Cutaneous manifestations in COVID-19 patients in a district COVID care centre

Authors

  • Prathyusha Dasari Department of DVL, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna Avutapalli, Andhra Pradesh, India
  • Swetha A. Chowdary Department of DVL, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna Avutapalli, Andhra Pradesh, India
  • Haritha Samanthula Department of DVL, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna Avutapalli, Andhra Pradesh, India
  • Soumya Ruvva Department of DVL, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna Avutapalli, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20214205

Keywords:

COVID-19, Cutaneous manifestions, Asymptomatic cases

Abstract

Background: COVID-19, initially started as respiratory illness and evolved to involve various systems. Skin has been the least targeted organ with manifestations limited to case reports and series in a foreign scenario. Here, we tried to understand a same in an Indian scenario.

Methods: This was cross-sectional study done in district COVID centre among patients with a confirmed diagnosis of COVID-19 with cutaneous manifestations for 3 months. A detailed history, complete cutaneous examination was carried out. Timing in relation to other symptoms and severity was assessed.

Results: Among the 1603 patients, 39 (2.4%) had skin manifestations. Urticaria (20.5%), petechiae/purpura (17.9%), pruritis (15.4%) were the most common followed by maculo-papular rash (7.7%), manifestations secondary to drugs (7.7%), diffuse hair fall (7.7%), pseudo-chilblains (5.1%), vesicular eruptions (5.1%), infections (5.1%), cellulitis, gangrene and livedoid vasculitis. Timing of skin lesions ranged from 2 days before (10.3%) onset of COVID-19 symptoms or diagnosis to 10 days after (69.2%). Urticaria, petechiae, maculopapular rash were seen more commonly in patients with fever and respiratory symptoms. Asymptomatic cases showed urticaria, petechiae and pseudo-chilblains. Majority were in mild and moderate disease and livedoid vasculitis patient had severe disease.

Conclusions: Skin manifestations in COVID-19 are relatively uncommon in Indian scenario. However, few of the manifestations give a hint of infection while some correlate with the severity of disease.

Author Biographies

Prathyusha Dasari, Department of DVL, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna Avutapalli, Andhra Pradesh, India

Post graduate, department of DVL

Swetha A. Chowdary, Department of DVL, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna Avutapalli, Andhra Pradesh, India

ASISSTANT PROFESSOR, DEPARTMENT OF DVL

Haritha Samanthula, Department of DVL, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna Avutapalli, Andhra Pradesh, India

Head of the department, department of DVL

Soumya Ruvva, Department of DVL, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna Avutapalli, Andhra Pradesh, India

Post graduate, department of DVL

References

Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, et al. The origin, transmission, and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak-an update on the status. Mil Med Res. 2020;7(1):11.

Han Y, Yang H. The transmission and diagnosis of 2019 novel coronavirus infection disease (COVID-19): a Chinese perspective. J Med Virol. 2020;92(6):639-44.

Shaukat S, Butt G, Hussain I. Cutaneous manifestations of COVID-19. J Pak Assoc Dermatol. 2020;30(1):181-9.

Zhai P, Ding Y, Wu X, Long J, Zhong Y, Li Y. The epidemiology, diagnosis, and treatment of COVID-19. Int J Antimicrob Agent. 2020;55(5):105955.

Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Eng J Med. 2020;382:1708-20.

Hunt M, Koziatek C. A case of COVID-19 pneumonia in a young male with full body rash as a presenting symptom. Clin Pract Cases Emerg Med. 2020;4(2):219-21.

Daneshgaran G, Dubin DP, Gould DJ. Cutaneous manifestations of COVID 19: an evidence based review. Am J Clin Dermatol. 2020;21:627-39.

Tay MZ, Poh CM, Renia L. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol. 2020;20:363-74.

Hamming I, Timens W, Bulthuis M, Lely A, Navis G, Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step inunderstanding SARS pathogenesis. J Pathol. 2004;203(2):631-7.

Sachdeva M, Gianotti R, Shah M, Lucia B, Tosi D, Veraldi S, et al. Cutaneous manifestations of COVID19: Report of three cases and a review of literature. J Dermatol Sci. 2020;98(2):75-81.

Manalo IF, Smith MK, Cheeley J, Jacobs R. A dermatologic manifestation of COVID-19: Transient livedo reticularis. J Am Acad Dermatol. 2020;83(2):700.

Joob B, Wiwanitkit V. COVID-19 can present with a rash and be mistaken for dengue. J Am Acad Dermatol. 2020;82(5):177.

Guan WJ, Hu Y. Clinical characteristics of Coronavirus disaese 2019 in China. N Engl J Med. 2020;382:1708.

Casas CG, Catala A, Hernandez GC, Rodríguez-Jiménez P, Fernández-Nieto D, Lario AR, et al. Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases. Br J Dermatol. 2020;183(1):71-7.

Recalcati S. Cutaneous manifestations in COVID-19: a first perspective. J Eur Acad Dermatol Venereol. 2020;34(5):212-3.

Zhang Y, Cao W, Xiao M, Li YJ, Yang Y, Zhao J, et al. Clinical and coagulation characteristics of 7 patients with critical COVID-2019 pneumonia and acro-ischemia. Zhonghua Xue Ye Xue Za Zhi. 2020;41:006.

Jindal R, Chauhan P. Cutaneous manifestations of coronavirus disease 2019 in 458 confirmed cases: A systematic review. J Family Med Prim Care. 2020;9(9):4563-9.

Freeman EE, McMahon DE, Lipoff JB, Rosenbach M, Kovarik C, Desai SR, et al. The spectrum of COVID-19 asscociated dermatological manifestations: an international registry of 716 patients from 31 countries. J Am Acad Dermatol. 2020;83(4):1118-29.

Genovese G, Colonna C, Marzano AV. Varicella-like exanthem associated with COVID-19 in an 8-year-old girl: A diagnostic clue? Pediatr Dermatol. 2020;37(3):435-6.

Sernicola A, Carnicelli G, DiFraia M, Chello C, Furlan C, Muharremi R, et al. Toxic erythema and eosinophilia associated with tocilizumab therapy in a COVID-19 patient. J Eur Acad Dermatol Venereol. 2020;34(8):368-70.

Test ER, Vezzoli P, Carugno A, Raponi F, Gianatti A, Rongioletti F, et al. Acute generalized exanthematous pustulosis with erythema multiforme-like lesions induced by Hydroxychloroquine in a woman with coronavirus disease 2019 (COVID-19). J Eur Acad Dermatol Venereol. 2020;34(9):457-9.

DeGiorgi V, Grazzini M, Alfaioli B, Savarese I, Corciova S, Guerriero G, et al. Cutaneous manifestations of breast carcinoma. Dermatol Ther. 2010;23:581-9.

Kumar T. Dermatological manifestations of COVID-19: a review based on existing reports. Int J Cur Res Rev. 2020;12(13):65-8.

Bai Y, Yao L, Wei T. Presumed asymptomatic carrier transmission of COVID-19. J Am Assoc. 2020;323:1406-14.

Downloads

Published

2021-10-27

Issue

Section

Original Research Articles