reported a wide spectrum of cutaneous reactions after both SARS-CoV-2 infection and COVID-19 vaccination [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] .…”

Prevalence of cutaneous manifestations in COVID‐19: A meta‐analysis

“…Some skin manifestations are more common in severe patients, urticarial eruptions are usually an indicator of severe disease. 34 A study in Spain indicates that 19% of COVID‐19 patients had urticarial lesions, which is a bad prognosis, as the mortality rate is 2%. 12 COVID‐19 adults with livedoid lesions tend to need intensive care support.…”

“…Our subgroup analysis revealed that I 2 value of studies including severe COVID‐19 patients was 0.0%, indicating that the severity of COVID‐19 was probably the source of heterogeneity in our study. Some skin manifestations are more common in severe patients, urticarial eruptions are usually an indicator of severe disease 34 . A study in Spain indicates that 19% of COVID‐19 patients had urticarial lesions, which is a bad prognosis, as the mortality rate is 2% 12 .…”

How to differentiate skin rash in covid, mononucleosis, chickenpox, sixth disease and measles

“…Duration of vesicular eruption has been reported to range between 8 and 10 days [1]. Histology varies according to the lesion ‘age’: ‘early lesions’ feature basal layer vacuolar degeneration, multinucleated and hyperchromatic keratinocytes with dyskeratotic apoptotic cells, and minimal to absent inflammatory infiltrate, while ‘late lesions’ show intraepidermal unilocular vesicles containing multinucleated and ballooned keratinocytes with acantholytic and dyskeratotic cells along with epidermal reticular degeneration [11]. Although diffuse vesicular eruptions, with lesions developing simultaneously on the trunk and spreading distally with possible involvement of the palms and soles have been reported, localized forms with scattered lesions are the most frequent presentations [1,4,12].…”