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To the Editor: Reported cutaneous manifestations incidence during COVID‐19 infection varied between countries, a recent review showed a worldwide mean incidence of 1.7%. These manifestations are polymorphic, and vary dependently on the disease severity. Few pityriasis rosea (PR) and PR‐like eruptions have been reported during COVID‐19 infection.

International audience; The link between SARS‐CoV‐2 and the reported cutaneous manifestations has not been established. We assessed a possible correlation between the paediatric dermatological manifestations and the biological investigations, using for the first time 3 different SARS‐CoV‐2 tests.

The COVID‐19 pandemic has limited dermatologic care with >50% decrease in the number of patients seen and biopsies completed1. Even after this pandemic has passed, social distancing may limit the number of patients seen in‐person and telemedicine will likely play a larger permanent role.

The COVID‐19 pandemic has disproportionally affected men.1 Men infected with SARS‐CoV‐2 are more than twice as likely to be admitted to the intensive care unit (ICU).2 This disparity in ICU admissions suggests the important role of androgens in COVID‐19 severity.3 Previously, we reported that among 122 men hospitalized due to COVID‐19, 79% were diagnosed with androgenetic alopecia (AGA),4 which is commonly treated with anti‐androgens. Anti‐androgens commonly used in the treatment of AGA such as finasteride, dutasteride, spironolactone, and bicalutamide could improve outcomes among men infected by SARS‐CoV‐2.

We have read with great interest the publication by Herman, et al., which reported occurrence of drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug‐induced hypersensitivity syndrome (DiHS), in a COVID‐19 patient:1 the patient developed DiHS/DRESS 17~18 days after starting azithromycin and hydroxychloroquine.

Toxic Epidermal Necrolysis (TEN) is classified as severe cutaneous adverse reaction. It can be induced by drugs, infection, and malignancy or can be idiopathic. We present a 62‐year‐old male of Indian origin with a widespread, tender, erythematous maculo‐papular eruption and targetoid lesions on the palms and soles. He had a history of multiple myeloma and a stem cell transplant in 2008. He was recently started on amoxicillin for a suspected lower respiratory tract infection and lenalidomide, septrin and allopurinol 6 weeks prior to presentation due to a relapse of the myeloma. The rash evolved into large areas of flaccid blistering (over 30% of the body surface area) with severe mucosal involvement (Fig.1a) and a diagnosis of TEN was made.

Psoriasis is a chronic inflammatory disease associated with comorbidities known to increase risk of severe COVID‐19, such as hypertension, cardiovascular disease, diabetes and obesity.1,2 Use of systemic therapies may increase a patient’s risk of infections.3 Our study aims to evaluate the association of psoriasis systemic therapy and COVID outcomes.

Chilblain‐like1‐3 and erythema multilforme‐like4 lesions represent the most reported and studied acral skin eruptions occurring in the pediatric age during the SARS‐CoV‐2 pandemic. In the same period, we observed a peculiar acral eruption in pediatric patients. Five children (4 females and 1 male) aged from 1 to 4 years (mean age: 3 years) presented erythema and oedema involving the palmar (5/5 cases) and plantar (3/5) surfaces. The most affected sites where thenar and hypothenar areas, and the fingertips. After some days, an intense superficial desquamation with a centrifugal pattern of expansion occurred (figure 1).

Patients with novel coronavirus disease 2019 (COVID‐19) can present with a wide variety of cutaneous manifestations. Drug‐induced eruptions, however, are often indistinguishable from the COVID‐19‐related rash

For Malignant Melanoma (MM), the Breslow thickness and the presence of ulceration are important elements for determining the staging and prognosis1. Skin cancer screening and dermoscopic examination allowed an earlier recognition of cutaneous MM, causing especially an over‐detection of thin lesions, without a proportional decline in later‐stage disease2. Furthermore, the incidence of thicker MMs does not seem to be decreasing3;4.

We herein describe the case of a 33‐year‐old male patient who presented at our emergency department with concomitant flu symptoms and a maculopapular rash. The evening prior to consultation he had first noticed erythematous macules on the trunk and arms, which had then rapidly progressed overnight. The rash was markedly pronounced at injection sites of interferon‐beta (IFN‐β) administered for relapsing remitting multiple sclerosis (RRMS) (see Fig. 1a). Pruritus was moderate (3/10 numeric rating scale). Fever up to 38°C, fatigue, hoarseness and muscle and joint pain had begun four days prior to consultation. Another four days earlier, the patient and his family had visited a private party. Some of the guests as well as the patient’s wife and children experienced equivalent flu symptoms albeit no skin eruptions.

