Recalcati S. Cutaneous manifestations in COVID-19: a first perspective [published online ahead of print, 2020 Mar 26]. J Eur Acad Dermatol Venereol. 2020;10.1111/jdv.16387. doi:10.1111/jdv.16387
Erythematous rash, widespread urticaria, and chickenpox-like vesicles, acrosyndrome may occur in asyntomatic individuals as possible carriers.
We have to pay more attention to cutaneuous findings in this time.
An erythematous exanthem (including a lacy pattern and a petechial, dengue-like rash)
Livedo reticularis
Cutaneous vasculitis
Acute urticaria
Chickenpox-like blisters
'COVID toes' in which there are digital infarcts resulting in black crusted lesions on the tips of fingers and toes, which are described as like pernio/chilblains or frostbite
We need more papers to confirm and better understand skin involvement in COVID19
These authors provided a summary of the skin manifestations to be under suspicion Covid 19
https://13wham.com/news/coronavirus/covid-toes-other-rashes-latest-possible-rare-virus-signs
An early report from dermatologists working with COVID-19 patients in Italy found that, in a group of 88 confirmed positive patients, 20% developed skin symptoms, with a little under half developing a rash at the onset of disease, and a little more than half developing it after hospitalization. Of the affected patients, the most common manifestation was erythematous rash, or a patchy red rash. A few developed urticaria, or hives, and one developed chickenpox-like blisters. The trunk was the most commonly involved site.
Whao! There is so much to unfold gradually about COVID-19. However are this skin manifestation solely due to COVID-19 or the bodies response to the infection. Could they be due to drugs used during the management? Can the cutaneous manifestations be explained pathophysiologically?
Interesting questions !We observed a lot of different clinical cases but we need to go in depth by linking the cutaneous manifestations to different stages of covid 19 activity and to post-infectious reactions as observed after others viral infections . We are trying to find the relationship between thrombotic occlusions of cutaneous vessels, direct damage from the virus and endothelial damage from uncontrolled inflammatory reaction. in It is necessary in all cases to have the correspondent histological features in order to understand the pathophysiology of the damage.
This is a complex interdisciplinary work in progress which needs great efforts from both patients and researchers
Although COVID-19-associated cutaneous manifestations have been increasingly reported, their exact incidence has yet to be estimated, their pathophysiological mechanisms are largely unknown, and the SARS-CoV-2 role in their pathogenesis is still debated. We describe the clinical and histopathological features of 2 Italian patients with different cutaneous presentations after COVID-19 infection, observed and followed at the P.O. Sandro Pertini ASL Roma2. Both patients had COVID-19 positive serological tests, negative RT-PCR test for COVID-19 virus, negative for other viral and bacterial agents tests suggesting that COVID-19 infection can give rise to cutaneous manifestations through mechanisms that are not known yet, even after the elimination of the virus by the organism. Skin lesions decreased and disappeared after systemic corticosteroid therapy suggesting an immune-mediated inflammatory reaction.