TY - JOUR
T1 - The clinical spectrum of COVID-19–associated cutaneous manifestations: An Italian multicenter study of 200 adult patients
AU - Marzano, Angelo Valerio
AU - Genovese, Giovanni
AU - Genovese, Giannicola
AU - Moltrasio, Chiara
AU - Gaspari, Valeria
AU - Vezzoli, Pamela
AU - Maione, Vincenzo
AU - Misciali, Cosimo
AU - Sena, Paolo
AU - Patrizi, Annalisa
AU - Offidani, Annamaria
AU - Quaglino, Pietro
AU - Arco, Renato
AU - Caproni, Marzia
AU - Rovesti, Miriam
AU - Bordin, Giorgio
AU - Recalcati, Sebastiano
AU - Potenza, Concetta
AU - Guarneri, Claudio
AU - Fabbrocini, Gabriella
AU - Tomasini, Carlo
AU - Sorci, Mariarita
AU - Lombardo, Maurizio
AU - Gisondi, Paolo
AU - Conti, Andrea
AU - Casazza, Giovanni
AU - Peris, Ketty
AU - Calzavara-Pinton, Piergiacomo
AU - Berti, Emilio
AU - Berti, Emanuele
PY - 2021
Y1 - 2021
N2 - Background: COVID-19 is associated with a wide range of skin manifestations. Objective: To describe the clinical characteristics of COVID-19–associated skin manifestations and explore the relationships among the 6 main cutaneous phenotypes and systemic findings. Methods: Twenty-one Italian Dermatology Units were asked to collect the demographic, clinical, and histopathologic data of 200 patients with COVID-19–associated skin manifestations. The severity of COVID-19 was classified as asymptomatic, mild, moderate, or severe. Results: A chilblain-like acral pattern was significantly associated with a younger age (P <.0001) and, after adjusting for age, significantly associated with less severe COVID-19 (P =.0009). However, the median duration of chilblain-like lesions was significantly longer than that of the other cutaneous manifestations taken together (P <.0001). Patients with moderate/severe COVID-19 were more represented than those with asymptomatic/mild COVID-19 among the patients with cutaneous manifestations other than chilblain-like lesions, but only the confluent erythematous/maculo-papular/morbilliform phenotype was significantly associated with more severe COVID-19 (P =.015), and this significance disappeared after adjustment for age. Limitations: Laboratory confirmation of COVID-19 was not possible in all cases. Conclusions: After adjustment for age, there was no clear-cut spectrum of COVID-19 severity in patients with COVID-19–related skin manifestations, although chilblain-like acral lesions were more frequent in younger patients with asymptomatic/pauci-symptomatic COVID-19.
AB - Background: COVID-19 is associated with a wide range of skin manifestations. Objective: To describe the clinical characteristics of COVID-19–associated skin manifestations and explore the relationships among the 6 main cutaneous phenotypes and systemic findings. Methods: Twenty-one Italian Dermatology Units were asked to collect the demographic, clinical, and histopathologic data of 200 patients with COVID-19–associated skin manifestations. The severity of COVID-19 was classified as asymptomatic, mild, moderate, or severe. Results: A chilblain-like acral pattern was significantly associated with a younger age (P <.0001) and, after adjusting for age, significantly associated with less severe COVID-19 (P =.0009). However, the median duration of chilblain-like lesions was significantly longer than that of the other cutaneous manifestations taken together (P <.0001). Patients with moderate/severe COVID-19 were more represented than those with asymptomatic/mild COVID-19 among the patients with cutaneous manifestations other than chilblain-like lesions, but only the confluent erythematous/maculo-papular/morbilliform phenotype was significantly associated with more severe COVID-19 (P =.015), and this significance disappeared after adjustment for age. Limitations: Laboratory confirmation of COVID-19 was not possible in all cases. Conclusions: After adjustment for age, there was no clear-cut spectrum of COVID-19 severity in patients with COVID-19–related skin manifestations, although chilblain-like acral lesions were more frequent in younger patients with asymptomatic/pauci-symptomatic COVID-19.
KW - COVID-19
KW - SARS-CoV-2
KW - coronavirus
KW - infection
KW - skin manifestations
KW - COVID-19
KW - SARS-CoV-2
KW - coronavirus
KW - infection
KW - skin manifestations
UR - http://hdl.handle.net/10807/205981
U2 - 10.1016/j.jaad.2021.01.023
DO - 10.1016/j.jaad.2021.01.023
M3 - Article
SN - 0190-9622
VL - 84
SP - 1356
EP - 1363
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
ER -