Apart from the symptom triad—fever, dry cough, and shortness of breath, COVID-19 is now associated with a long list of other symptoms, including cutaneous manifestations that have not been widely looked into by health experts.
Recent reports from Italy and Thailand now suggest that skin rash is a telling symptom of the much-dreaded COVID-19.
With the emergence of skin rash as a possible symptom of the coronavirus, doctors now include the presence of skin rashes during their assessment of patients suspected of being infected with COVID-19.
What doctors know at present is that the development of skin rashes may be a possible symptom of COVID-19, and patients who exhibit them along with the three standard symptoms need to be tested for proper diagnosis and proper treatment.
Early Cases of Skin Symptoms
Based on early reports from dermatologists providing treatment to COVID-19 patients in Italy, 20% of 88 confirmed COVID-19 patients developed skin rashes, with almost 50% of these patients developing skin rashes at the onset of infection.
Fifty percent of those who manifested skin rashes required hospitalisation to receive proper treatment and medical intervention.
Another observation is that from the list of affected patients with skin rashes, the most prevalent skin symptom that manifested was the development of patchy red rashes.
Some suffered from urticaria or hives, while one patient eventually developed blisters that were similar to chickenpox. The skin rashes mostly appeared in the trunk.
In a separate report, clinicians in Thailand described a COVID-19 patient who was initially misdiagnosed with dengue to broken blood vessels, a skin rash common among dengue patients.
There were also reports of confirmed COVID-19 patients who manifested mottling, which is a clear sign of occlusion of blood vessels near the superficial layer of the skin. The challenge for clinicians who work with COVID-19 patients is that symptoms widely vary from one patient to another.
The skin rashes that were manifested by COVID-19 patients are also prevalent signs of other diseases. To date, no one rash type is specific to COVID-19.
One of the questions that dermatologists struggle with at this point is whether there is one specific rash type that develops exclusively among COVID-19 patients. They are also speculating whether the presence of skin symptoms is telling of the course or severity of the disease process.
Ultimately, they want to determine whether skin rashes affect the prognosis of a patient diagnosed with COVID-19. These questions are yet to be answered.
Recording of COVID-19 Patients with Skin Symptoms
Clinicians are releasing more insightful information as of late. The American Academy of Dermatology (AAD) created a registry for physicals and healthcare workers that will help them deal with patients who develop skin symptoms, or COVID-19 patients with existing skin rashes.
Furthermore, the AAD also released a dedicated COVID-19 dermatology platform that allows access to information and resources that will be extremely helpful for front liners.
Observe the Development of Skin Rashes
Until more reliable information is consolidated and looked into by dermatologists, clinicians need to be aware that a skin rash may be a possible symptom of COVID-19. With this in mind, skin rashes with other proven symptoms can be used to support the accurate diagnosis of coronavirus infection.
Physicians also need to keep in mind the possibility of misdiagnosis, especially in the case of mild rashes that have been reported.
Treatment for skin rashes among patients with COVID-19 should be geared towards establishing comfort for patients. The skin rashes are expected to subside during the recovery of patients.
The inclusion of skin rashes as a positive sign of COVID-19 is crucial as this helps clinicians improve the detection, prognosis, and treatment of COVID-19 positive individuals.