Skin manifestations of COVID-19

Cover Page

Cite item


The infection caused by the recently identified SARS-CoV-2, dubbed coronavirus disease-19 (COVID-19), has become a pandemic. With exponential growth of morbidity among the people around the world, the clinical characteristics of COVID-19 are becoming clearer and description of new disease symptoms descriptions is emerging. The sufficient amount of descriptions of various skin manifestations in patients with COVID-19 has appeared, however they are characterized by great heterogeneity. The pathogenetic mechanisms of the development of skin rashes in patients with COVID-19 are currently unknown, however, hypotheses have been put forward that they have an overactive immune response, activation of the complement system and microvascular damage. Based on the published literature data and our own experience, the following characteristic types of skin rashes can be distinguished among the skin manifestations of this viral disease: urticaria, confluent, papulovesicular exanthema, acral rashes similar to frostbite, livedo reticularis and purpura. Possible development of skin lesions against the background of the development of COVID-19 provides the need to inform dermatologists about the features of the skin manifestations of this disease, as well as to study further these symptoms of COVID-19 to determine their diagnostic and prognostic value.

About the authors

E. V. Dvoryankova

Center for theoretical problems of physical and chemical pharmacology of the Russian Academy of Sciences

Author for correspondence.
Moscow, Russian Federation

I. M. Korsunskaya

Center for theoretical problems of physical and chemical pharmacology of the Russian Academy of Sciences

Moscow, Russian Federation

T. A. Slavyanskaya

Peoples’ Friendship University of Russia (RUDN University)

Moscow, Russian Federation


  1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727-733.
  2. Recalcati S. Cutaneous manifestations in COVID-19: a first perspective. J Eur Acad Dermatol Venereol. 2020;34:212-213.
  3. Galván Casas C, Català A, Carretero Hernández G, Rodríguez-Jiménez P, Fernández Nieto D. Rodríguez-Villa Lario A, et al. Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases. Br J Dermatol. 2020;183:71-77.
  4. Marzano AV, Cassano N, Genovese G, Moltrasio C, Vena GA. COVID-19-associated cutaneous manifestations. Br J Dermatol. 2020;183:431-442.
  5. Otto MA. The Hospitalist. Skin manifestations are emerging in the coronavirus pandemic. Available at: https://www.the-hospitalist. org/hospitalist/article/220183/coronavirus-updates/skin-manifestations-are-emerging-coronavirus-pandemic (accessed 28 May 2020).
  6. Imbalzano E, Casciaro M, Quartuccio S, Miciullo P., Cascio A, Calapai G, Gangemi S. Association between urticaria and virus infections: a systematic review. Allergy Asthma Proc. 2016;37:18-22.
  7. Mahe A, Birckel E, Krieger S, Merklen C, Bottlaender L. A distinctive skin rash associated with coronavirus disease 2019? J Eur Acad Dermatol Venereol. 2020;34:246-247.
  8. Estebanez A, Perez-Santiago L, Silva E, Guillen-Climent S, Garcia-Vazquez A, Ramon MD, et al. Cutaneous manifestations in COVID-19: a new contribution. J Eur Acad Dermatol Venereol. 2020;34:e250-1.
  9. Sanchez A, Sohier P, Benghanem S, L’Honneur A.-S, Rosenberg F, Dupin N, Garel B. Digitate papulosquamous eruption associated with severe acute respiratory syndrome coronavirus 2 infection. JAMA Dermatol. 2020;156(7): 819-820.
  10. Bouaziz JD, Duong T, Jachiet M, Velter C, Lestang P, CassiusC, et al. Vascular skin symptoms in COVID-19: a French observational study. J Eur Acad Dermatol Venereol. 2020. In press [https://].
  11. Otto MA. The Hospitalist. Skin manifestations are emerging in the coronavirus pandemic. Available at: https://www.the (Accessed 28 May 2020).
  12. Magro C, Mulvey JJ, Berlin D, Nuovo G, Salvatore S, Harp J, et al. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases. Transl Res. 2020;220:1-13.
  13. Joob B, Wiwanitkit V. COVID-19 can present with a rash and be mistaken for dengue. J Am Acad Dermatol 2020;82:e177.

Copyright (c) 2021 Dvoryankova E.V., Korsunskaya I.M., Slavyanskaya T.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies