The cutaneous manifestations of COVID-19, personal protective equipment and treatment

  • Afaf Haddad Associate Professor, School of Medicine, University of Notre Dame, Sydney, Australia and Surgical Pathologist, Anatpath Services, Melbourne, Australia
  • Isabelle Haddad School of Pharmacy, Monash University Parkville, Australia


Since the beginning of COVID-19 pandemic in late 2019, the symptoms and signs detailed in the medical literature and the media concentrated on the effect of causative virus SARS-COV-2 on the respiratory tract, the coagulopathy associated with severe forms of the disease and the febrile flu like illness in the mild cases. The widespread publicising of the symptoms has been one of the important public health measures in combatting the rapid spread of COVID-19. Less known is the direct or indirect effect of COVID-19 on the skin and underlying soft tissue. Recognising the various cutaneous manifestations may prove a useful tool in early detection and management of COVID-19.

Keywords: covid-19, vaccine, rash, inflammation, vasculitis, pernio


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Author Biography

Afaf Haddad, Associate Professor, School of Medicine, University of Notre Dame, Sydney, Australia and Surgical Pathologist, Anatpath Services, Melbourne, Australia

Associate Professor, School of Medicine, University of Notre Dame, Sydney, Australia

Surgical Pathologist, Anatpath Services, Melbourne, Australia


1. Gottlieb M and Long B. Dermatologic manifestations and complications of COVID-19. Am J Emerg Med [Internet]. 2020 Sep; 38(9):1715-21. Available from:
2. Zara A, Fleming R, Lee K and Lynde C. The COVID-19 pandemic and its skin effects. Can Fam Physician [Internet]. 2021 Aug; 67(8):582-7. Available from:,%2C%20and%20Kawasaki%2Dlike%20rashes.
3. Suchonwanit P, Leerunyakul K, Kositkuljorn C. Cutaneous manifestations in COVID-19: Lessons learned from current evidence. J Am Acad Dermatol [Internet]. 2020 Jul; 83(1):e57-e60. Avaliable from:
4. Freeman EE, McMahon DE, Lipoff JB, Rosenbach M, Kovarik, C, Desai SR, Harp J, Takeshita J, French LE, Lim HW, Thiers BH, Hruza GJ, Fox LP. The spectrum of COVID-19 associated dermatologic manifestations: An international registry of 716 patients from 31 countries. J Am Acad Dermatol [Internet]. 2020 Oct; 83(4):1118-129. Available from:
5. Wollina U, Karadag AY, Rowland-Payne C, Chiriac A, Lotti T. Cutaneous signs in COVID-19 patients: A review. Dermatol Ther [Internet]. 2020 Sep; 33(5):e13549. Available from:
6. Gisondi P, Plaserico S, Bordin C, Alaibac M, Girolomoni G and Naldi L. Cutaneous manifestations of SARS-COV-2 infection: a clinical update. J Eur Acad Dermatol Venereol [Internet]. 2020 Nov; 34(11): 2499-504. Available from:,urticarial%20and%20acro%2Dpapular%20eruption.
7. Matar S, Oules B, Sohier P, Chosidow O, Beylot-Barry M, Dupin N and Aractingi S. Cutaneous Manifestations in SARS-CoV-2 infection (COVID-19): a French experience and systematic review of the literature. J Eur Acad Dermatol Venereol [Internet]. 2020 Jul; 34(11):e686-9. Available from:
8. Rahimi A and Tehranchinia Z. A comprehensive review of cutaneous manifestations associated with COVID-19. BioMed Research International [Internet]. 2020 July. Available from:
9. Freeman EE, McMahon DE, Lipoff JB, Rosenbach M, Kovarik, C, Takeshita J, French LE, Thiers BH, Hruza GJ, Fox LP. Pernio-like skin lesions associated with COVID-19: A case series of 318 patients from 8 countries. J Am Acad Dermatol [Internet]. 2020 Aug; 83(2):486-92. Available from:,with%20relatively%20mild%20COVID%2D19.
10. Marzano AV, Cassano N, Genovese G, Moltrasio C and Vena GA. Cutaneous manifestations in patients with COVID-19 preliminary review of an emerging issues. Br J Dermatol [Internet]. 2020 Sep;183(3):431-42. Available from:
11. Genovese G, Moltrasio C, Berti E, Marzano AV. Skin Manifestations associated with COVID-19: Current knowledge and future perspectives. Dermatology [Internet]. 2021 Nov; 237(1):1-12. Available from:
12. Lavery MJ, Bouvier CA, Thompson B. Cutaneous manifestations of COVID-19 in children (and adults): A virus hat does not discriminate. Clin Dermatol [Internet]. 2021 Apr; 39(2):323-8. Available from:
13. Fernandez-Nieto D, Ortega-Quijano D, Suarez-Valle A, Jiminez-Cauhe J, Jaen-Olasolo P and Fernandez-Guarino M. Lack of skin manifestations in COVID-19 hospitalised pateints during the second epidemic wave in Spain: a possible association with a novel SARS-CoV-2 variant – a cross-sectional study. J Eur Acad Dermatol Venereol [Internet]. 2021 Mar;35(3):e183-5. Available at:
