Symptomatology and Treatment of COVID-19 Affecting Skin Appendages: A Narrative Review Beyond Covid-Toes

The review discusses the impact of COVID-19 on skin appendages, focusing on symptoms beyond the commonly reported 'COVID-toes'. The research found that COVID-19 can affect skin appendages in both symptomatic and asymptomatic patients. The most common hair disorders in COVID-19 patients are telogen effluvium, androgenetic alopecia, and alopecia areata. Nails are less commonly affected, with splinter hemorrhages and leukonychia being the most frequent findings. SARS-CoV-2 spike proteins have been identified in eccrine sweat glands, but sebaceous glands seem to be uninvolved. Alopecia areata is often seen in asymptomatic COVID-19 patients, while telogen effluvium is observed in both symptomatic and asymptomatic patients. The 'half-moon sign' on nails could indicate a more severe course of COVID-19. The review also summarizes treatment options for these conditions.