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?:abstract
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Introduction Because of the increasing emergence of skin manifestations of the coronavirus disease 2019 (COVID-19) worldwide, we investigated the published reports of these lesions. Methods We conducted a literature search for original and review articles published from November 11, 2019, to September 30, 2020. Results We determined five skin lesions common in patients with COVID-19: pseudo-chilblains, maculopapular, urticarial, vesicular, and vaso-occlusive lesions. These lesions manifest at various times in relation to COVID-19 symptoms, which may indicate whether the lesions are virus-induced or are delayed immunological responses to the infection. Skin lesions are more prevalent among Europeans and US residents than among Asians, as is pseudo-chilblain, and the morphology of the skin lesions varies between continents. Pseudo-chilblains are the most common COVID-19 skin manifestation in Europe and the United States, but there is only one reported case from Asian populations. Additionally, patients with vaso-occlusive lesions are more likely than those with pseudo-chilblains to be admitted to the intensive care unit and to die. Conclusion Different cutaneous manifestations in patients with COVID-19 could reflect a wide spectrum of viral interactions with the skin, though reporting bias may play a role as well.
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