What Skin Conditions Are Associated with COVID-19?

In just a few months, the novel coronavirus has infected millions of people and disrupted daily life around the world.

Common symptoms include a fever, dry cough and shortness of breath. Some patients may experience headaches, muscle pain and a loss of taste or smell, according to the Centers for Disease Control and Prevention. Between 25% and 50% of people who get COVID-19 are asymptomatic, which means they have no symptoms at all.

Many patients have also developed skin-related symptoms such as a rash or discoloration. Because this is a new viral infection, researchers are still working to determine how common these symptoms are and what is causing them. While one study found that just 0.2% of hospitalized patients developed a rash, another found dermatological symptoms occurring in 20% of patients. 

A recent study in the British Journal of Dermatology identified five unique skin conditions that may be associated with COVID-19. Findings are based on an assessment of 375 confirmed and suspected cases of the novel coronavirus. 

• Maculopapular eruptions are red bumps with reddish skin similar to rashes that appear with measles. These occurred in 47% of patients examined for the study.
• Pseudo-chilblains were present in 19% of patients. Nicknamed “Covid Toes,” this condition appears similar to frostbite and causes red or purple discoloration on the feet or hands. It occurs most often in younger patients and those with milder cases.
• Urticarial lesions, which appear as a rash similar to hives, were found in 19% of cases. Patients experienced a nettled rash with pink and white raised areas on the surface of the skin. 
• Vesicular eruptions, which consist of small blisters appearing mostly on the trunk, was found in 9% of patients. This condition occurs most frequently in middle-aged patients and is associated with symptoms of intermediate severity. 
• Livedo or necrosis, which appeared in 6% of cases, occurs mostly in older patients and those with severe forms of COVID-19. Caused by impaired circulation under the skin, this condition results in a blotchy red or bluish appearance, along with a rash. 

As noted earlier, much more rigorous research is needed to determine why some COVID-19 patients develop skin symptoms and what the best courses of treatment may be. 

The American Academy of Dermatology has established a COVID-19 Dermatology Registry to facilitate more comprehensive study. The registry is collecting data from health care professionals who care for either (1) COVID-19 patients who develop skin conditions or (2) dermatology patients with other conditions who later get COVID-19.

No personal patient information which could be identifying is included. Instead, health professionals are asked to report the following information: 

• Patient demographic information, such as age and gender
• Details about the patient’s dermatologic condition
• The patient’s past medical history including prior dermatologic conditions
• Past dermatologic treatments received
• Details of the patient’s COVID-19 diagnosis, treatment and outcome

In the meantime, what should you do if you develop unexplained skin symptoms and suspect you may have COVID-19? 

First, self-isolate as a precaution to avoid spreading the virus to others. Speak to your dermatologist or other health professional. At Cayce Dermatology, we encourage you to schedule a telehealth appointment. It’s a safe and secure way to tell us about your symptoms, while reducing the risk to other patients and employees. 

Get tested for COVID-19 if your doctor recommends it and seek immediate attention if you have difficulty breathing or other severe symptoms.

At Cayce Dermatology, our dermatologists are here to listen to your concerns, answer your questions and recommend a custom treatment plan. Please call us at 573-234-1000 or contact us online to schedule an appointment.