The Dermatological Spectrum of Coronavirus Disease-19 Disease: Cutaneous Signs for Diagnostics and Prognosis and an Expanded Classification

Abstract

During severe acute respiratory syndrome coronavirus (CoV)-2- induced CoV disease (COVID)-19 pandemic cutaneous signs of the disease gained increasing interest for early diagnosis, to establish a prognosis and for differential diagnoses. The present review aims to summarize current knowledge on cutaneous findings in COVID-19. The findings are classified and described clinically. The spectrum of cutaneous signs include acro-ischemic lesions, rash, chilblain-like eruptions, and androgenetic alopecia. Their significance is given, and treatment options are presented. This may allow the clinicians to support triage and optimal treatment for COVID-19 patients.
 Key Bullets
 • _The COVID-19 pandemic has affected patients world-wide. Despite the leading symptoms are in the respiratory, cardiovascular, hematologic, and neurologic systems, cutaneous manifestations are increasingly be observed.
 • _Cutaneous findings in COVID-19 patients may have prognostic and therapeutic consequences. This review attempts to classify cutaneous symptoms, document the observed frequency of their occurrence, the significance for triage of COVID-19-patients, and the treatment of cutaneous manifestations.

Nails and COVID ‐19 – A comprehensive review of clinical findings and treatment

“…One of the most frequently observed cutaneous sign is the COVID‐toe or ‐finger, a pernio‐like periungual erythematous edema (Figure 1). Pernio‐like lesions on the fingers or toes typically occur as part of a resolution phase, milder or asymptomatic course of COVID‐19, whereas livedoid lesions and retiform purpura are associated with coagulopathy and more severe disease 3–6 . In one study on 54 patients cryofibrinogenemia was detected in 66.7% 9 …”

“…Pernio-like lesions on the fingers or toes typically occur as part of a resolution phase, milder or asymptomatic course of COVID-19, whereas livedoid lesions and retiform purpura are associated with coagulopathy and more severe disease. [3][4][5][6] In one study on 54 patients cryofibrinogenemia was detected in 66.7%. 9 Kanitakis et al (2020) studied 17 patients with suspected but unconfirmed SARS-CoV-2 infection and pernio-like acral lesions.…”

“… 2 The dermatological signs of this systemic infection have been now categorized and have obtained a much better awareness. 3 , 4 , 5 , 6 …”

“…Although cutaneous manifestations have only rarely been mentioned in the early reports from Wuhan, China, they gained increasing attention later when the pandemic affected Europe and America 2 . The dermatological signs of this systemic infection have been now categorized and have obtained a much better awareness 3–6 …”