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.

Marzano, A. V., Genovese, G., Moltrasio, C., Gaspari, V., Vezzoli, P., Maione, V., Misciali, C., Sena, P., Patrizi, A., Offidani, A., Quaglino, P., Arco, R., Caproni, M., Rovesti, M., Bordin, G., Recalcati, S., Potenza, C., Guarneri, C., Fabbrocini, G., Tomasini, C., Sorci, M., Lombardo, M., Gisondi, P., Conti, A., Casazza, G., Peris, K., Calzavara-pinton, P., Berti, E., The clinical spectrum of COVID-19–associated cutaneous manifestations: An Italian multicenter study of 200 adult patients, <<JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY>>, 2021; 84 (5): 1356-1363. [doi:10.1016/j.jaad.2021.01.023] [http://hdl.handle.net/10807/205981]

The clinical spectrum of COVID-19–associated cutaneous manifestations: An Italian multicenter study of 200 adult patients

Genovese G.;Peris K.;Berti E.
2021

Abstract

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.
Inglese
Marzano, A. V., Genovese, G., Moltrasio, C., Gaspari, V., Vezzoli, P., Maione, V., Misciali, C., Sena, P., Patrizi, A., Offidani, A., Quaglino, P., Arco, R., Caproni, M., Rovesti, M., Bordin, G., Recalcati, S., Potenza, C., Guarneri, C., Fabbrocini, G., Tomasini, C., Sorci, M., Lombardo, M., Gisondi, P., Conti, A., Casazza, G., Peris, K., Calzavara-pinton, P., Berti, E., The clinical spectrum of COVID-19–associated cutaneous manifestations: An Italian multicenter study of 200 adult patients, <>, 2021; 84 (5): 1356-1363. [doi:10.1016/j.jaad.2021.01.023] [http://hdl.handle.net/10807/205981]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/205981
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