TABLE 1.
Case reports of COVID‐19 skin manifestations
| First author | Title | Cutaneous manifestation | Case characteristic | Accompanied by COVID‐19 symptoms | Drug history | Involvement site | Skin biopsy | Duration of skin lesion |
|---|---|---|---|---|---|---|---|---|
| Andrea Estébanez | Cutaneous manifestations in COVID‐19: a new contribution 8 | Pruritic erythematous‐yellowish papules | 28‐year‐old woman | 15 days after COVID‐19 diagnose | 10 days after last dose of paracetamol | On both heels | Not reported | Not reported |
| Henry, D | Urticarial eruption in COVID‐19 infection 9 | Pruritic disseminated erythematous plaques eruption | 27‐year‐old woman | Before fever and respiratory syndrome | Not reported | Particular face and acral involvement | Not reported | Not reported |
| B. ahouach | Cutaneous lesions in a patient with COVID‐19: are they related? 10 | Rash (Diffuse fixed erythematous blanching maculopapular lesions) | 57‐year‐old woman | 2 days after fever and in same time with dry cough | Not reported | Limbs and trunk and palms | Slight spongiosis, basal cell vacuolation and mild perivascular lymphocytic infiltrate | Not reported |
| Anwar Alramthan |
A case of COVID‐19 presenting in clinical picture resembling chilblains disease. First report from the Middle East 11 |
Rash (red‐purple papules) | A 27‐year‐old females | Asymptotic, RT‐PCR confirmed COVID‐19 | Not reported | Acral areas (dorsal aspect of fingers bilaterally) | Not reported | Not reported |
| Rash (red‐purple papules) + diffused erythema | 35‐year‐old female + subungual area of the right thumb | asymptotic RT‐PCR confirmed COVID‐19 | Not reported | Acral areas (dorsal aspect of fingers bilaterally) | Not reported | Not reported | ||
| Nerea landa | Chilblain‐like lesions on feet and hands during the COVID‐19 Pandemic 12 | Reddish and papular resembling chilblains after 1 week they become more purpuric and flattened (referred discomfort or pain when palpated) | 15 year old male | Same time with chest x‐ray showing mild bilateral pneumonia | Not reported | Five in toes and heels | Not reported | Not reported |
| 23 year old female | 3 weeks after COVID‐19 symptoms | Not reported | Toes (were a little itchy) | Not reported | Not reported | |||
| 44 year old male | 10 days after COVID‐19 symptoms | Not reported | Toe (slightly painful) | Not reported | Not reported | |||
| 91 year old male | 3 weeks after COVID‐19 confirmed by PCR | Not reported | Toe | Not reported | Not reported | |||
| 24 year old female | after COVID‐19 confirmed by PCR | Not reported | Toes | Not reported | Not reported | |||
| 15 year old female | 1 week after COVID‐19 symptoms | Not reported | Fingers and heels (mildly painful when pressing) | Not reported | Not reported | |||
| Wu, Ping | A child confirmed COVID‐19 with only symptoms of conjunctivitis and eyelid dermatitis 13 | Dermatitis | 2 years and 10 months old | 7 days after RT‐PCR confirmed COVID‐19 | Not reported | Eyelid | Not reported | 5 days |
| Sachdeva, Muskaan | Cutaneous manifestations of COVID‐19: Report of three cases and a review of literature 14 | Maculo‐papular rash | 71‐year‐old Caucasian woman | 10 dayes after COVID‐19 symptomes | No medication | Trunk (itchy) | Not reported | Not reported |
| Diffuse maculopapular exanthem (morbilliform) + macular hemorrhagic rash | 77‐year‐old Caucasian woman | At the same time with COVID‐19 symptoms | Not reported | Trunk + legs | Not reported | Not reported | ||
| Papular‐vesicular, pruritic eruption | 72‐year‐old Caucasian woman | 4 days After COVID‐19 symptoms | Not reported | Sub‐mammary folds, trunk and hips | Not reported | Not reported | ||
| Rivera‐Oyola, Ryan | Dermatologic findings in two patients with COVID‐19 15 | Rash and scattered erythematous macules coalescing into papules | 60‐year‐old male | 3 days after COVID‐19 symptoms | no recent changes to her medications | Back, flanks, groin and upper thighs | Mild perivascular infiltrate of predominantly mononuclear cells surrounding the superficial blood vessels and epidermis showed scattered foci of hydropic changes along with minimal acanthosis, slight spongiosis and foci of parakeratosis | 7 days |
| Mild hemi‐facial atrophy and scoliosis, generalized, pruritic rash, large, disseminated, urticarial plaques | 60‐year‐old woman | 9 days after COVID‐19 symptoms | no recent changes to her medications | Trunk, head, upper and lower extremities | Not reported | 1 day | ||
| Manalo, Iviensan F. | A Dermatologic Manifestation of COVID‐19: Transient Livedo Reticularis 16 | transient non‐pruritic blanching unilateral livedoid patch | 67‐year‐old Caucasian male | 7 days after COVID‐19 symptoms | Not reported | Right anterior thigh | Not reported | 1 day |
