Dermatological Manifestations Associated with COVID-19: A Comprehensive Review of the Current Knowledge

July 2021 in “ Journal of Medical Virology ”

Zeinab Mohseni Afshar, Arefeh Babazadeh, Amir Hossein Hasanpour, Mohammad Barary, Babak Sayad, Alireza Janbakhsh, Zeinab Aryanian, Soheil Ebrahimpour

telogen effluvium anagen effluvium alopecia areata androgenetic alopecia topical corticosteroids antihistamines anticoagulants antimicrobial agents antifungal agents hair shedding hair loss hair thinning male pattern baldness steroid creams allergy medications blood thinners antibiotics antifungals

TLDR COVID-19 can cause various skin issues, including rashes and hair loss, which usually heal on their own and don't always indicate severe illness.

This comprehensive review details the dermatological manifestations associated with COVID-19, noting that skin involvement varies from 1% to 20% and includes a wide range of symptoms such as urticarial rash, erythematous/maculopapular/morbilliform rash, papulovesicular exanthem, chilblain-like acral pattern, livedo reticularis/racemosa-like pattern, and purpuric "vasculitic" pattern. It also discusses the impact of COVID-19 on hair, mentioning conditions like telogen effluvium, anagen effluvium, alopecia areata, and androgenetic alopecia, as well as a unique nail manifestation known as "COVID red half-moon" nail sign. The review emphasizes that skin lesions may not correlate with disease severity but certain manifestations are more common in severe cases. It also notes that skin symptoms can vary by age, with different presentations in children and adults, and that most COVID-19 related skin lesions resolve spontaneously. The review addresses medication-related skin eruptions, the psychological impact of COVID-19 on skin health, and the challenges for dermatologists during the pandemic, including managing chronic dermatoses and occupational skin disorders among healthcare workers. Management strategies for skin complications include using barrier creams, proper PPE sizing, and treatment with topical corticosteroids, antihistamines, and anticoagulants for vascular lesions, with antimicrobial or antifungal agents for secondary infections.

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