Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
J Am Acad Dermatol. 2021 May;84(5):1356-1363. doi: 10.1016/j.jaad.2021.01.023. Epub 2021 Jan 18.
COVID-19 is associated with a wide range of skin manifestations.
To describe the clinical characteristics of COVID-19-associated skin manifestations and explore the relationships among the 6 main cutaneous phenotypes and systemic findings.
Twenty-one Italian Dermatology Units were asked to collect the demographic, clinical, and histopathologic data of 200 patients with COVID-19-associated skin manifestations. The severity of COVID-19 was classified as asymptomatic, mild, moderate, or severe.
A chilblain-like acral pattern was significantly associated with a younger age (P < .0001) and, after adjusting for age, significantly associated with less severe COVID-19 (P = .0009). However, the median duration of chilblain-like lesions was significantly longer than that of the other cutaneous manifestations taken together (P < .0001). Patients with moderate/severe COVID-19 were more represented than those with asymptomatic/mild COVID-19 among the patients with cutaneous manifestations other than chilblain-like lesions, but only the confluent erythematous/maculo-papular/morbilliform phenotype was significantly associated with more severe COVID-19 (P = .015), and this significance disappeared after adjustment for age.
Laboratory confirmation of COVID-19 was not possible in all cases.
After adjustment for age, there was no clear-cut spectrum of COVID-19 severity in patients with COVID-19-related skin manifestations, although chilblain-like acral lesions were more frequent in younger patients with asymptomatic/pauci-symptomatic COVID-19.
COVID-19 与广泛的皮肤表现有关。
描述 COVID-19 相关皮肤表现的临床特征，并探讨 6 种主要皮肤表型与全身表现之间的关系。
21 家意大利皮肤科单位被要求收集 200 例 COVID-19 相关皮肤表现患者的人口统计学、临床和组织病理学数据。COVID-19 的严重程度分为无症状、轻度、中度或重度。
冻疮样肢端皮损与年龄较小显著相关（P<.0001），并且在校正年龄后，与 COVID-19 严重程度较轻显著相关（P=.0009）。然而，冻疮样皮损的中位持续时间明显长于其他皮肤表现的总和（P<.0001）。在有皮肤表现而无冻疮样皮损的患者中，中度/重度 COVID-19 患者比无症状/轻度 COVID-19 患者更常见，但只有融合性红斑/斑丘疹/麻疹样表型与更严重的 COVID-19 显著相关（P=.015），并且在校正年龄后这种显著性消失。
并非所有病例均进行了 COVID-19 的实验室确认。
在校正年龄后，COVID-19 相关皮肤表现患者的 COVID-19 严重程度没有明确的范围，尽管冻疮样肢端皮损在无症状/少症状 COVID-19 的年轻患者中更为常见。
