Cutaneous Manifestations of Covid-19: A review of the Literature

Many different cutaneous findings have been reported in coronavirus disease 2019 (COVID-19) patients. It is still uncertain whether these findings are associated with disease. On the other hand, lesions had different features, time of onset and prognostic relations. We reviewed published data in PubMed database with keywords of “covid-19” and “cutaneous”. We found out 34 articles consisted with 563 patients. Urticarial rash was the most common followed by chilblain-like and vesicular lesions. However, total number non-specified maculopapular rashes were higher than other lesions according to one article which included both confirmed and suspected patients. Livedo-like lesions and acro-ischemia tent to appear in severe COVID-19 patients. Chilblain-like lesions were reported more frequently in young patients at late periods of disease and also, in young normal population without history of COVID-19. Petechial and purpuric lesions were developed either true vasculitis or thrombogenic vasculopathy. Vesicular eruptions resembled to herpes simplex virus (HSV) and varicella-zoster virus (VZV) infections and these infections should strongly be considered. More studies and reports are needed to determine non-specific maculopapular and rare lesions such as mottling. Although many reports and classifications exist about cutaneous findings of COVID-19, their exact relationships remain to be elucidated especially for maculopapular and urticarial lesions which can also be seen in other viral exanthems and drug eruptions. Furthermore, clinical data and histopathologic features weren’t reported in several articles. In conclusion, varied types of cutaneous lesions can be seen in COVID-19 and beneficial for suspicion of disease and prognosis.