Rash as a sign of COVID-19?

The first cases of Coronavirus disease, also known as COVID-19, presented in China in December of 2019. Clinical signs of COVID include dry cough, fever, shortness of breath, fatigue, loss of taste, loss of smell, loss of appetite and rhinorrhea. Due to the extraordinary need of medical providers in Italy, dermatologists found themselves along the front lines providing care to COVID positive patients. A recently published letter to the Editor in the Journal of the European Academy of Dermatology and Venereology reveals the first known report of cutaneous findings of these dermatologists providing care to these patients.

In this small sample of patients, 20% developed cutaneous manifestations with close to half of these patients presenting with these at the onset. The most common presentation was an . Additional presentation included widespread urticaria and one patient presented with a vesicular rash similar to varicella. Of these patients, there was no observed correlation between severity of disease and cutaneous manifestations. In addition, pruritus was absent or minimal and lesion duration was for a few days.

Only with time will we have a full picture of COVID-19, but this early report may give clues to additional, under-reported signs of this disease. As the incubation period of COVID may be as long as 14 days, it is important we gather as much information as possible to allow diagnosis and isolation of these patients. Skin findings may be another clue to those who may be infected with the virus.