Cutaneous findings in hospitalized and critically ill patients with COVID-19: A case series of 15 patients

Strom, Mark A.; Trager, Megan H.; Timerman, Dmitriy; Coromilas, Alexandra; Burris, Katy; Belsito, D.; Eber, Ariel E.; Greenberg, Steven; Husain, Sameera; Lewin, John M.; Naka, Fludiona; Patrone, Christina C.; Coulon, Aaron; Cooper, Chelsea; Bartholomew, Frederick B.; Beck, Melissa; Dowd, Margaret; Ensslin, Courtney J.; Gallitano, Stephanie M.; Loesch, Eric; Malajian, Dana; Melnick, Laura; Niedt, George W.; Uwakwe, Laura N; Vu, Ha Linh; Walther, Robert R.; Geskin, Larisa J.

doi:10.1016/j.jaad.2020.10.014

Cited by 6 publications

(12 citation statements)

References 5 publications

(4 reference statements)

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“…However, these were selected cases for which a dermatology consult was requested. 9 Here we also describe clinical course among hospitalized adults with COVID-19 and mucocutaneous disease. Patients with eruptions had nearly twice the prevalence of mechanical ventilation, y Twelve patients who had ulcers of the cheek or chin were excluded from the analysis of the ventilation outcome, as it was difficult to discern whether these cutaneous manifestations were directly related to COVID-19 infection, patients being ventilated for a prolonged period, or a combination of both.…”

Section: Discussionmentioning

confidence: 98%

“…Several reports, case series, and 1 cross-sectional study of patients from the international medical community have described chilblain-like lesions involving the fingers and toes, maculopapular eruptions, livedo, petechiae, purpura, necrosis, wheals, and vesicles. 5,[8][9][10][11][12][13][14][15][16] The series of 171 confirmed, predominantly ambulatory COVID-19 cases from the American Academy of Dermatology's registry is an important resource for description of the breadth of mucocutaneous findings. 8 This registry also has limitations that impact the interpretation of observations.…”

Section: Discussionmentioning

confidence: 99%

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Eruptions and related clinical course among 296 hospitalized adults with confirmed COVID-19

Rekhtman

Tannenbaum

Strunk

et al. 2021

Journal of the American Academy of Dermatology

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Eruptions and related clinical course among 296 hospitalized adults with confirmed COVID-19

Rekhtman

Tannenbaum

Strunk

et al. 2021

Journal of the American Academy of Dermatology

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“… 12 COVID‐19 adults with livedoid lesions tend to need intensive care support. 35 Mohammed et al study 36 showed that vascular rashes in the spectrum of livedo/purpura/necrosis were significantly related to severe forms of COVID‐19. The skin manifestations related to COVID‐19 deserve physicians' continuous attention, especially in patients with severe COVID‐19 infection.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of cutaneous manifestations in COVID‐19: A meta‐analysis

Wen

et al. 2022

The Journal of Dermatology

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The global epidemic of coronavirus disease 2019 (COVID‐19) endangers more and more people. Many studies on cutaneous manifestations related to COVID‐19 have emerged, but their prevalence has varied widely. The objective of this study was to conduct a meta‐analysis estimating the prevalence of skin manifestations in COVID‐19. Four databases PubMed, Web of Science, CBM, and CNKI were searched, and the results were screened by two reviewers. A random‐effects model was used to evaluate the overall prevalence. Heterogeneity was assessed by I 2 . Further subgroup analyses were conducted by region, sample size, sex, age, and severity of COVID‐19. A funnel plot and Egger's test were performed to assess publication bias. The pooled prevalence of cutaneous manifestation of 61 089 patients in 33 studies was 5.6% (95% confidence intervals [CI] = 0.040–0.076, I 2 = 98.3%). Severity of COVID‐19 was probably the source of heterogeneity. Studies with sample size <200 report higher prevalence estimates (10.2%). The prevalence of detailed types was as follows: maculopapular rash 2%, livedoid lesions 1.4%, petechial lesions 1.1%, urticaria 0.8%, pernio‐like lesions 0.5%, vesicular lesions 0.3%. Petechial lesions and livedoid lesions contain a higher proportion of severe patients than other skin manifestations. The prevalence rates of pernio‐like lesions, urticaria and petechial lesions vary greatly in different regions.

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“…If CBLL presents with other SARS-CoV-2 symptoms, it indicates an overall good prognosis, as these lesions typically occur in mild SARS-CoV-2 cases [ 14 , 17 ]. In a case series study, Strom et al reported that no CBLL was seen in a group of 15 hospitalized and critically ill patients with SARS-CoV-2 infection [ 18 ]. CBLL are self-limiting, lasting from 10 to 14 days and occasionally for a few months [ 13 ].…”

Section: Chilblain-like/pernio-like Lesionsmentioning

confidence: 99%

“…Treatment options for livedoid lesions vary widely in pediatrics and adults. Intensive care support tends to be needed in adults with livedoid lesions [ 18 ]. In severe cases, necrosis may be present along with scabbing and sloughing of the skin.…”

Section: Livedoid Lesionsmentioning

confidence: 99%

Cutaneous Manifestations of SARS-CoV-2 Infection

et al. 2022

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the coronavirus disease 2019 (COVID-19) pandemic, affecting people worldwide. SARS-CoV-2 infection is a multisystem disease with potential for detrimental effects on various systemic organs. It affects people of all ages with varying degrees of disease severity. Patients with SARS-CoV-2 infection commonly present with dry cough, fever, and fatigue. A clinical spectrum of skin findings secondary to SARS-CoV-2 has also been reported. The most common cutaneous patterns associated with COVID-19 are chilblain-like lesions (CBLL), maculopapular lesions, urticarial lesions, vesicular lesions, and livedoid lesions. Other skin findings secondary to SARS-COV-2 infection are erythema multiforme (EM)-like lesions and skin findings associated with multisystem inflammatory syndrome in children (MIS-C) and rarely multisystem inflammatory syndrome in adults (MIS-A). Physician awareness of skin manifestations of SARS-CoV-2 infection can help with early identification and treatment. This narrative review provides an update of various skin manifestations reported with SARS-CoV-2 infection, including clinical presentation, proposed pathogenesis, histopathology, prognosis, and treatment options.

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Cutaneous findings in hospitalized and critically ill patients with COVID-19: A case series of 15 patients

Cited by 6 publications

References 5 publications

Eruptions and related clinical course among 296 hospitalized adults with confirmed COVID-19

Eruptions and related clinical course among 296 hospitalized adults with confirmed COVID-19

Prevalence of cutaneous manifestations in COVID‐19: A meta‐analysis

Cutaneous Manifestations of SARS-CoV-2 Infection

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