Cutaneous manifestations of COVID ‐19: A review of the published literature

Abstract

COVID‐19 is a highly contagious respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2. COVID‐19 outbreak, which caused thousands of deaths, has been declared a pandemic by the World Health Organization in March 2020. The infection has been reported to demonstrate different types of cutaneous manifestations including urticarial, maculopapular, papulovesicular, purpuric, livedoid, and thrombotic‐ischemic lesions. Given the high mortality rate of the infection, timely and accurate identification of relevant cutaneous manifestations may play a key role in the early diagnosis and management. In this study, we provide a review with a focus on the reported cutaneous manifestations of COVID‐19.

Inflammation and Vascular Injury as the Basis of COVID-19 Skin Changes: Preliminary Analysis of 23 Patients from the Literature

“…By reviewing the current published literature, Elmas revealed that the cutaneous manifestations of COVID-19 included urticarial, maculopapular, varicellalike, purpuric, livedoid, and thrombotic-ischemic rashes. 11 There are studies that classify the skin changes of COVID-19 according to the features of skin lesions. Galván Casaset al conducted a rapid prospective nationwide analysis in Spain and suggested that cutaneous manifestations of COVID-19 might be classified as acral areas of erythema with vesicles or pustules, other vesicular eruptions, urticarial lesions, maculopapular eruptions and livedo or necrosis based on the study.…”

Clinical and Laboratory Diagnosis of SARS-CoV-2, the Virus Causing COVID-19

“… 33 − 35 Major manifestations observed in COVID-19 patients including different types of lesions such as purpuric, papulovesicular, livedoid, urticarial, maculopapular, and thromboticischemic. 36 …”

Manifestações Cutâneas Associadas à COVID-19: Uma Revisão Narrativa

“…29 Podem associar-se a doença sistémica ou não, sendo que no primeiro caso se incluem condições hematológicas, reumáticas, cardiovasculares e infeciosas. 67 Em contexto de infeção a ocorrência de trombose deve-se à invasão das células endoteliais pelo agente infecioso ou à ativação da cascata da coagulação, que pode variar entre fenómenos subclínicos, apenas com aumento ligeiro dos marcadores associados à formação de fibrina e trombina, e coagulação intravascular disseminada (CID). 68 Manalo et al reportaram livedo reticular assintomático, transitório, em dois doentes com quadros ligeiros de COVID-19, pressupondo uma correlação entre o grau de oclusão provocada por microtromboses e a gravidade da infeção, embora com algumas limitações, já que não tiveram acesso a estudo analítico ou biópsia cutânea.…”