Vulnerability to coronavirus disease 2019 (COVID‐19) in patients with cardiovascular risk factors is well known. However, the prognostic influence of immunosuppressive drugs or their ability to counteract the cytokine storm involving critically‐ill patients are uncertain. The scarce related literature mainly involves transplantation.

Reports on COVID‐19 in children are limited. Despite new data emerging, and understanding of the disease improves rapidly, there are as yet several features and complications related to the disease that remain unknown. Herein, we report the first case of a child with chilblains and retinal vasculitis related to COVID‐19.

Throughout March and April 2020, dermatologists have observed an outbreak of chilblains despite climatic conditions not conducive to their apparition. These lesions have occurred simultaneously to the COVID‐19 epidemic, suggesting a relationship between their onset and SARS‐CoV‐2 infection. Here we describe a series of 10 patients presenting chilblain‐like lesions in whom we have searched for evidence of SARS‐CoV‐2 infection.

Dermatological manifestations of the Coronavirus Disease 2019 (COVID‐19) may include unspecific macular erythematous rash, urticarial lesions and chickenpox‐like vesicles1,2. Acroischemic lesions have been described in two different types of COVID‐19 patients. Firstly, critically ill patients with severe limb ischemia and secondly, paucisymptomatic young patients with chilblain‐like lesions3. The etiopathogenesis and clinical implications of these lesions remains unclear.

A Dermatology walk‐in clinic available to all hospital staff (HS) was commenced to treat skin problems related to personal protective equipment (PPE) during the COVID‐19 pandemic. An observational case series was conducted in a single district general hospital within Wales (United Kingdom) to record the dermatological diagnoses. Our participant sample comprised of clinical and non‐clinical staff working in COVID‐19 and non‐COVID‐19 areas of the hospital. Over the data collection period (6 weeks), a total of 72 patients attended the clinic of whom 62 were female and 10 were male (mean age = 43yrs). Data comprised of demographic data, current occupation (shown in Table 1), duration of symptoms, past medical history, regular medication and treatment interventions. An analysis of the clinical diagnoses seen are reported in Table 2.

A‐83‐year‐old man was admitted on the 3rd of April 2020 for respiratory distress. He had presented with fever the 20th of march. On the 2nd of April he had an acute pain of both legs associated with discoloration. He was admitted to the emergency room on the following day. His temperature was 38°C, he was dyspneic despite oxygen. He had bilateral and symmetrical well limited black skin on both legs (Figure).

SARS‐CoV‐2 is a new coronavirus that causes COVID‐19, a disease associated with severe pneumonia.1 Many other clinical manifestations have been associated with the disease (diarrhoea, anosmia, dysgeusia, etc.) and patients can be healthy carriers of the virus.2 Several dermatologic manifestations associated with COVID‐19 have been reported.3 Among them are numerous cases of chilblain‐like lesions (CBLL) in young patients in good general condition, often not tested, or tested negative, for the SARS‐CoV‐2.4,5 In a recent study on 375 Spanish patients with suspected or confirmed COVID‐19, these CBLL accounted for 19% of all cutaneous lesions;3 they were observed in young patients with mild systemic symptoms and seemed to appear late in the course of the disease.

Coronavirus disease 2019 (COVID‐19), caused by severe acute respiratory syndrome‐related coronavirus 2 (SARS‐CoV‐2), was first reported in China on December 2019. Almost 5 months into the pandemic, little is still known about cutaneous manifestations in COVID‐19. In fact, the prevalence of cutaneous signs varies greatly in the literature, ranging from 0.2% to 20.4%. Given their potential association with COVID‐19, acral lesions have received special attention worldwide, both in the medical literature and the media. Our aim is to share our experience regarding acral manifestations during this pandemic.

Coronavirus 19 (COVID‐19) was declared as a pandemic viral infection by the World Health organization on March 11th 2020. Usual clinical manifestations of COVID‐19 infection include fever, fatigue, myalgia, headache, diarrhea, dry cough, dyspnea that may lead to acute respiratory distress syndrome and death (1). Skin symptoms of COVID‐19 have been poorly described but may include erythematous rash, urticaria and chicken pox like lesions (2‐7). Angiotensin‐converting enzyme 2 (ACE2) is a cellular receptor for COVID‐19.

