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J Am Acad Dermatol . The clinical spectrum of COVID-19-associated cutaneous manifestations: an Italian multicentre study of 200 adult patients

tetano

Editor, Senior Moderator
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[SUP] 1 [/SUP], Giovanni Genovese[SUP] 2 [/SUP], Chiara Moltrasio[SUP] 3 [/SUP], Valeria Gaspari[SUP] 4 [/SUP], Pamela Vezzoli[SUP] 5 [/SUP], Vincenzo Maione[SUP] 6 [/SUP], Cosimo Misciali[SUP] 4 [/SUP], Paolo Sena[SUP] 5 [/SUP], Annalisa Patrizi[SUP] 4 [/SUP], Annamaria Offidani[SUP] 7 [/SUP], Pietro Quaglino[SUP] 8 [/SUP], Renato Arco[SUP] 9 [/SUP], Marzia Caproni[SUP] 10 [/SUP], Miriam Rovesti[SUP] 11 [/SUP], Giorgio Bordin[SUP] 12 [/SUP], Sebastiano Recalcati[SUP] 13 [/SUP], Concetta Potenza[SUP] 14 [/SUP], Claudio Guarneri[SUP] 15 [/SUP], Gabriella Fabbrocini[SUP] 16 [/SUP], Carlo Tomasini[SUP] 17 [/SUP], Mariarita Sorci[SUP] 18 [/SUP], Maurizio Lombardo[SUP] 19 [/SUP], Paolo Gisondi[SUP] 20 [/SUP], Andrea Conti[SUP] 21 [/SUP], Giovanni Casazza[SUP] 22 [/SUP], Ketty Peris[SUP] 23 [/SUP], Piergiacomo Calzavara-Pinton[SUP] 6 [/SUP], Emilio Berti[SUP] 2 [/SUP], Italian SkinCovid-19 Network of the Italian Society of Dermatology and Sexually Transmitted Diseases (SIDeMaST)



Affiliations

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.
 
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