COVID-19 RASHES

COVID-19 RASHES

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A tiny virus with a mighty agenda has disrupted our world and our lives, and thrown us in the middle of a war we know very little about. Purpose of this page is to rapidly communicate information on skin manifestations of COVID-19 as it becomes available. Please note that this is a very rapidly evolving illness, and we will encounter the many faces and manifestations of this illness. As clinical efforts continue globally, novel findings are being reported across nations and borders. This page will be updated as more information becomes available. The cases reported on this page should be viewed as observations only and not as recommendations for evaluation or treatment.

Please refer to World Health Organization (WHO), CDC, and your local health agencies for most up to date information about current situation and guidelines. Seek your doctor for any changes in your health or symptoms.

What is COVID-19?

Coronaviruses are a large family of viruses that are known to cause common colds, gastro-intestinal diseases, to severe illnesses like MERS (Middle East Respiratory Syndrome) and SARS (Severe Acute Respiratory Syndrome). COVID-19 is the viral respiratory illness caused by a coronavirus that was first identified in Wuhan, China in December 2019. This virus was named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2).

How does one catch the virus that causes COVID-19?

The virus spreads mainly from person-to-person and people of all ages can get infected. When an infected person sneezes or coughs, respiratory droplets get deposited on uninfected person, surfaces, and can even get suspended in the air. These droplets can land in the mouths or noses of nearby people (within 6 feet) or be contracted when a person touches a surface or object that has the virus on it. When the virus particles are inhaled into lungs, or brought to own mouth, nose, or eyes by touching, the infection can start developing in the next person. Some infected people spread the virus without even showing signs or symptoms of shedding (asymptomatic shedding).

What are the common signs and symptoms of COVID-19?

Most patients with confirmed COVID-19 suffer from mild to severe respiratory illness with fever, dry cough, shortness of breath, and fatigue. Some patients experience muscle aches, headaches, sore throats, diarrhea, or loss of taste or smell. Symptoms usually appear 2-14 days after exposure.

What is the treatment?

Many patients do not exhibit any symptoms at all and do not even know that they are infected. Most healthy individuals have mild or moderate illness and do not require a clinic visit or hospitalization. Any individuals that show symptoms should self-quarantine at home for 14 days to prevent spreading the virus to others. It is still important to monitor your symptoms at home as infected patients can suddenly become seriously ill, especially during the second week of illness. It is recommended to monitor body temperature and oxygen saturation at home using a fingertip pulse oximeter.

Who is at risk for acquiring COVID-19?

Those at highest risk for severe illness include elderly, those with certain underlying health conditions, and those with weakened immune systems. High risk medical conditions include blood disorders, chronic kidney disease, chronic liver disease, compromised immune system, late term or recent pregnancy, endocrine disorders, metabolic disorders, heart disease, lung disease, and neurological conditions. Your doctor can tell you if you are considered a high-risk patient.

What are the skin rashes seen with COVID-19?

The SARS-CoV-2 virus responsible for COVID-19 can cause viral exanthem, which is a skin rash associated with viral infections.

COVID-19 cases in Italy

One study by dermatologists at the Alessandro Manzoni Hospital in Lecco, Northern Italy observed skin rashes in about one-fifth (20%) of their COVID-19 patients (J Eur Acad Dermatol Venereol. 2020 Mar 26.This study reported chicken-pox like rash, diffuse red rash and hives-like rash in patients with confirmed COVID-19. 

Skin rashes we are seeing in COVID-19 patients, “are similar to cutaneous involvement occurring during common viral infections,” said Dr Sebastiano Recalcati, a dermatologist at Alessandro Manzoni Hospital.

COVID-19 cases in Thailand

We are also seeing case reports emerging from Thailand where first case of COVID-19 was diagnosed in January 2020. A COVID-19 patient presented at a Bangkok hospital with rash that looked like the rash of dengue fever with low platelet counts and petechiae (red pinpoint rash from bleeding under the skin). It was initially misdiagnosed as Dengue because of the clinical similarity, but the patient was eventually diagnosed with COVID-19 at a tertiary center where he presented with respiratory issues (J Am Acad Dermatol. 2020 Mar 22. pii: S0190-9622[20]30454-0. doi: 10.1016/j.jaad.2020.03.036)

COVID-19 cases in US

Dermatologists across the nation are exchanging observations from their outpatient dermatology offices of confirmed or suspected COVID-19 rashes. There have been many reports of COVID-19 associated livedoid rashes and perniosis (chilblains) rashes. Similar reports are coming out of France.

Click on representative photos to read more about the clinical presentation, signs, and symptoms of these skin conditions.

Dengue Rash
Dengue Rash
Dengue Rash
Hives (Urticaria)
Urticaria (hives)
Hives (Urticaria)
chicken pox like rash
chicken pox like rash
Petechial rash
Petechial rash
Chilblains Perniosis
Chilblains Perniosis
Livedo Reticularis
Livedo Reticularis