Marzano AV, Cassano N, Genovese G, Moltrasio C, Vena GA, et al.
The British journal of dermatology. Date of publication 2020 Sep 1;volume 183(3):431-442.
1. Br J Dermatol. 2020 Sep;183(3):431-442. doi: 10.1111/bjd.19264. Epub 2020 Jul 5.
Cutaneous manifestations in patients with COVID-19: a preliminary review of an
emerging issue.
Marzano AV(1)(2), Cassano N(3), Genovese G(1)(2), Moltrasio C(1), Vena GA(3).
Author information:
(1)Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico,
Milan, Italy.
(2)Department of Pathophysiology and Transplantation, Università degli Studi di
Milano, Milan, Italy.
(3)Dermatology and Venereology Private Practice, Bari and Barletta, Italy.
BACKGROUND: The infection caused by the recently identified SARS-CoV-2, called
coronavirus disease-19 (COVID-19), has rapidly spread throughout the world. With
the exponential increase of patients worldwide, the clinical spectrum of COVID-19
is being better defined and new symptoms are emerging. Numerous reports are
documenting the occurrence of different cutaneous manifestations in patients with
COVID-19.
OBJECTIVES: To provide a brief overview of cutaneous lesions associated with
COVID-19.
METHODS: A literature search was performed in the PubMed, Scopus and Web of
Science databases up to 30 April 2020. This narrative review summarizes the
available data regarding the clinical and histological features of
COVID-19-associated skin manifestations.
RESULTS: The literature reports showed a great heterogeneity in
COVID-19-associated cutaneous manifestations, as well as in their latency periods
and associated extracutaneous symptoms. Pathogenic mechanisms are unknown,
although the roles of a hyperactive immune response, complement activation and
microvascular injury have been hypothesized. Based on our experience and the
literature data, we subdivided the reported cutaneous lesions into six main
clinical patterns: (i) urticarial rash; (ii) confluent
erythematous-maculopapular-morbilliform rash; (iii) papulovesicular exanthem;
(iv) chilblain-like acral pattern; (v) livedo reticularis-livedo racemosa-like
pattern; and (vi) purpuric 'vasculitic' pattern. These six patterns can be merged
into two main groups: the first - inflammatory and exanthematous - includes the
first three groups listed above, and the second includes the vasculopathic and
vasculitic lesions of the last three groups.
CONCLUSIONS: The possible presence of cutaneous findings leading to suspect
COVID-19 puts dermatologists in a relevant position. Further studies are needed
to delineate the diagnostic and prognostic values of such cutaneous
manifestations.
© 2020 British Association of Dermatologists.
DOI: 10.1111/bjd.19264
PMCID: PMC7300648
PMID: 32479680 [Indexed for MEDLINE]
