key: cord-0763077-0wwdd3km
authors: Dertlioğlu, Selma Bakar
title: Skin manifestations in COVID‐19: A case series of five patients from Elazığ, Turkey
date: 2020-07-13
journal: Dermatol Ther
DOI: 10.1111/dth.13932
sha: 22ab6b41a151a9ecbd2f0b59d1bfdde577bc9d62
doc_id: 763077
cord_uid: 0wwdd3km

nan

A 29-year-old man presented with an acute eruption on his trunk. The 

We present a healthy teenager with no history of any other skin problems. His symptoms began with a mild headache, anosmia, and low-grade fever. A few days after the onset of these symptoms, his cutaneous lesions appeared. Purple, erythematous macules were seen on the left four toes, involving the metatarsophalangeal joints ( Figure 4 ).

He showed complete clinical recovery within a few days.

The last patient is a 10-month-old baby. He exhibited a widespread erythematous rash on his body and arm ( Figure 5 ). The rash disappeared on day 10 without treatment.

The first report of cutaneous manifestations in COVID-19 was from Italy. They concluded that the manifestations are similar to skin findings seen in other common viral infections. 1 In another review on the clinical features of COVID-19 from China, rash was observed in 0.2% of cases. However, no details about skin findings were described in that study. 3 There were also publications reporting that two infants had rashes at birth. 4 It is possible for COVID-19 patients to initially present with a skin rash that may be misdiagnosed as another disease. In a case report, erythematous rashes similar to drug reactions were observed, suggesting that dermatologists must also consider COVID-19 in the differential diagnosis of cutaneous drug reactions. 5, 6 COVID-19 can feature signs of small blood vessel occlusion. In the literature, there are some reports describing ischemic and ecchymotic lesions of the fingers, dusky acrocyanosis and dry gangrene and more frequently of the toes in patients suffering from very severe, often lethal forms of COVID-19. 1, [7] [8] [9] In brief, consistent with Recalcati's report, the lesions we describe often look like erythematous, urticaria, or morbilliform rash. The trunk was the most frequently involved region, itching was mild or absent, and the lesions usually healed within a few days. The COVID-19 patients who presented with skin findings were relatively young and most had a mild clinical course, which we believe is a result of their younger age and lack of additional pathologies. The cutaneous manifestations could be related to the patients' immune response. Indeed, the observed skin manifestations were generally non-specific and similar to those viral infec- 

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