So you’re a veritable COVID specialist, having recently acquired internet degrees in both epidemiology and viral statistics, but I bet you’re less versed in the skin manifestations of the pandemic. Coronavirus infection can mimic many skin diseases.
Clinicians from all over the world have shared their clinical experience and there are currently 3 skin rashes most commonly linked to COVID.
The three most common skin presentations of COVID can be seen before any classic symptoms or instead of the classic symptoms as the ONLY symptom.
1. Hive- type rash (urticaria)
A sudden appearance of itchy, raised red bumps which come and go in a matter of hours. It can involve any part of the body and often starts on the chest or back.
These tend to occur at the same time as other symptoms and usually occur in more severe disease.
2. Chicken-pox type rash
Areas of small, itchy or burny bumps and blisters that can be widespread- but usually affect the elbows, knees as well as the backs of hands and feet.
This rash seems to appear before other symptoms and is associated with medium disease severity.
3. COVID fingers and toes (chilblains)
This rash is the most specific to COVID and can be the only symptom of the disease in younger people. Reddish, purplish, painful (rather than itchy) bumps occur on the fingers and toes.
This is usually associated with less severe instances of the disease.
Many viral infections can affect the skin, so it’s not surprising that we are seeing these rashes with COVID. However, it is important to note that in some cases, a rash may be the only presenting feature. Don’t panic when you develop a new rash – consult your GP or dermatologist to see whether testing is warranted.
Regular hand washing and wearing a mask help prevent COVID-19. But these precautions can also bother your skin. I have been seeing two rashes, linked to these precautions rather than the disease, with increasing frequency during the last couple of months.
Hand dermatitis (eczema)
Cracked, extremely dry, itchy hands not responding to regular moisturising – sound familiar? Excessive hand washing and sanitising can cause flare ups in patients known to have hand eczema, but can even cause milder disease in those without a history of eczema.
Maskne
Yes, ‘maskne’ is officially a thing! I have patients calling saying they have never had a breakout and now their faces look like that of a teenager.
The clinical term for maskne is acne mechanica a.k.a the kind of acne athletes get from wearing a helmet or cap during frequent exercise. In the case of maskne, it is caused by friction, increased moisture and bacterial overgrowth under the mask. I’ve been seeing classic pimples, but also red burning bumps around the nose and mouth- peri-oral dermatitis linked to mask wearing.
Sanitising and wearing a cloth mask are here to stay for the foreseeable future- my next article will tackle how to prevent maskne and will include instructions on how to care for your hands during a pandemic.
