To the Editor: Although SARS-CoV-2 is categorized as a respiratory virus, a significant body of literature is emerging regarding the effects of COVID-19 across multiple organ systems, encompassing neurologic, cardiac, renal, gastrointestinal, and dermatologic symptoms.1 Specifically, research on cutaneous manifestations of COVID-19 has increased, and as these sequelae are further explored, more highly cited articles will have an increasing impact on shaping public discourse and driving future research directions.2 To better understand the current landscape of this burgeoning literature, we aimed to describe the top 100 most-cited articles relating to COVID-19 and dermatology.
A query of the scientific indexing database Scopus was performed on January 20, 2022, using the search terms “COVID-19 AND dermatology,” “dermatologic,” “dermatological,” “cutaneous,” OR “skin.” Articles in English focusing on dermatology or incorporating a substantial discussion of dermatology-specific information were included. The article type and theme were determined by 2 blinded reviewers (KMM and BGM), country of origin was determined by the first author’s institutional affiliation, and author gender was determined using online gender application programming interface software.
Our query returned 1818 articles (8913 total citations) published between December 2019 and January 2022. Author demographics and affiliated institutions of the top 100 most-cited articles are presented in Table I. Women were the first authors in 43% of the articles, and these articles accounted for 57% of all citations. Over half (53%) of the top 100 most-cited articles originated from European countries, while over one-fourth (27%) came from the United States. Table II presents article information, including journal, type, and common themes. The Journal of the European Academy of Dermatology and Venereology had both the most articles and total citations in the top 100, followed closely by the Journal of the American Academy of Dermatology in both categories. Nearly half (49%) of the articles were either review articles or case reports/series, with 12 retrospective studies and 6 prospective studies. Most (70%) articles explored the primary cutaneous symptoms of COVID-19, and 20% of the cited articles within the top 100 discussed altered dermatologic health care delivery.
Table I.
Demographic first author/institutional information of top 100 most-cited dermatology and COVID-19 articles
| Demographic characteristic | Number of publications within top 100 | Total number of citations among top 100 publications |
|---|---|---|
| Gender | ||
| Male | 54 | 3421 |
| Female | 43 | 5087 |
| Indeterminate | 3 | 405 |
| Primary specialty | ||
| Dermatology | 65 | 5056 |
| Other | 35 | 3857 |
| Country∗ | ||
| United States | 27 | 3268 |
| Italy | 22 | 1853 |
| Spain | 14 | 1350 |
| France | 8 | 516 |
| China | 4 | 190 |
| Institution∗ | ||
| Ramón y Cajal University Hospital |
7 | 417 |
| Granda Ospedale Maggiore Policlinico |
6 | 472 |
| Massachusetts General Hospital | 5 | 450 |
| University of Verona | 3 | 137 |
| University of Naples | 3 | 128 |
| Journal∗ | ||
| Journal of the European Academy of Dermatology and Venereology | 24 | 1833 |
| Journal of the American Academy of Dermatology | 22 | 1823 |
| Dermatologic Therapy | 12 | 513 |
| British Journal of Dermatology | 5 | 850 |
| JAMA Dermatology | 4 | 204 |
JAMA, Journal of the American Medical Association.
Only top 5 included.
Table II.
