Female-presenting doctors examines skin marks with a magnifying glass on a man’s back (illustration)

The American Academy of Dermatology has started a registry to collect evidence and case reports from doctors following increasing evidence that COVID-19, the disease caused by the coronavirus SARS-CoV-2, causes skin rashes and symptoms.

Since the outbreak of COVID-19, experts have learned that the virus causes more than respiratory symptoms for patients. Along with telltale signs such as a fever, cough and shortness or breath and severe difficulty breathing in serious cases, research suggests COVID-19 can lead to a wide range of other symptoms. These symptoms may include digestive issues, pink eye, sudden loss of smell or taste, and in rarer cases, heart and neurological issues.

In March, some doctors started to notice skin-related symptoms in people who were diagnosed with COVID-19. A small early study based in Italy found that 20% of the 88 patients studied developed a skin symptom. About half of the participants developed the rash at the beginning of their illness while the other half didn’t develop a rash until later. A case report about a patient in Thailand highlighted that a patient was misdiagnosed based on a skin rash that turned out to be COVID-19.

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Skin symptoms doctors around the world have observed in COVID-19 patients include:

Patchy, red rash (erythematous rash)

Hives

Chicken pox-like blisters

Blotchy, reddish-purple mottling (livedoid eruptions caused by small blood vessel blockages or occlusions)

Small, round purple-brown spots on the skin (petechiae also caused by blood vessel occlusions)

Tiny bruises (due to blood vessel occlusions)

Other viruses are known to cause skin symptoms, so the fact COVID-19 may do the same isn’t surprising to researchers. So far, there isn’t enough information to determine which rashes or skin symptoms are most common in COVID-19 patients or what they could mean for patient outcomes. The American Academy of Dermatology developed a registry for doctors to enter case reports to better understand how COVID-19 may impact the skin.

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“It’s so varied, what we’re seeing, and the rashes being reported can be seen in a variety of other diseases,’” Sarah Young, M.D., a medical dermatologist, told Cleveland Clinic.  “I do think reports are starting to come out, so as we are building these types of registries, I think we will start to see more information about skin symptoms.”

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