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      Classification of the cutaneous manifestations of COVID‐19: a rapid prospective nationwide consensus study in Spain with 375 cases

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          Summary

          Background

          Cutaneous manifestations of COVID‐19 disease are poorly characterized.

          Objectives

          To describe the cutaneous manifestations of COVID‐19 disease and to relate them to other clinical findings

          Methods

          Nationwide case collection survey of images and clinical data. Using a consensus, we described 5 clinical patterns. We later described the association of these patterns with patient demographics, timing in relation to symptoms of the disease, severity, and prognosis.

          Results

          Lesions may be classified as acral areas of erythema with vesicles or pustules (Pseudo‐chilblain) (19%), other vesicular eruptions (9%), urticarial lesions (19%), maculopapular eruptions (47%) and livedo or necrosis (6%). Vesicular eruptions appear early in the course of the disease (15% before other symptoms). The pseudo‐chilblain pattern frequently appears late in the evolution of the COVID‐19 disease (59% after other symptoms), while the rest tend to appear with other symptoms of COVID‐19. Severity of COVID‐19 shows a gradient from less severe disease in acral lesions to most severe in the latter groups. Results are similar for confirmed and suspected cases, both in terms of clinical and epidemiological findings. Alternative diagnoses are discussed but seem unlikely for the most specific patterns (pseudo‐chilblain and vesicular).

          Conclusions

          We provide a description of the cutaneous manifestations associated with COVID‐19 infection. These may help clinicians approach patients with the disease and recognize paucisymptomatic cases.

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          Author and article information

          Contributors
          Ignacio.garcia.doval@sergas.es
          Journal
          Br J Dermatol
          Br. J. Dermatol
          10.1111/(ISSN)1365-2133
          BJD
          The British Journal of Dermatology
          John Wiley and Sons Inc. (Hoboken )
          0007-0963
          1365-2133
          29 April 2020
          : 10.1111/bjd.19163
          Affiliations
          [ 1 ] Hospital Universitario de Móstoles Madrid Spain
          [ 2 ] Hospital Plató Barcelona Spain
          [ 3 ] Hospital Universitario de Gran Canaria Dr. Negrín Las Palmas Spain
          [ 4 ] Hospital Universitario de la Princesa Madrid Spain
          [ 5 ] Hospital Universitario Ramón y Cajal Madrid Spain
          [ 6 ] Hospital Universitario Príncipe de Asturias, Alcalá de Henares Madrid Spain
          [ 7 ] Hospital Universitario "Marqués de Valdecilla" Santander Spain
          [ 8 ] Hospital Universitario Clínico San Cecilio Granada Spain
          [ 9 ] Hospital Universitario 12 de Octubre Madrid Spain
          [ 10 ] Gavín Dermatólogos Vigo Spain
          [ 11 ] Hospital General Universitario Gregorio Marañón Madrid Spain
          [ 12 ] Hospital Universitari Vall d'Hebron Barcelona Spain
          [ 13 ] Hospital Universitari Germans Trias i Pujol Badalona Spain
          [ 14 ] Hospital de la Santa Creu i Sant Pau Barcelona Spain
          [ 15 ] Hospital Universitario de Bellvitge Hospitalet de Llobregat Barcelona Spain
          [ 16 ] Consorci Sanitari Parc Taulí, Sabadell Barcelona Spain
          [ 17 ] Althaia, Xarxa Assistencial Universitària de Manresa, Manresa Barcelona Spain
          [ 18 ] Complejo Asistencial Universitario de Salamanca Salamanca Spain
          [ 19 ] Hospital General de Granollers Barcelona Spain
          [ 20 ] Hospital Universitario La Paz Madrid Spain
          [ 21 ] Research Unit Fundación Piel Sana Academia Española de Dermatología y Venereología Madrid Spain
          Author notes
          [*] [* ] Corresponding author

          Ignacio Garcia‐Doval

          Email: Ignacio.garcia.doval@ 123456sergas.es

          [†]

          Equally contributed as first authors

          Article
          BJD19163
          10.1111/bjd.19163
          7267236
          32348545
          9a8b3e3f-9c4f-4c12-8603-402ae6119081
          This article is protected by copyright. All rights reserved.

          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
          Page count
          Figures: 0, Tables: 0, Pages: 28, Words: 534
          Categories
          Original Article
          Original Articles
          Custom metadata
          2.0
          accepted-manuscript
          Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.3 mode:remove_FC converted:03.06.2020

          Dermatology
          covid‐19,skin manifestations,diagnosis
          Dermatology
          covid‐19, skin manifestations, diagnosis

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