International audience; Since the coronavirus disease 2019 (COVID 19) outbreak was first reported in the Chinese city of Wuhan on December 31, 2019, it has stricken more than 1,000,000 persons worldwide, of whom over 50,000 have died (1). Having been infected by severe acute respiratory syndrome coronavirus 2 (SARS‐COV‐2), patients with COVID‐19 mainly present with fever and respiratory symptoms (2). Isolated sudden onset anosmia has also frequently been reported (3). Less frequently, rhinorrhea, diarrhoea and dysgeusia may be associated. While only a few reports have evoked cutaneous manifestations (4), we read with interest an initial study on the topic entitled “Cutaneous manifestations in COVID‐19: a first perspective ” by Recalcati S. (5).

COVID‐19 pandemic raised questions both in dermatologists and in patients about the use of immunosuppressive medications. Although dermatologic societies recommend the continuing of psoriatic systemic therapies and biologics, little is known about treatment adherence in psoriatic patients during COVID‐19 outbreak. Medication self‐management may feel burdensome to patients with psoriasis due to the nature of treatments and many of them face additional challenges as they may suffer from comorbidities. Under these already difficult conditions, COVID‐19 disease puts extra pressure on individuals and may undermine adherence. Acknowledging treatment non‐adherence as a consequence of conflicting goals may help to find the reasons for but, most important, solutions to non‐adherence especially during public health crises. The objective of our study was to evaluate the adherence of psoriatic patients in traditional systemic treatment as well as biologics and identify possible influencing factors of drug interruption during COVID‐10 pandemic.

Emilia‐Romagna was one of the Italian regions mostly affected by the COVID‐19 pandemic and lockdown measures were taken to slow the COVID‐19 outbreak. All routine activities in Modena hospitals were suspended; however, urgent procedures were still to be performed. Setting the priority of procedures in oncological dermatology in the COVID‐19 era is challenging.

We read with great interest the article by Piccolo et al1. describing chilblain‐like lesions (CLL) on feet and hands during the COVID‐19 Pandemic. They mention the rate of association to autoimmune conditions was very low, which led the to exclude a note autoimmune disorder as main cause of CLL. Here, we hypothesize the possible relationship between the development of these lesions and immune‐chained phenomena following viral infection in a certain group of patients.

Since the outbreak of Coronavirus Disease (COVID‐19) pandemic began in Europe, a plethora of cutaneous manifestations have been related to this infection1,2. However, their underlying mechanism and prognostic relevance remain unclear. Thus, we collected data from all COVID‐19 cases presenting with skin manifestations in our hospital in Madrid during one month.

A novel Coronavirus strain, named “Severe Acute Respiratory Syndrome Coronavirus 2” (SARS‐CoV‐2) was recently identified as the etiological agent of the COronaVIrus Disease 2019 (COVID‐19). Interestingly, a consistent number of COVID‐19‐associated skin manifestations seem to share a certain degree of vascular damage as common pathogenetic mechanism1. Vascular injury may be due to the direct damage of endothelial cells by the virus or may represents an epiphenomenon of a dysregulated host inflammatory responses triggered by the infection2. Here, we describe an unprecedented case of leukocytoclastic vasculitis presenting with a hemorrhagic bullous eruption in a patient affected by COVID‐19.

We present a case of an 83‐year‐old woman with a history of hypertension, transient ischemic attack (TIA), atrial fibrillation, chronic renal impairment presented to our dermatology emergency room on April 9, 2020, for evaluation of purple palpable papules and serohaematic blisters on both her lower legs, feet and toes that had appeared 5 days earlier (Figure 1).

First cases of pneumonia with unknown cause were reported in Wuhan, China, in December 20191. The new pathogen, called SARS‐CoV‐2, has rapidly spread reaching the level of a pandemic disease. The worldwide diffusion of coronavirus disease 2019 (COVID‐19) is characterized by various clinical presentations and different related complications. This disease exacerbates in some patients and causes pulmonary edema, multiple organ failure and acute respiratory distress syndrome.

