The Impact of COVID-19 Pandemic on Dermatological Conditions: A Novel, Comprehensive Review

Abstract

Background: The earliest cases of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, in December 2019. Since the declaration as a pandemic on 11 March 2020, further dermatological conditions continue to be documented. We herein present a novel literature review of dermatological manifestations associated with the Coronavirus Disease 2019 (COVID-19) pandemic. To date, this literature review is the first broad-spectrum examination that analyzes a range of dermatological manifestations related to the COVID-19 pandemic: infection, vaccinations, personal protective equipment (PPE), and psychosocial factors. Methods: A detailed literature search was conducted using key terms for cutaneous manifestations associated with the scope of this review. The search retrieved 2199 articles. Results: The COVID-19 pandemic has triggered a significant range of dermatologic sequela. Etiologies of lesions continue to be investigated. Proposed mechanisms include inflammatory response to spike protein, vitamin D deficiency, ACE2 receptor activation, androgen levels, and increased psychological stress. One prominent mechanism describes viral spike protein invasion into the dermis by binding to the angiotensin-converting enzyme 2 (ACE-2) receptors in keratinocytes, with a secondary immunological response. Conclusions: Dermatologists play an integral role in the proper diagnosis and treatment of COVID-related lesions. Early treatment regimens and timely prophylaxis have been shown to safely reduce infection-related dermatological sequelae. Additional investigations and data collection can reduce disease burden and improve overall prognosis.

Relevant Dermatoses Among U.S. Military Service Members: An Operational Review of Management Strategies and Telemedicine Utilization

“…With the ongoing SARS-CoV-2 pandemic and the recent emergence of the mutated monkeypox virus, novel and infectious cutaneous conditions continue to emerge [256][257][258][259]. Monkeypox virus belongs to the Orthopoxvirus genus in the family Poxviridae [257].…”

A Call to Action: Evidence for the Military Integration of Teledermoscopy in a Pandemic Era

“…When compared to in-person evaluations, teledermatology offers matched diagnostic accuracy in skin disease [ 13 ]. The most common skin conditions requiring teledermatology consultation include acne, atopic dermatitis, hair loss, and skin cancer [ 14 ]. Of note, patients with suspicious lesions should always consult board-certified dermatologists for a full body skin examination.…”

“…Additionally, teledermatology can be utilized to manage common ambulatory dermatoses and assess cutaneous manifestations of COVID-19 infections [ 33 ]. Such cutaneous manifestations include morbilliform rash, varicella-like rash, and livedo reticularis [ 14 ]. Many of these mild cutaneous conditions resolve spontaneously without medical intervention [ 14 ].…”

“…Such cutaneous manifestations include morbilliform rash, varicella-like rash, and livedo reticularis [ 14 ]. Many of these mild cutaneous conditions resolve spontaneously without medical intervention [ 14 ].…”

“…Additionally, with the recent emergence of the mutated Monkeypox virus, new cutaneous conditions continue to develop [ 14 , 35 , 36 , 37 ]. The rash associated with Monkeypox infection begins as a maculopapular rash that transforms into vesicles that scab and crust.…”