The spectrum of COVID-19-associated dermatologic manifestations: an international registry of 716 patients from 31 countries

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      Abstract

      Background

      Coronavirus disease 2019 (COVID-19) has associated cutaneous manifestations.

      Objective

      To characterize the diversity of cutaneous manifestations of COVID-19, and facilitate understanding of underlying pathophysiology.

      Methods

      Case series from an international registry from the American Academy of Dermatology and International League of Dermatological Societies.

      Results

      The registry collected 716 cases of new-onset dermatologic symptoms in patients with confirmed/suspected COVID-19. Of the 171 patients in the registry with laboratory-confirmed COVID-19, the most common morphologies were morbilliform (22%), pernio-like (18%), urticarial (16%), macular erythema (13%), vesicular (11%), papulosquamous (9.9%), and retiform purpura (6.4%). Pernio-like lesions were common in patients with mild disease, while retiform purpura presented exclusively in ill, hospitalized patients.

      Limitations

      We cannot estimate incidence or prevalence. Confirmation bias is possible.

      Conclusion

      This study highlights the array of cutaneous manifestations associated with COVID-19. Many morphologies were non-specific, while others may provide insight into potential immune or inflammatory pathways in COVID-19 pathophysiology.

      Keywords