| Unilateral asymptomatic rash | 47‐year‐old Caucasian female | 10 days after RT‐PCR confirmed COVID‐19 | Not reported | Right leg | Not reported | 1 day | ||
| Mahé, A. | A distinctive skin rash associated with Coronavirus Disease 2019? 17 | Erythematous rash | 64 years old woman | 4 days after COVID‐19 symptoms | 4 days after began to take oral paracetamol | Both antecubital fossa, extended on the trunk and axillary folds | Not reported | 5 days |
| Lu, S. | Alert for non‐respiratory symptoms of Coronavirus Disease 2019 (COVID‐19) patients in epidemic period: A case report of familial cluster with three asymptomatic COVID‐19 patients 18 | Generalized Urticaria | Not reported | 1 week after dry cough | Not reported | Generalized | Not reported | Not reported |
| Hunt, M. | A Case of COVID‐19 Pneumonia in a Young Male with Full Body Rash as a Presenting Symptom 19 | Diffuse morbilliform maculopapular rash | 20 years old man | Fever and rash simultaneously | Not reported | Trunk, extremities | Not reported | Not reported |
| Magro, C. | Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID‐19 infection: a report of five cases 20 | Retiform purpura with extensive surrounding inflammation | 32 years old male | One week after fever and cough he became ventilator dependent, 4 days after ventilator support skin rash appeared | hydroxychloroquine, azithromycin and remdesivir | Buttocks | There was a significant degree of interstitial and perivascular neutrophilia with prominent leukocytoclasia. IHC showed striking and extensive deposition of C5b‐9 within the microvasculature | Not reported |
| Dusky purpuric patches | 66 years old woman | 9 days after having fever, cough, diarrhea and chest pain, she became hypoxemic and after 11 days in hospital skin rash appeared | Hydroxychloroquine, enoxaparin | Palms and soles bilaterally | Extensive vascular deposits of C5b‐9 (figure 6C), C3d, and C4d were observed throughout the dermis, with marked deposition in an occluded artery. | Not reported | ||
| Mildly purpuric reticulated eruptions, consistent with livedo racemosa | 40‐year‐old woman | after 2 weeks of dry cough, fever, myalgias, diarrhea, and progressive dyspnea | Not reported | chest, legs and arms | . Significant vascular deposits of C5b‐9 and C4d | Not reported | ||
| Chen, Y. | Infants Born to Mothers with a New Coronavirus (COVID‐19) 21 | Diffuse maculopapular rash and Facial skin ulceration | Above 37‐week gestational age infant | edema of the lateral thigh | Nothing | Diffuse | Not reported | 1 day |
| First on forehead and progress to diffuse small miliary red papules | Above 37‐week gestational age infant | TTN (transient tachypnea of the newborn) | Nothing | Not reported | Not reported | 8‐9 days | ||
| Najarian | Morbilliform exanthem associated with COVID‐19 22 | Pruritic progressive erythematous macules gradually changed to patches | 58‐year‐old Hispanic male | Cough and pain in hands and legs 3 days ago | azithromycin and benzonatate | legs, thighs, forearms, arms, shoulders, back, chest, and abdomen | Not reported | 2 days |
| Hoenig, Leonard J. | Rash as a Clinical Manifestation of COVID‐19 Photographs of a Patient 23 | Erythematous, edematous, malar eruption | 26 years old man | Sore throat, malaise, ache, nonproductive cough, anosmia, ageusia, fever | adalimumab | Face | Not reported | 6 days |
| Jimenez‐Cauhe, Juan | Reply to “COVID‐19 can present with a rash and be mistaken for Dengue”: Petechial rash in a patient with COVID‐19 infection 24 | Erythemato‐purpuric, millimetric, coalescing macules | 84‐year‐old woman | 3 days after hospitalization (11 days after COVID‐19 symptoms) | hydroxychloroquine and lopinavir/ritonavir | Flexural regions mainly in peri‐axillary area | Not reported | Not reported |
| Quintana‐Castanedo, Lucía | Urticarial exanthem as early diagnostic clue for COVID‐19 infection 25 | Pruritic urticarial rash consisting of confluent, edematous and erythematous papules | 61‐year‐old Spanish Medical Doctor | Not reported | No drug during the last 2 months | Thighs, arms, and forearms | Not reported | 7 days |
| Miriam Morey | Cutaneous manifestations in the current pandemic of coronavirus infection disease (COVID 2019) 26 | Erythematous, confluent, nonpruritic maculopapular rash | 6‐year old boy | 2 weak after symptoms and 48 hours after confirmed COVID‐19 test | Not reported | Trunk and neck that gradually spread to the cheeks and upper and lower extremities, reaching the palms of the hands | Not reported | 5 days |
| Acute urticaria, apparently pruritic | 2‐ month old girl | 4 days after low fever, at the same time with COVID‐19 cinfirm | Not reported | Face and upper extremities and spread in a few hours to the trunk and lower extremities | Not reported | 5 days |