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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
PLEASE NOTE: THIS IS NO LONGER RELEVANT AND IS NOT BEING UPDATED BUT HAS BEEN LEFT ON THE SITE FOR REFERENCE PURPOSES ONLY

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