COVID‐19 is a disease caused by severe acute respiratory syndrome coronavirus 2 of the genus Betacoronavirus (SARS‐CoV‐2). It was first described in Wuhan (China) on December 2019 and has spread to become a pandemic. Its clinical presentation is mainly characterized by cough, fever and dyspnea, although many other symptoms have been described within its presentation pattern. In some cases, it causes an acute respiratory distress that has lead to the death of thousands of people around the world. Furthermore, different types of skin lesions have been described during the infection period of illness.1 In this exceptional situation of global health emergency, physicians are undertaking research work in order to achieve notions on the etiopathogenesis of these skin lesions. The first report of cutaneous manifestations described different forms of skin lesions such as erythematous rash, urticaria and chicken‐pox‐like vesicles.2 Further studies have classified 5 different type of skin lesions, and associated them with patient demographics, timing in relation to symptoms of the disease, severity and prognosis.

The pandemic of infection with the severe acute respiratory syndrome coronavirus (SARS‐CoV‐2) causing the atypical pneumonia coronavirus disease 19 (Covid‐2019) has become a global health emergency. In parallel with the spread of the infection, there are new information on cutaneous involvement reminiscent to autoimmune diseases and concerns about the risk of disease and management of patients with cutaneous autoimmunity under immunosuppression.

Over the past two decades, 3 zoonotic global coronavirus outbreaks have occurred: 1. SARS starting in 2002 in China due to SARS‐CoV; 2. MERS starting in 2012 in Saudi Arabia due to MERS‐CoV; 3. Covid‐19 due to SARS‐CoV‐2 starting in 2019 in Wuhan, China (1). Both beta‐coronaviruses, SARS‐CoV and MERS‐CoV caused a severe disease in most infected people.

The Editor in chief and Deputy Editors of the JAMA recently shared their concern regarding possible reporting of patients in more than one manuscript, while this has not been clearly indicated in the submission [1]. Although the unprecedented context of the COVID‐19 outbreak justifies efforts for rapid dissemination of knowledge, such practice may be responsible for inaccurate interpretation and overestimation of published data [1]. Similar concern applies to dermatology. In Spain, the national COVID Piel study have reported 372 patients with skin manifestations related with COVID‐19, including 71 patients with pseudo‐chilblains, from April 3rd to April 16th [2].

In December 2019, a new virus called severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) causing Coronavirus disease 2019 (COVID‐19) emerged in Wuhan, Hubei Province, China. SARS‐CoV‐2 is transmitted through respiratory droplets and object infected with droplets containing the virus. The diagnosis is made employing quantitative reverse transcriptase polymerase chain reaction to identify the viral nucleic acid in respiratory specimens or blood samples.

At the present time, the whole world is faced with coronavirus disease 2019 (Covid‐19). Cutaneous manifestations in these patients are being increasingly reported, including rash, acrocyanosis or urticaria(1). Exanthemas in covid‐19 patients are becoming frequent in our daily practice and they pose a challenge regarding their pathogenesis. We present a retrospective case series of twelve adult patients (6 male/6 female) with a mean age of 66,3 years (47‐79). All patients had pneumonia and nasopharyngeal swab PCR positive for SARS CoV‐2 and had received treatment for Covid‐19 per protocol established. Table 1 shows the characteristics of these patients.

SARS‐CoV‐2 has been hypothesized as the aetiologic agent of CLL, on the basis of the temporal correlation between the “burst” of skin manifestations and the viral pandemic, even though we have scarce evidence of swab‐confirmed infections. Authors have therefore suggested some pathogenetic mechanisms such as a delayed immune‐mediated reaction to the virus in genetically‐predisposed patients1 or an early IFN‐I response in young patients, muting early viral replication but also inducing microangiopathic changes.

as stated by Estébanez et al 1, incidence of dermatological affection in covid‐19 patients may be different than reported until now. Datas and evidences are building up every day and we wanted to add a contribution describing the case of a 67‐year‐old patient, caucasian, with moderate obesity, a history of alcoholism and various chronic morbidities. No drug allergy was referred. She was sent to ER due to progressive dyspnoea and fever: after RT‐PCR resulted positive to SARS‐CoV 2, she was admitted to hospital and then intubated a week later due to worsening of the respiratory condition.

The outbreak of COVID‐19 has stricken more than 203,000 people in Italy up to 30th of April 2020, with over 27,000 died according to official estimates1. While Italy was one of the most affected countries in Europe, the impact of the disease in the southern part of the state was less dramatic than in the north, due to some still not understood reasons. Particularly in Sicily, ‘only’ 3,140 cases have been recorded, of whom 533 encountered in the province of Messina.

