key: cord-0757587-dkzxifnu
authors: Conforti, Claudio; Zalaudek, Iris; Giuffrida, Roberta; Zorat, Francesca; Grillo, Andrea; Colapietro, Nina; Francica, Morena; di Meo, Nicola
title: “COVID‐Mask”: an atypical livedoid manifestation of COVID‐19 observed in a northern Italy hospital
date: 2020-05-29
journal: Dermatol Ther
DOI: 10.1111/dth.13701
sha: 7736efc4cd8192eed3ff10dd73b595874dcf6e5f
doc_id: 757587
cord_uid: dkzxifnu

nan

Dear Editor, we read with great interest "Cutaneous signs in COVID-19 patients: a review" by Wollina et al. recently published in Dermatologic Therapy Journal. 1 The Authors overviewed all skin findings related to coronavirus disease 2019 (COVID-19) infection described in literature until now, such as morbilliform or vesicular rash, urticaria and chilblains. 1,2 However livedo reticularis (LR) has been poorly described. This article is protected by copyright. All rights reserved.

LR is a cutaneous condition typically observed in the lower extremities, caused by reduction in blood flow and reduced oxygen supply to the skin, sustained by thrombosis, emboli or vasospasms. 4 It usually affects the gravity-dependent areas, which have an increased risk of thromboembolism. 4 The latter have been described in other organs (e.g. heart, lung, brain or kidney) in association or not with disseminated intravascular coagulation and recently also in the skin. 5 The reported case shows how even the trunk, the back and the face may also be affected. Due to the brief duration and evanescence of skin manifestations, which resolved 24 hours after starting therapy with heparin 4000 U.I. twice a day, it was not possible to perform a biopsy with histologica l examination. However, this report is a warning that the skin should also be carefully assessed in COVID-19 patients. The facial manifestation, renamed ''COVID-mask'' due to its mask-like appearance, in fact, can be confused with other inflammatory facial disorders even if it differs for its sudden onset and fugacity. Studies on larger cohorts of patients are certainly necessary to assess the actual incidence of this manifestation and to evaluate histological and laboratory correlations.

This article is protected by copyright. All rights reserved. 

This article is protected by copyright. All rights reserved.

Cutaneous Signs in COVID-19 Patients: A Review

Cutaneous manifestations in COVID-19: a first perspective

A Dermatologic Manifestation of COVID-19: Transient Livedo Reticularis

Livedo reticularis: an update

Endothelial cell infection and endotheliitis in COVID-19