Skin Manifestations Associated with COVID-19

The document reviews over 1,500 articles on skin manifestations associated with COVID-19, which occur in 0.2% to 45% of patients, averaging around 6%. Common manifestations include maculopapular eruptions and erythema pernio-like (EPL) lesions, while urticaria, vesicular conditions, and livedo/purpura/necrosis are rare. EPL lesions are common in younger patients, appearing late and lasting long. Vesicular lesions appear before general symptoms in 15% of cases. Livedo/necrosis are linked to complications like a hypercoagulable state and vascular damage. Telogen effluvium, a temporary hair loss, is reported in 10% of patients. The document also discusses the role of androgens in COVID-19, suggesting that androgen expression could be a risk factor. A study showed that men with androgenetic alopecia using a 5-alpha-reductase inhibitor showed reduced COVID-19 symptoms. However, the benefit of introducing anti-androgens after infection is uncertain. More studies are needed to understand the prevalence and patterns of skin lesions associated with COVID-19.