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Covid-19 and the skin

07.05.2020
Dermatovenerologists around the world have reported skin problems in patients with coronavirus. This phenomenon even has a name - Covid-19 skin.

“Recently, the skin reactions of the body associated with coronavirus have become more frequent,” says Czech dermatovenerologist Natalya Markova. 


- The American Academy of Dermatovenerology has set up a special registry in which 130 cases of skin disorders in patients with coronavirus have already been recorded. Basically, these are skin problems associated with vascular diseases, in particular with circulatory disorders, blood clotting, the presence of blood clots in the capillary bed. At the same time, Natalya Markova emphasizes that such problems are more common in patients with an asymptomatic course of the disease, and special attention should be paid to them. 


The Spanish Academy of Dermatovenerology conducted its own study, which involved 375 patients with confirmed coronavirus. During the study, 5 manifestations on the skin associated with the course of Covid-19 were recorded. 


  • So, in 19% of cases, patients with coronavirus had symptoms similar to frostbite. These lesions affected the limbs, arms and legs, and resembled small, itchy swelling, sometimes covered with vesicles or pustules.
  • In about 9% of patients, skin vasculitis appeared on the skin. Damage to blood vessels of the skin and subcutaneous tissue. 
  • In 19% of patients, a rash similar to hives was found on the skin. 
  • In 47% of cases, a maculopapular rash was observed. These are dense papules, the color of which varies from burgundy to purple, which can cover the entire body of an infected person. In elderly people, it is not often, but necrotic skin lesions have occurred, usually indicating vascular diseases, in which narrowing or blocking of arteries that limit blood flow in certain areas of the body occurs. 
  • Necrosis, or premature death of skin tissue, has been described in 6% of those infected. 

The French National Dermatologist-Venereologist Union (SNDV) issued a statement stating that skin problems have been reported in patients with asymptomatic disease. In this regard, they urge doctors around the world to pay attention to unexpected skin problems in patients and test them for Covid-19 even in the absence of other symptoms of the disease. 


The Russian news agency TASS quotes the head of the department of pulmonology at Sechenov University, a pulmonologist Sergei Avdeev. 


- Already known about skin rash. It is not so common in adults - about 3-5% of all patients with COVID-19, but nevertheless there are skin changes. The rash is erythematous (extensive red patches). With some viral infections, a rash is a fairly characteristic sign, for example, with rubella, with measles. With COVID-19, it is somewhat similar, although with rubella and measles, the rash is slightly different, ”he said. 


According to Avdeev, the smaller the patient’s age, the more skin manifestations from infection. - From the point of view of skin changes, attention is drawn to itself - Livedo reticularis (reticularis). It looks like a net, often on the feet. We expect to see such changes in severe patients with sepsis and septic shock, and as a rule they signal a violation of coagulation, that is, the coagulation of the blood system, the pulmonologist added.