Recently, young COVID‐19 patients have presented with erythematous and purpuric acral lesions similar to chilblains1–3. Despite the scarcity of published cases, this topic has attracted significant mass media attention.4 Dermatologists have noted that more people than would be expected at this time of year are seeking medical attention for these chilblain‐like lesions. Some have suggested that people presenting with this manifestation should be tested and isolated2. Determining the accuracy of this association is therefore crucial. To establish the real prevalence of COVID‐19 in patients with acral skin lesions, we firstly evaluated all the cases of acral lesions presented in dermatology and paediatrics departments and family doctors’ offices in an eastern Spanish region over a three‐week period. Then we prospectively performed a SARS‐CoV‐2 PCR on nasopharyngeal aspirates taken from all available patients to determine whether their cutaneous manifestations were predictive of a positive result. To put our findings into context, we reviewed all the articles published before May 2020 concerning COVID‐19 patients with cutaneous lesions. We evaluated 58 patients, whose characteristics are summarized in Table 1. In most cases, lesions were chilblain‐like. Fifteen patients had already been tested, and only one had a positive result: an 85‐year‐old man admitted for severe Covid‐19 pneumonia. He had an ulcer on a toe that was finally determined to be vascular in nature. We performed prospective PCR testing in 24 patients. All test results were negative. In total, then, PCR was negative in 38 patients and positive in a single patient whose lesion was very unlikely to be due to COVID‐19. Our bibliography search returned 97 articles and we found 2 more through cross‐references. Nine of these articles dealt with acral lesions specifically. Their results are summarized in Table 2. Data published in the literature are heterogeneous, as are the methods employed to collect them. The first papers looked at cutaneous manifestations in patients with confirmed SARS‐CoV‐2 infection.5–8 This approach cannot reveal whether this dermatologic manifestation is a specific marker of SARS‐CoV‐2 infection, since patients without COVID‐19 are not included. The other approach, which we have followed, is to analyse all patients with acral lesions. This can be done retrospectively, reporting on patients in the sample who have already been tested, or prospectively, performing the test on all available patients, regardless of whether they have symptoms. The retrospective method has a significant risk of confounding bias: due to the scarcity of COVID‐19 tests8, they are usually reserved for patients with COVID‐19‐related symptoms, who are obviously more likely to test positive. All previous studies including only patients with cutaneous acral lesions (summarized in table 2) have been retrospective, and only a minority of patients were tested. In total, 12 out of at least 49 tested patients were positive (24.5%). Combined with our results, they total 13 positives out of 88 tests (14.8%). There are two possible explanations for the high proportion of negative results: I) A high number of false negatives. II) The lesions are not related to SARS‐CoV‐2 infection. The low prevalence of an infected contact in our sample, after three weeks of strict confinement in Spain, makes the possibility of being infected in our cohort less likely. The diffusion of this entity by the mass media may have caused patients who would not normally consult to do so.9 . Other possible explanations include a concomitant parvovirus B19 outbreak10 or trauma‐induced lesions. Our study suggests that acral skin lesions are not a specific marker of SARS‐CoV‐2 infection. Although larger prospective studies are needed, current evidence indicates that acral skin lesions should not be regarded as a sign of COVID‐19 in otherwise asymptomatic patients.

Since the beginning of the COVID‐19 pandemic, different types of cutaneous manifestations have been reported. In Spain, there were reports in the first weeks of April 2020 of an increase in purpuric acral lesions similar to perniosis on the hands and especially the feet of children and young adults. These patients do not normally present with clinical manifestations linked to COVID‐19, and their PCR and serological tests are usually negative for specific IgM and IgG.

Dupilumab is a fully human monoclonal antibody against the alfa subunit of interleukin (IL)‐4 receptor that blocks signalling from both IL‐4 and IL‐13, which are key type 2 cytokines in the pathophysiology of atopic dermatitis (AD). It shows good efficacy with a rapid response and good safety with few side effects. In a paper of Deleuran et al. the authors showed long term safety and efficacy of dupilumab; they reported viral upper respiratory tract infection, cough and influenza in about 2% of patients.

we read with great interest the article entitled “Should SARS‐CoV‐2 influence immunosuppressive therapy for autoimmune blistering diseases?” published by Di Altobrando A. et al. in the JEADV. This is the first report of COronaVIrus DIsease 2019 (COVID‐19) in a patient affected by autoimmune blistering disease (ABD) during immunosuppressive treatment (i.e. azathioprine). The authors conclude that it is crucial to learn of more cases of ABD patients under immunosuppressive treatment who have developed COVID‐19, in order to better quantify the risk of infection under immunosuppressive therapy.

