Cutaneous Manifestations in Patients With COVID-19

A Preliminary Review of an Emerging Issue

A.V. Marzano; N. Cassano; G. Genovese; C. Moltrasio; G.A. Vena


The British Journal of Dermatology. 2020;183(3):431-442. 

In This Article


Different cutaneous manifestations have been described in the setting of COVID-19. Although their pathogenic mechanisms are still unclear, hyperactive immune response, complement activation and microvascular injury have been implicated. The possible relationship between skin manifestations and COVID-19 is an important aspect that deserves great attention and efforts in order to improve our understanding of such phenomena. On the other hand, the contributing roles of other infectious agents, patient comorbidities, immune status, concurrent treatments and other still undefined factors remain speculative.

The presence of cutaneous findings that can lead to suspicion of COVID-19 and identify potentially contagious cases with an indolent course puts dermatologists in a relevant position. Furthermore, the role of COVID-19-associated skin manifestations as prognostic markers needs to be further deepened.

However, literature reports indicated a great heterogeneity in cutaneous manifestations, and their latency periods and associated extracutaneous symptoms. Moreover, difficulties are increased by the possible occurrence of skin lesions in paucisymptomatic or asymptomatic patients. Wide use of reliable serological assays will be important. Moreover, in future studies it would be useful to assess the viral load at different timepoints,[47] and to detect viral RNA or particles within lesional skin.