J Am Acad Dermatol
. 2021 Jan 18;S0190-9622(21)00166-3.
doi: 10.1016/j.jaad.2021.01.023. Online ahead of print.
The clinical spectrum of COVID-19-associated cutaneous manifestations: an Italian multicentre study of 200 adult patients
Angelo Valerio Marzano 1 , Giovanni Genovese 2 , Chiara Moltrasio 3 , Valeria Gaspari 4 , Pamela Vezzoli 5 , Vincenzo Maione 6 , Cosimo Misciali 4 , Paolo Sena 5 , Annalisa Patrizi 4 , Annamaria Offidani 7 , Pietro Quaglino 8 , Renato Arco 9 , Marzia Caproni 10 , Miriam Rovesti 11 , Giorgio Bordin 12 , Sebastiano Recalcati 13 , Concetta Potenza 14 , Claudio Guarneri 15 , Gabriella Fabbrocini 16 , Carlo Tomasini 17 , Mariarita Sorci 18 , Maurizio Lombardo 19 , Paolo Gisondi 20 , Andrea Conti 21 , Giovanni Casazza 22 , Ketty Peris 23 , Piergiacomo Calzavara-Pinton 6 , Emilio Berti 2 , Italian SkinCovid-19 Network of the Italian Society of Dermatology and Sexually Transmitted Diseases (SIDeMaST)
Affiliations
- PMID: 33476725
- DOI: 10.1016/j.jaad.2021.01.023
Abstract
Background: COVID-19 is associated with a wide range of skin manifestations.
Objective: To describe the clinical characteristics of COVID-19-associated skin manifestations, and explore the relationships between the six main cutaneous phenotypes and systemic findings.
Methods: Twenty-one Italian Dermatology Units were asked to collect the demographic, clinical and histopathological data of 200 patients with COVID-19-associated skin manifestations. The severity of COVID-19 was classified as asymptomatic, mild, moderate, or severe.
Results: A chilblain-like acral pattern significantly associated with a younger age (p<0.0001) and, after adjusting for age, significantly associated with less severe COVID-19 (p=0.0009). However, the median duration of chilblain-like lesions was significantly longer than that of the other cutaneous manifestations taken together (p <0.0001). 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 significantly associated with more severe COVID-19 (p=0.015), and this significance disappeared after adjusting for age.
Limitations: Laboratory confirmation of COVID-19 was not possible in all cases.
Conclusions: After adjusting 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/paucisymptomatic COVID-19.
Keywords: COVID-19; SARS-CoV-2; coronavirus; infection; skin manifestations.