We read with great interest the publication of Messina et al 1 reporting the first case of SARS-CoV2 infection in a young patient of 32-year-old suffering from psoriasis and psoriatic arthritis treated by Guselkumab, a monoclonal antibody that targets specifically the p19 subunit of Interleukin (IL)-232 .The patient contracted the SARS-CoV2 infection after a dinner with some friends but fortunately she developed very discrete symptoms including only mild fever and rhinorrhea. These findings support the potential role of IL-23p19 inhibitors to counteract the « cytokine storm » triggered by the SARS-CoV2 and which is potentially implicated in the severity of the symptoms 3 ., SCOPUS: le.j, info:eu-repo/semantics/published

The coronavirus COVID‐19 pandemic, which emerged in Wuhan, China several months ago,1 has led to large‐scale lockdown in many countries around the world, including Spain. Uncertainty about the duration of these measures led us to consider the potential impact of diagnostic delays due to the paralyzation of certain health procedures and services on the prognosis of patients with melanoma.

The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is responsible for a pandemic that is causing thousands of deaths worldwide. The virus can be transmitted from person to person, directly or indirectly, via the respiratory, oro‐fecal and probably sexual routes.1 The eventual vertical transmission route is still poorly explored. However, mother‐to‐child SARS‐CoV‐2 transmission through the placenta probably does not occur, or likely occurs very rarely.2 All the studies conducted on COVID‐19 pregnant women involved patients undergoing cesarean section, but the indications for such delivery modality were not clearly stated.

The Italian National Health System is currently living through some catastrophic days, owing to the rapid spread of COVID‐19 across the country. At the time of writing, our Government has passed emergency laws (March 11, 2020), with a view to preventing widespread viral infection among the population, which may well lead to an increase in the number of people requiring intensive care unit (ICU) hospital treatment. Currently, most of the northern Italian regions are close to saturation point in terms of the number of available ICU inpatient beds.

We have read with great interest the article: Cutaneous manifestations in COVID‐19: a first perspective by Recalcati S.1 This article is the first report of the cutaneous manifestations in Coronavirus Disease 2019 (COVID‐19) patients during the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic in Lombardy, Italy.

Since December 2019, SARS‐CoV‐2 epidemic has spread all over the world.1 To date, few reports regarding the cutaneous involvement in COVID‐19 have been published.2,3 Herein, we report a four cases series describing skin lesions probably related with COVID‐19. The case 1 was a 66‐year‐old Caucasian female with a history of hypertension and dyslipidaemia. When hospitalized, she showed fever, nasal congestion and pneumonia symptoms. A chest‐TC displayed bilateral interstitial lungs’ involvement and a nasopharyngeal‐swab confirmed SARS‐CoV‐2 infection. At day 6 of hospitalization, an asymptomatic erythematous‐pomphoid skin rash occurred on the trunk (Figure 1A).

Global public health is currently dealing with the explosive spread of the novel Coronavirus disease 2019 (COVID‐19) [1]. This new type of viral pneumonia, spread from its first focus in Wuhan (Hubei, China) to across all the world, until a pandemic condition was declared. Clinically. the most common symptoms of the disease are cough and fever. More than 80% of patients have asymptomatic to moderate disease, but about 15% get severe pneumonia and 5% develope a multi‐organ failure [2].

International audience; Skins symptoms during COVID‐19 have been recently described but their relation to SARS‐CoV‐2 is unclear while results for real‐time reverse transcriptase polymerase chain reaction (rRT‐PCR) testing were variable. Recalcati et al. reported 14 cases of patients with skin symptoms consistent with previous described COVID‐19 lesions but all the patients were tested negative. They asked for a serology to validate the hypothesis that these lesions are related to COVID‐19.

With the COVID‐19 pandemic we are facing a changing world. This new coronavirus (SARS‐CoV‐2) poses new challenges to dermatologists too. Some of us are in the field, others are describing skin aspects related to this infection, either directly or indirectly caused (e.g: dermatoses resulting from prolonged contact with personal protective equipment and excessive personal hygiene). Still, cutaneous manifestations are uncommonly reported and the majority has no clinical or histological pictures.