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      Maculopapular skin eruptions associated with Covid‐19: A systematic review

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          Abstract

          In this systematic review, we anticipated in summarizing clinical features, histopathological hallmarks, and possible pathology behind the maculopapular skin eruptions occurring in Covid‐19 patients. A literature search was executed using MEDLINE/PubMed and Embase databases for articles published till 20 November 2020. All eligible articles including observational studies, case reports, and case series reporting the maculopapular skin lesion in Covid‐19 patients were included. Data were obtained for 354 Covid‐19 patients presenting with maculopapular lesions from 40 studies. The mean age of these patients was 53 years, and with 42% of them being male. These maculopapular lesions differed considerably in terms of distribution and appearance, ranging from diffuse erythematous maculopapular lesions to scattered erythematous macules coalescing into papules to maculopapular lesions in plaques. The mean duration of the lesion was 8 days. These lesions were frequently localized on trunks and extremities. Superficial perivascular dermatitis with lymphocytic infiltrate was a histopathological hallmark of these lesions. As these skin lesions may have a possible association with diagnosis, management, prognosis, and severity of the disease, all health practitioners need to be well acquainted with these Covid‐19 skin lesions. Also, in the middle of this worldwide pandemic, early identification of this eruption may help manage this infection's further spread.

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          Most cited references55

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          Clinical Characteristics of Coronavirus Disease 2019 in China

          Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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            A Novel Coronavirus from Patients with Pneumonia in China, 2019

            Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)
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              Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement

              David Moher and colleagues introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses
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                Author and article information

                Contributors
                sawais.rathore77@gmail.com
                Journal
                Dermatol Ther
                Dermatol Ther
                10.1111/(ISSN)1529-8019
                DTH
                Dermatologic Therapy
                John Wiley & Sons, Inc. (Hoboken, USA )
                1396-0296
                1529-8019
                02 February 2021
                : e14788
                Affiliations
                [ 1 ] Internal Medicine Ross University School of Medicine Miramar Florida USA
                [ 2 ] Internal Medicine Dr. Sampurnanand Medical College Jodhpur India
                [ 3 ] Internal Medicine MGM Medical College and Hospital Aurangabad India
                [ 4 ] Internal Medicine Kasturba Medical College Manipal India
                [ 5 ] Internal Medicine Andhra Medical College Visakhapatnam India
                [ 6 ] Internal Medicine Ziauddin Medical University Karachi Pakistan
                [ 7 ] Internal Medicine, School of medicine Universidad Peruana Cayetano Heredia Lima Peru
                [ 8 ] Scientific Society of Medical Students Cayetano Heredia Lima Peru
                [ 9 ] Internal Medicine Dow Medical College Karachi Pakistan
                [ 10 ] Internal Medicine Liaquat College of Medicine and Dentistry Karachi Pakistan
                [ 11 ] Internal Medicine Ziauddin Medical College Karachi Pakistan
                Author notes
                [*] [* ] Correspondence

                Sawai Singh Rathore, Medical student, Dr. Sampurnanand Medical College, Shastri Nagar, Residency Road, Jodhpur, India.

                Email: sawais.rathore77@ 123456gmail.com

                Author information
                https://orcid.org/0000-0003-1954-094X
                https://orcid.org/0000-0002-3910-1189
                https://orcid.org/0000-0002-4937-0227
                Article
                DTH14788
                10.1111/dth.14788
                7995033
                33481314
                7893026e-0b8f-41b4-9d4a-264559b0e94c
                © 2021 Wiley Periodicals LLC.

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 01 January 2021
                : 09 December 2020
                : 17 January 2021
                Page count
                Figures: 1, Tables: 4, Pages: 14, Words: 7226
                Categories
                Review Article
                Review Articles
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.9 mode:remove_FC converted:26.03.2021

                covid‐19,sars‐cov‐2,skin,skin diseases,viral exanthema

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