Abstract
Background: COVID-19 is associated with a wide range of skin manifestations. Objective: To describe the clinical characteristics of COVID-19–associated skin manifestations and explore the relationships among the 6 main cutaneous phenotypes and systemic findings. Methods: Twenty-one Italian Dermatology Units were asked to collect the demographic, clinical, and histopathologic data of 200 patients with COVID-19–associated skin manifestations. The severity of COVID-19 was classified as asymptomatic, mild, moderate, or severe. Results: A chilblain-like acral pattern was significantly associated with a younger age (P <.0001) and, after adjusting for age, significantly associated with less severe COVID-19 (P =.0009). However, the median duration of chilblain-like lesions was significantly longer than that of the other cutaneous manifestations taken together (P <.0001). Patients with moderate/severe COVID-19 were more represented than those with asymptomatic/mild COVID-19 among the patients with cutaneous manifestations other than chilblain-like lesions, but only the confluent erythematous/maculo-papular/morbilliform phenotype was significantly associated with more severe COVID-19 (P =.015), and this significance disappeared after adjustment for age. Limitations: Laboratory confirmation of COVID-19 was not possible in all cases. Conclusions: After adjustment for age, there was no clear-cut spectrum of COVID-19 severity in patients with COVID-19–related skin manifestations, although chilblain-like acral lesions were more frequent in younger patients with asymptomatic/pauci-symptomatic COVID-19.
Original language | English |
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Pages (from-to) | 1356-1363 |
Number of pages | 8 |
Journal | Journal of the American Academy of Dermatology |
Volume | 84 |
Issue number | 5 |
DOIs | |
Publication status | Published - 2021 |
Keywords
- coronavirus
- COVID-19
- infection
- SARS-CoV-2
- skin manifestations
- adult
- age
- aged
- Article
- chilblain
- clinical feature
- coronavirus disease 2019
- demography
- disease association
- disease duration
- disease severity
- female
- histopathology
- human
- livedo reticularis
- maculopapular rash
- major clinical study
- male
- measles like rash
- multicenter study
- phenotype
- priority journal
- risk factor
- skin manifestation
- clinical trial
- Italy
- middle aged
- onset age
- pathology
- severity of illness index
- viral skin disease
- virology
- Adult
- Age of Onset
- Aged
- Chilblains
- Humans
- Male
- Middle Aged
- Severity of Illness Index
- Skin Diseases, Viral