Medical Dermatology

Coronavirus Pandemic: How COVID-19 Affects the Skin

Learn more about how COVID-19 affects the skin. Please refer to the CDC, WHO and State Departments of Health for the most up to date guidelines and information about COVID-19 in your community.

October 6, 2020

As each day goes by, we are learning more and more about the novel Coronavirus that causes COVID-19.  There is a burgeoning compendium of information that COVID-19 may present with skin symptoms.  Please note the knowledge base as it pertains to COVID-19 is rapidly evolving and we hope to keep you informed via this wiki.  The information contained below is solely for educational purposes and should not be used as a substitute for a visit with your physician who can properly evaluate and manage your symptoms.  Please refer to the CDC, WHO and State Departments of Health for the most up to date guidelines and information about COVID-19 in your community.

What is COVID-19?

“COVID-19 also known as Coronavirus disease 2019 is a respiratory illness that can spread from person to person.”  The virus that causes COVID-19, is named SARS-CoV-2 or Severe Acute Respiratory Syndrome Coronavirus 2.  SARS-CoV-2 virus belongs to a larger family of viruses called Coronavirues, these viruses have existed for quite some time and have been known to cause common colds, GI diseases and more severe but limited regionally diseases like SARS (Severe Acute Respiratory Syndrome) or MERS (Middle East Respiratroy Syndrome).  The novel coronavirus, SARS-CoV-2 and the disease it causes COVID-19 “was first identified during an investigation into an outbreak in Wuhan, China.”

How does COVID-19 spread?

Sars-CoV-2 likely started as an infection from an animal that was then spread to humans.  It is now spreading from person to person and leads to COVID-19 symptoms.  The virus is thought to spread between people in close contact with each other (within 6-13 feet) through respiratory droplets when an infected person coughs or sneezes.  These respiratory droplets can also land on surfaces or even be suspended in air after someone coughs or sneezes and if you touch the surface that has the virus and then touch your face, eyes, nose, or mouth or inhale the virus then you too can possibly become infected.

What are the symptoms of COVID-19?

The most common symptoms of COVID-19 include fever, cough, and shortness of breath.  Some patients may exhibit muscle aches, sore throat, loss of sense of smell or taste, headaches and GI disturbance such as diarrhea.  These symptoms can range from extremely mild to very severe including life threatening disease such as pneumonia, multi-organ failure and death.

How can I protect myself from COVID-19?

You can protect yourself from COVID-19 by socially distancing, wearing a face covering, like mask and googles and gloves when outside your home.  Avoid close contact with people who are sick. Avoid touching your eyes, nose, mouth and face with unwashed hands. Wash you hands with soap and water for at least 20 seconds (sing a song to yourself while you wash your hands to make sure you do it for at least 20 seconds).  Use an alcohol based hand sanitizer with at least 60% alcohol if soap and water are not available.

Is there a treatment or vaccine for COVID-19?

Currently there is no specific treatment or vaccine for COVID-19.  There are many investigative therapies and vaccines being studied and many early results have shown promise.  That being said there is much work to be done treat and/or vaccinate against COVID-19.  If you have symptoms of COVID-19 be sure to seek medical advice from your physician.

What are the skin rashes seen with COVID-19?

There has been a rapidly developing fund of knowledge that COVID-19 can lead to many skin rashes.  While initially, it was presumed that like most viruses it could lead to viral exanthem like rashes like Pityriasis Rosea, a rash commonly seen after the common cold which yields one large red patch followed by many smaller patches in a Christmas tree distribution on the trunk, it is now thought that COVID-19 has a much wider spectrum of skin diseases seen. These include pseudo-frostbite, red spots that look like chicken pox, livedo reticularis (when your skin looks mottled or net or lace like), new onset hives, painful persistent redness of the skin, or transient red patches particularly on the digits or nose known as perniosis.  These skin manifestations can be seen with or without respiratory disease.

COVID-19 skin rashes seen around the world

One study by Dermatologist Dr. Sebastiano Recalcati and staff Alessandro Mazzoni Hospital in Lecco, Italy showed of 88 patients seen, “18 patients (20.4%) developed cutaneous manifestations.  8 patients developed cutaneous involvement at the onset, 10 patients after hospitalization.  Cutaneous manifestations were erythematous rash (14 patients), widespread urticaria (3 patients) and chickenpox-like vesicles (1 patient). Trunk was the main involved region. Itching was low or absent and usually lesions healed in few days. Apparently there was no correlation with disease’s severity.” (J Eur Acad Dermatol Venereol. 2020 Mar 26. ( There are many Dermatologists across the US also seeing skin signs of COVID-19 in their offices and exchanging ideas, thoughts and observations throughout the country via social media. The most common signs being reported are livedo reticularis and perniosis, both as described above.  In addition, similar cases are being seen in France and discussed amongst French Dermatologists on a large WhatsApp group.

Skin Rashes seen in COVID-19 Positive patients:

Coronavirus Skin Rashes
Covid-19 Skin Rash

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