1. Presentation and Management of Cutaneous Manifestations of COVID-19
- Author
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Guilerme Almeida, Neil S. Sadick, Elaine Marques, Nichola Michalany, and Suleima Arruda
- Subjects
Adult ,Male ,medicine.medical_specialty ,Livedo ,Adolescent ,Disease ,Skin Diseases ,Diagnosis, Differential ,Young Adult ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Medical history ,Child ,Chilblains ,Aged ,Retrospective Studies ,Livedo reticularis ,business.industry ,COVID-19 ,Disease Management ,Infant ,General Medicine ,Middle Aged ,medicine.disease ,Dermatology ,Purpura ,Child, Preschool ,030220 oncology & carcinogenesis ,Female ,Chills ,medicine.symptom ,Differential diagnosis ,business - Abstract
INTRODUCTION: The spread of the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has instigated a fervent race of the medical community to identify its manifestations, the patients at risk, and optimal disease management. While the COVID-19 illness is largely associated with respiratory consequences, there is increased reporting of other organ-specific disease sequelae that include the skin. OBJECTIVE: To identify, describe, and classify the main skin manifestations of COVID-19 and associated protocols for management. METHODS: Forty-five patients from three clinical centers in North and South America with positive COVID-19 PCR and/or serology presenting cutaneous manifestations were included in this retrospective chart review. Medical history, biopsies, dermoscopy, laboratory findings, clinical photography, and disease management were documented. RESULTS: Seven main types of cutaneous manifestations were identified: exanthema/molbilliform, urticaria, papular/pustular/vesicular, petechiae/purpura, livedo reticularis, chilblains, and alopecia. Histopathogical analysis from skin biopsies and/or dermoscopy highlighted an inflammatory or vascular pathophysiology depending on the type of manifestation. While the first three types of COVID-19 skin manifestations preceded or coincided with other symptoms such as anosmia, fever, chills, chilblains, and livedo were found in later disease stages. All cases had a positive resolution with appropriate treatment. CONCLUSIONS: Cutaneous symptoms are part of the COVID-19 disease spectrum. Early identification, diagnosis, and management through a multidisciplinary approach can facilitate safe disease resolution for patients. J Drugs Dermatol. 2021;20(1):76-83. doi:10.36849/JDD.2021.5676.
- Published
- 2020
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