COVID-19 and Dermatology: One Year in Review

Esther E. Freeman, MD, PhD, Editor

Devon E. McMahon, MD, Editor

COVID-19 has fundamentally altered health care, from the direct impacts of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and spread, to resulting changes in medical practice.¹ Dermatologists have played an important role in all aspects of the COVID-19 pandemic, from identification of cutaneous manifestations of the virus, to restructuring clinical practice to accommodate lockdown and social distancing measures, and now to vaccine roll out and management of cutaneous vaccine side effects.2, 3, 4, 5, 6

Despite a year of loss and disruption for so many, one silver lining of the COVID-19 pandemic has been collaboration across the medical and scientific community, ultimately leading to a substantial body of literature on SARS-CoV-2 genomics, pathogenesis, epidemiology, and now vaccination. Scientific progress has been accelerated not just by novel research techniques but also through collaboration across institutions and countries, with results disseminated more rapidly with the growth of preprint publishing, virtual conferences, and use of social media.⁷ Although disruptions in medical practice due to lockdowns had negative results for many patients, this change also prompted a surge in telemedicine use, which has many important applications for delivering timely and more equitable care.⁸

Undoubtedly, the COVID-19 pandemic has also heightened the medical community’s attention to the important topics of health care disparities and structural racism, in addition to awareness of the rise in anti-Asian sentiment.^{1 , 9 , 10} Lockdown measures and school closures have also taken an unprecedented toll on women in medicine and scientific fields, raising the important issue of gender inequity in medicine.¹¹

In this issue of Dermatologic Clinics of North America, we have invited experts in COVID-19 dermatology to review multiple important issues in this emerging field of study. In these articles, our authors describe cutaneous morphologies of COVID-19 vaccine reactions and SARS-CoV-2 infection, as well as cutaneous manifestations specific to pediatric patients and hospitalized patients. We recognize how images of COVID-19 cutaneous manifestations have been underrepresented in patients with skin of color. We investigate dermatoses related to increased personal protective equipment use by both medical professionals and the public. We further explore some of the immunologic underpinnings of COVID-19 cutaneous manifestations, as well as recommendations for dermatology patients on biologic medications during the pandemic. We reflect on how COVID-19 has transformed dermatology practice as a whole, from changes in clinic flow, to advances in teledermatology, to delays in skin cancer management, as well as impacts on dermatology residency and the residency selection process. We examine how COVID-19 has changed the global landscape of dermatology across multiple countries and had far-reaching effects for global dermatology training programs. We then discuss updates of multiple dermatology COVID-19 registries, which have collected real-world evidence from providers and patients to inform patient care. Last, we examine cutaneous side effects of the novel COVID-19 vaccines and provide recommendations for patients who experienced a cutaneous reaction to their first vaccine dose.

Thank you to all the dermatologists and trainees who have made this special issue possible. This collaboration across multiple institutions and countries in many ways reflects the larger collaborative spirit we have been privileged to be a part of during the COVID-19 pandemic. Although the pandemic and its effects are far from over,¹² the amount of scientific knowledge on COVID-19 dermatology we have been able to gather in a year is remarkable.