14. Sohier P, Matar S, Meritet JF, Laurent-Roussel S. Histopathological features of Chillblain-like lesions developing in the setting of the COVID-19. Arch Pathol Lab Med [Internet]. 2021 Feb:145(2):137-44. Avaliable from: pandemic.
15. Nobari NN, Seirafinapour F, Dodangeh M, Sadeghzadeh-Bazargan A, Behrangi E, Mozafarpoor S. A systematic review of histopathologic survey on skin biopsies in patients with Corona Virus Disease 2019 (COVID-19) who developed virus or drug-related mucocutaneous manifestations. Exp Dermatol [Internet]. 2021 Sep;30(9):1233-53. Available from:
16. Gomez MC, Gonzalez-Cruz C, Ferrer B, Barbera MJ. Leucocytoclastic vasculitis in a patient with COVID-19 with positive SARS-CoV-2 PCR in skin biopsy. BMJ Case Rep [Internet]. 2020 Oct. 13(10):e238039. Available from:
17. Shehi E, Chilimuri S, Shin D, Patel M, Ali N and Niazi M. Microthrombi in skin biopsy of a patient with COVID-19. JAAD Case Rep [Internet]. 2020 Dec; 6(12):1327-9. Available from:
18. Jiminez-Cauhe J, Ortega-Quijano D, Carretero-Barrio I, Suarez-Valle A, Saceda-Corralo D, Moreno-Garcia Del Real C et al. Erythema multiforme-like eruption in patients with COVID-19 infection: clinical and histological findings. Clin Exp Dermatol [Internet]. 2020 Oct; 45(7):892-5. Available from:
19. Lin P, Zhu S, Huang Y, Li L, Tao J, Lei T et al. Adverse skin reactions amongst healthcare workers during the coronavirus disease 2019 outbreak: a survey in Wuhan and its surrounding regions. Br J Dermatol [Internet]. 2020 May; 183(1):190-2. Available at:,%25)%20during%20the%20SARS%20outbreak.
20. Deoghare S, Pol D, Kothari R, Kumar A, Deora MS. Dermatological manifestations among doctors using personal protective equipment in coronavirus disease 19 pandemic: a study based on self-reported questionnaire and telephonic consultations. Indian J Dermatol Venereol Leprol [Internet]. 2022 Feb; 6(1):42-6. Available at:;year=2022;volume=6;issue=1;spage=42;epage=46;aulast=Deoghare;type=3
21. Lan J, Song Z, Miao X, Li H, Li Y, Dong L et al. Skin damage among healthcare workers managing coronavirus disease-2019. J Am Acad Dermatol [Internet]. 2020 May; 82(5):1215-6. Available at:
22. Zuo Y, Hua W, Luo Y and Li L. Skin reactions of N95 masks and medial masks among health-care personnel: A self-report questionnaire survey in China. Contact Dermatitis [Internet]. 2020 Aug; 83(2): 145-7. Available at:
23. Sushma, I, Simon N, Pravin AJS, Padmaprasad MK, Vijayabharathi M, Varghese MG. Clinical evaluation of mark induced dermatitis on healthcare workers during COVID-19 pandemic: a cross sectional study. Int J Res Dernatol [Internet]. 2021 May; 7(3):413-7. Available at:
24. Painter WE, Holman W, Bush JA, Almazedi F, Malik H, Eraut N et al. Human Safety, tolerability and pharmacokinetics of Molnupiravir, a novel broad-spectrum oral antiviral agent with activity against SARS-CoV-2. Antimicrob Agents Chemother [Internet] 2021 Mar;65(5):e02428-20. Available at:
25. Tursen U, Tursen B, Lotti T. Cutaneous side-effects of the potential COVID-19 drugs. Dermatol Ther [Internet]. 2020 Jul; 33(4):e13476. Available at:
26. MIMS online. Remdesivir. (2022). Cited 2022 June 20. Available from
27. MIMS online. Sotrovimab. (2022). Cited 2022 June 20. Available from
28. MIMS online. Anakinra. (2022). Cited 2022 June 20. Available from
29. MIMS online. Lopinavir. (2022). Cited 2022 June 20. Available from
30. MIMS online. Tixagevimab. (2022). Cited 2022 June 20. Available from
31. MIMS online. Cilgavimab. (2022). Cited 2022 June 20. Available from
32. Sun Q, Fathy R, McMahon DE, Freeman E. COVID-19 Vaccines and the Skin. Dermatol Clin [Internet]. 2021 Oct;39(4):653-73. Available at:
33. Burlando M, Russo R, Cozzani E, Parodi A. COVID-19 “second wave” and vaccines: the dermatologists’ perspective. Int J Dermatol [Internet]. 2021 Jul; 60(7):889-90. Available at:
34. Freeman EE, Sun Q, McMahon DE, Singh R, Fathy R, Tyagi A et al. Skin reactions to COVID-19 vaccines: An American Academy of Dermatology/International League of Dermatological Societies registry update on reaction location and COVID vaccine type. J Am Acad Dermatol [Internet]. 2022 Apr; 86(4):e165-7. Available at:
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How to Cite
Haddad, A., and I. Haddad. “The Cutaneous Manifestations of COVID-19, Personal Protective Equipment and Treatment”. World Journal of Current Medical and Pharmaceutical Research, Vol. 4, no. 5, Oct. 2022, pp. 113-7, doi:10.37022/wjcmpr.v4i5.226.
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