Characteristics of top 20 most-cited dermatology articles on COVID-19∗
| Rank | Article title | Authors | Journal | Article type | Article theme | Citations |
|---|---|---|---|---|---|---|
| 1 | Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: A report of five cases | Magro et al | Translational Research | Case report/series | COVID-19 effects | 1078 |
| 2 | Extrapulmonary manifestations of COVID-19 | Gupta et al | Nature Medicine | Review | COVID-19 effects | 832 |
| 3 | Cutaneous manifestations in COVID-19: A first perspective | Recalcati | JEADV | Case report/series | COVID-19 effects | 698 |
| 4 | Classification of the cutaneous manifestations of COVID-19: A rapid prospective nationwide consensus study in Spain with 375 cases | Galván Casas et al | BJD | Survey | COVID-19 effects | 629 |
| 5 | COVID-19 can present with a rash and be mistaken for dengue | Joob et al | JAAD | Case report/series | COVID-19 effects | 254 |
| 6 | Varicella-like exanthem as a specific COVID-19–associated skin manifestation: Multicenter case series of 22 patients | Marzano et al | JAAD | Case report/series | COVID-19 effects | 194 |
| 7 | Physical and mental health impacts of COVID-19 on healthcare workers: A scoping review | Shaukat et al | International Journal of Emergency Medicine | Review | Health care delivery | 176 |
| 8 | Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: A registry-based study of 414 cases | McMahon et al | JAAD | Retrospective study | Treatment/vaccine effects | 156 |
| 9 | Follow-up of adults with noncritical COVID-19 two months after symptom onset | Carvalho-Schneider et al | Clinical Microbiology and Infection | Prospective study | COVID-19 effects | 142 |
| 10 | Cutaneous manifestations of COVID-19: Report of three cases and a review of literature | Sachdeva et al | Journal of Dermatological Science | Case report/series | COVID-19 effects | 140 |
| 11 | A dermatologic manifestation of COVID-19: Transient livedo reticularis | Manalo et al | JAAD | Case report/series | COVID-19 effects | 139 |
| 12 | Characterization of acute acral skin lesions in non hospitalized patients: A case series of 132 patients during the COVID-19 outbreak | Fernandez-Nieto et al | JAAD | Case report/series | COVID-19 effects | 130 |
| 13 | The spectrum of COVID-19–associated dermatologic manifestations: An international registry of 716 patients from 31 countries | Freeman et al | JAAD | Case report/series | COVID-19 effects | 128 |
| 14 | Cutaneous manifestations in COVID-19: A new contribution | Estebanez et al | JEADV | Case report/series | COVID-19 effects | 128 |
| 15 | Acral cutaneous lesions in the time of COVID-19 | Recalcati et al | JEADV | Case report/series | COVID-19 effects | 122 |
| 16 | Cutaneous signs in COVID-19 patients: A review | Wollina et al | Dermatologic Therapy | Review | COVID-19 effects | 119 |
| 17 | Chilblains is a common cutaneous finding during the COVID-19 pandemic: A retrospective nationwide study from France | de Masson et al | JAAD | Retrospective study | COVID-19 effects | 111 |
| 18 | Extra respiratory manifestations of COVID-19 | Lai et al | International Journal of Antimicrobial Agents | Review | COVID-19 effects | 105 |
| 19 | COVID-19: Specific and non specific clinical manifestations and symptoms: The current state of knowledge | Baj et al | Journal of Clinical Medicine | Review | COVID-19 effects | 96 |
| 20 | Pernio-like skin lesions associated with COVID-19: A case series of 318 patients from 8 countries | Freeman et al | JAAD | Case report/series | COVID-19 effects | 95 |
BJD, British Journal of Dermatology; JAAD, Journal of the American Academy of Dermatology; JAMA, Journal of the American Medical Association; JEADV, Journal of the European Academy of Dermatology and Venereology.
Characteristics of the top 100 articles are available as Supplement is available at Mendeley via https://doi.org/10.17632/j5zybgxk9t.1.
The rapid dissemination of new research on COVID-19 and dermatology has led to departures from several trends previously seen in the dermatology literature. Female first authorship before the pandemic hovered at around 50% in high-impact dermatology journals,3 and female first-authored publications received fewer citations on average than male first-authored publications in such journals from 2015 to 2018.4 We showed that, among high-impact publications pertaining to COVID-19 and dermatology, female-led research has received more citations. Additionally, we found that the order of the most-cited journals for research pertaining to COVID-19 and dermatology does not align with that of established H-indices.5 This suggests that the urgency of disseminating and building upon pandemic-related research may supersede traditional measures of journal impact. Finally, while the dermatologic manifestations of COVID-19 are well documented in descriptive reviews and case reports, our findings suggest that robust clinical studies (eg, randomized controlled trials) are needed to further understand the optimal management of cutaneous COVID-19 manifestations and the extent to which dermatologic symptoms correlate with disease severity.
Conflicts of interest
None disclosed.
Footnotes
Funding sources: BGM was supported by NIH/NIAID (R25AI140490).
IRB approval status: Not applicable.
References
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