Freeman EE, McMahon DE, Lipoff JB, Rosenbach M, Kovarik C, Desai SR, Harp J, Takeshita J, French LE, Lim HW, Thiers BH, Hruza GJ, Fox LP, et al.
Journal of the American Academy of Dermatology. Date of publication 2020 Oct 1;volume 83(4):1118-1129.
1. J Am Acad Dermatol. 2020 Oct;83(4):1118-1129. doi: 10.1016/j.jaad.2020.06.1016.
Epub 2020 Jul 2.
The spectrum of COVID-19-associated dermatologic manifestations: An international
registry of 716 patients from 31 countries.
Freeman EE(1), McMahon DE(2), Lipoff JB(3), Rosenbach M(3), Kovarik C(3), Desai
SR(4), Harp J(5), Takeshita J(3), French LE(6), Lim HW(7), Thiers BH(8), Hruza
GJ(9), Fox LP(10).
Author information:
(1)Department of Dermatology, Massachusetts General Hospital, Harvard Medical
School, Boston, Massachusetts; Medical Practice Evaluation Center, Mongan
Institute, Massachusetts General Hospital, Boston, Massachusetts. Electronic
address: efreeman@mgh.harvard.edu.
(2)Department of Dermatology, Massachusetts General Hospital, Harvard Medical
School, Boston, Massachusetts.
(3)Department of Dermatology, University of Pennsylvania, Philadelphia,
Pennsylvania.
(4)Department of Dermatology, The University of Texas Southwestern Medical
Center, Dallas, Texas; Innovative Dermatology, Plano, Texas.
(5)Department of Dermatology, Weill Cornell Medicine, New York, New York.
(6)Department of Dermatology, University Hospital, Munich University of Ludwig
Maximilian, Munich, Germany; Department of Dermatology, Dr Phillip Frost
Department of Dermatology and Cutaneous Surgery, Miller School of Medicine,
University of Miami, Miami, Florida.
(7)Department of Dermatology, Henry Ford Health System, Detroit, Michigan.
(8)Department of Dermatology and Dermatologic Surgery, Medical University of
South Carolina, Charleston, South Carolina.
(9)Department of Dermatology, St. Louis University, St Louis, Missouri.
(10)Department of Dermatology, University of California San Francisco, San
Francisco, California.
BACKGROUND: Coronavirus disease 2019 (COVID-19) has associated cutaneous
manifestations.
OBJECTIVE: To characterize the diversity of cutaneous manifestations of COVID-19
and facilitate understanding of the underlying pathophysiology.
METHODS: Case series from an international registry from the American Academy of
Dermatology and International League of Dermatological Societies.
RESULTS: The registry collected 716 cases of new-onset dermatologic symptoms in
patients with confirmed/suspected COVID-19. Of the 171 patients in the registry
with laboratory-confirmed COVID-19, the most common morphologies were
morbilliform (22%), pernio-like (18%), urticarial (16%), macular erythema (13%),
vesicular (11%), papulosquamous (9.9%), and retiform purpura (6.4%). Pernio-like
lesions were common in patients with mild disease, whereas retiform purpura
presented exclusively in ill, hospitalized patients.
LIMITATIONS: We cannot estimate incidence or prevalence. Confirmation bias is
possible.
CONCLUSIONS: This study highlights the array of cutaneous manifestations
associated with COVID-19. Many morphologies were nonspecific, whereas others may
provide insight into potential immune or inflammatory pathways in COVID-19
pathophysiology.
Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc.
All rights reserved.
DOI: 10.1016/j.jaad.2020.06.1016
PMCID: PMC7331510
PMID: 32622888 [Indexed for MEDLINE]
