key: cord-0844155-3w209h6i
authors: Pangti, R.; Gupta, S.; Nischal, N.; Trikha, A.
title: Recognizable vascular skin manifestations of SARS CoV‐2 infection are uncommon in patients with skin‐of‐color
date: 2020-08-16
journal: Clin Exp Dermatol
DOI: 10.1111/ced.14421
sha: 284d3348e0e8e08de6e6e45f3e01b05ce4b70d00
doc_id: 844155
cord_uid: 3w209h6i

Reported cutaneous manifestations of SARS‐Cov‐2 infection include maculopapular rash, urticarial rash, varicelliform or vesicular lesions, petechiae/purpura, livedoid/necrotic lesions, chilblains‐like lesions (Covid toes), erythema multiforme‐like lesions,(1) and aphthous ulcers.(2) These cutaneous manifestations have been mostly reported from countries with Caucasian populations with a paucity of data from the skin‐of‐color populations.(3) We conducted a prospective study to report the prevalence and patterns of cutaneous manifestations in COVID‐19 patients from India.

We included all patients of an inpatient department at a dedicated center for COVID-19-positive patients in All India Institute of Medical Sciences, India from June 11 to July 10, 2020. The patients were admitted after a positive report of a reverse transcription-polymerase chain reaction for COVID-19. All the inpatients were screened for any cutaneous lesions by one dermatologist (RP).

A total of 10 patients (7.25%) had cutaneous manifestations out of 138 patients admitted in a 30day period. We devised the following criteria to distinguish COVID-19 related cutaneous manifestations from incidental or unrelated skin findings: Major criteria-Temporal correlation with the onset of COVID-19 symptoms or positivity (-2 to 21 days from systemic symptoms).

This range was kept after analyzing the various cases reported in literature. 4 There seems to be a wide variation in the prevalence of cutaneous manifestations, ranging from 0.2% in a study on Chinese patients 5 , 7.25% in our study to 20.4% in a study from Italy. 6 Recognizable vascular cutaneous manifestations are uncommon in Indian patients such as chilblains-like lesions, livedoid/ necrotic lesions, vasculitis, and vasculopathic ulcers. Geographic differences have also been observed in the severity of COVID-19 symptoms and the mortality rates across various parts of the world, with India having a low case fatality rate. The explanation for this is not known, however, lipoprotein A has been identified to be an independent risk factor for cardiovascular, peripheral arterial and cardiovascular diseases, and impaired fibrinolysis. 

This article is protected by copyright. All rights reserved manifestations in systemically asymptomatic patients. The limitation of the study is small sample size. The strength, however, is the patients were screened by a dermatologist who was directly involved in the care of the COVID-19 inpatients. 

This article is protected by copyright. All rights reserved 

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