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Covid-19 Primary Care Resources


What do I need to know about skin manifestations of Covid-19?



Advice from a Consultant Dermatologist at the Hospital for Tropical Diseases

This information is sourced from Dr Stephen Walker, Consultant Dermatologist

Q. I have seen photos of cutaneous manifestations of Covid-19. But do patients ever present with these signs in isolation or are they accompanied by more typical Covid-19 symptoms too? What should I look out for in primary care?

A.

I think that Covid should be considered in a patient who has a fever and urticaria/or another rash because of the fever first and foremost. They are both non-specific and so a low index of suspicion is required

Emerging Evidence

  • study analysing data reported by users of a symptom tracking app reported that 8.8% of individuals who reported having a positive swab test for SARS-CoV-2 had had a rash
  • A separate survey of 694 respondents, in the same study, who stated they had had a positive swab or antibody test for SARS-CoV-2 found the majority had had other signs of Covid-19 when they developed skin symptoms but that approximately 3.6% stated that skin symptoms were the only symptom of their illness

Peer Reviewed Evidence

  • The published data on skin manifestations and Covid-19 needs to be interpreted with caution due to their retrospective (or semi-retrospective) nature and that the cohorts were hospitalised. The ISARIC data suggests that skin involvement is rare
  • This article suggests that chillblain-like lesions may occur in young asymptomatics and those with mild disease 
  • This British Association of Dermatologists (BAD) provides a useful summary of the large Spanish and Italian hospital studies

The BAD is partnering with dermatologists at GSTT to collate information about cutaneous signs potentially associated with Covid-19, both in adults and children and welcomes submissions from primary care colleagues

Please complete this survey if you have encountered a patient with confirmed or suspected Covid-19 who has also displayed a new-onset rash or skin symptoms NOT attributable to a pre-existing or known skin disease or other viral disease

Sources