Rodriguez-Cerdeira Carmen, Uribe-Camacho Brianda I, Silverio-Carrasco Lianet, Méndez Wennia, Mahesh Ashwini R, Tejada Anakaren, Beirana Angelica, Martinez-Herrera Erick, Alba Alfonso, Arenas Roberto, Szepietowski Jacek C
Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain.
Dermatology Department, Hospital Vithas Ntra. Sra. de Fátima, 36206 Vigo, Spain.
Biology (Basel). 2021 Jan 13;10(1):54. doi: 10.3390/biology10010054.
The increasingly frequent cutaneous manifestations of coronavirus disease (COVID-19) remain to pose a problem to clinicians. Herein, we aimed to describe the clinical and pathological findings of skin lesions in patients with COVID-19. The case series, which was based on the International Dermatological Registry circulated to dermatologists worldwide, was conducted across organizations and societies belonging to five different countries. We documented 31 patients with dermatologic manifestations associated with COVID-19, including maculopapular rashes (16.10%), urticarial lesions (26.80%), pseudochilblains (22.60%), petechiae/purpura (6.50%), distal ischaemia and necrosis (6.50%), livedo racemosa (12.90%), and others (9.70%). Twenty-six cases (83.90%) were qRT-PCR-confirmed COVID-19 cases, two (6.50%) were serologically confirmed, while two others (9.7%) were suspected cases owing to previous contact with COVID-19-positive patients. Therefore, our findings indicate that a febrile rash or even a rash in an afebrile state in the early stages of the disease may be the only clinical manifestation of COVID-19. In the future, we recommend close monitoring of all patients with skin lesions not attributable to other causal factors; in the diagnostic perspective, clinicians should aim to confirm if the skin lesions are associated with COVID-19.
冠状病毒病（COVID-19）皮肤表现日益频繁，这仍然给临床医生带来难题。在此，我们旨在描述COVID-19患者皮肤病变的临床和病理表现。该病例系列基于分发给全球皮肤科医生的国际皮肤病学登记处，在五个不同国家的组织和协会中开展。我们记录了31例与COVID-19相关的皮肤表现患者，包括斑丘疹（16.10%）、荨麻疹样损害（26.80%）、冻疮样病变（22.60%）、瘀点/紫癜（6.50%）、远端缺血和坏死（6.50%）、网状青斑（12.90%）以及其他（9.70%）。26例（83.90%）为qRT-PCR确诊的COVID-19病例，2例（6.50%）为血清学确诊，另有2例（9.7%）因先前接触COVID-19阳性患者而被怀疑。因此，我们的研究结果表明，发热性皮疹甚至疾病早期的无热皮疹可能是COVID-19的唯一临床表现。未来，我们建议密切监测所有无其他病因的皮肤病变患者；从诊断角度来看，临床医生应致力于确认皮肤病变是否与COVID-19相关。
