Maculopapular eruptions associated to COVID-19: A subanalysis of the COVID-Piel study

Dermatol Ther. 2020 Nov;33(6):e14170. doi: 10.1111/dth.14170. Epub 2020 Sep 9.

Abstract

A previous study has defined the maculopapular subtype of manifestations of COVID-19. The objective of our study was to describe and classify maculopapular eruptions associated with COVI-19. We carried out a subanalysis of the maculopapular cases found in the previous cross-sectional study. Using a consensus, we defined seven clinical patterns. We described patient demographics, the therapy received by the patient and the characteristics of each pattern. Consensus lead to the description of seven major maculopapular patterns: morbilliform (45.5%), other maculopapular (20.0%), purpuric (14.2%), erythema multiforme-like (9.7%), pytiriasis rosea-like (5.7%), erythema elevatum diutinum-like (2.3%), and perifollicular (2.3%). In most cases, maculopapular eruptions were coincident (61.9%) or subsequent (34.1%) to the onset of other COVID-19 manifestations. The most frequent were cough (76%), dyspnea (72%), fever (88%), and astenia (62%). Hospital admission due to pneumonia was frequent (61%). Drug intake was frequent (78%). Laboratory alterations associated with maculo-papular eruptions were high C-reactive protein, high D-Dimer, lymphopenia, high ferritin, high LDH, and high IL-6. The main limitation of our study was the impossibility to define the cause-effect relationship of each pattern. In conclusion, we provide a description of the cutaneous maculopapular manifestations associated with COVID-19. The cutaneous manifestations of COVID-19 are wide-ranging and can mimic other dermatoses.

Keywords: COVID-19; coronavirus; cutaneous manifestations; skin.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use
  • COVID-19 / complications
  • COVID-19 / diagnosis
  • COVID-19 / virology*
  • COVID-19 Drug Treatment
  • Cross-Sectional Studies
  • Female
  • Host-Pathogen Interactions
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • SARS-CoV-2 / drug effects
  • SARS-CoV-2 / pathogenicity*
  • Skin / pathology
  • Skin / virology*
  • Skin Diseases, Viral / diagnosis
  • Skin Diseases, Viral / virology*
  • Spain
  • Young Adult

Substances

  • Antiviral Agents