Cutaneous Manifestation | Subtype, if Applicable | Morphology | Additional Clinical Findings |
---|---|---|---|
Alopecia | Androgenetic alopecia | Hair loss from the anterior hairline moving posteriorly or thinning at the vertex scalp | Associated with worse clinical outcomes in some studies148,149 |
Telogen effluvium | Diffuse hair shedding 2–3 mo after a stressor150,151 | ||
Gianotti-Crosti-like rash | Pruritic erythematous papules and vesicles on elbows, anterior thighs, and bilateral popliteal fossa coalescing into plaques.152 | Rash started 18 d after onset of symptoms, 13 d after +COVID test, and 3 d after resolution of all respiratory and systemic symptoms. | |
SDRIFE-like | Erythematous rash on bilateral axillae and antecubital fossae, which subsequently extended to trunk and inner thighs153,154 | ||
Grover-disease-like | Red papules and papulovesicles distributed on the trunk155 Note: some evidence suggests clinical overlap with vesicular, or “varicella-like” eruptions | ||
Erythema elevatum diutinum-like | Firm symmetric smooth nodules on extensor surfaces, particularly joints156 | ||
Reactive infectious mucocutaneous eruption (formerly known as Mycoplasma-induced rash and mucositis) | Shallow erosions of the vermilion lips, hard palate, periurethral glans penis.157 | Reported patient with +COVID PCR 1 wk before rash onset, and again positive at rash onset. Mycoplasma PCR negative, IgM negative, IgG positive (consistent with past exposure). | |
Enanthems (eruptions of the mucous membranes) | 83% (5 patients) with petechial enanthem ± macular enanthem158 | Recorded from a group of 21 patients with COVID-19 and skin rash ranging from papulovesicular, purpuric periflexural, and erythema multiforme-like. | |
Oral lesions | Aphthous-like, ulcerations, and macules, tongue depapillation, angular cheilitis, ulcers, blisters, white plaques, dark pigmentations.159 | Etiology postulated to be multifactorial. Hypotheses include direct action of SARS-CoV-2 on oral mucosal cells, coinfection, immunity impairment, or adverse drug reactions160 | |
Acute genital ulcers (Lipschütz ulcers) | Necrotic ulcers with raised, sharply demarcated borders of the labia minora with no evidence of “kissing lesions.”161 | Single oral aphtha was also observed, with no cutaneous involvement | |
Transient rash in newborns | Transient “rash” (morphology not described) in babies born to mothers with COVID-19.162 Mottling noted in a neonate with sepsis and +COVID-19.163 |
Abbreviation: SDRIFE, symmetric drug-related intertriginous and flexural exanthema.