Presentation and Management of Cutaneous Manifestations of COVID-19.

INTRODUCTION: The spread of the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has instigated a fervent race of the medical community to identify its manifestations, the patients at risk, and optimal disease management. While the COVID-19 illness is largely associated with respiratory consequences, there is increased reporting of other organ-specific disease sequelae that include the skin. OBJECTIVE: To identify, describe, and classify the main skin manifestations of COVID-19 and associated protocols for management. METHODS: Forty-five patients from three clinical centers in North and South America with positive COVID-19 PCR and/or serology presenting cutaneous manifestations were included in this retrospective chart review. Medical history, biopsies, dermoscopy, laboratory findings, clinical photography, and disease management were documented. RESULTS: Seven main types of cutaneous manifestations were identified: exanthema/molbilliform, urticaria, papular/pustular/vesicular, petechiae/purpura, livedo reticularis, chilblains, and alopecia. Histopathogical analysis from skin biopsies and/or dermoscopy highlighted an inflammatory or vascular pathophysiology depending on the type of manifestation. While the first three types of COVID-19 skin manifestations preceded or coincided with other symptoms such as anosmia, fever, chills, chilblains, and livedo were found in later disease stages. All cases had a positive resolution with appropriate treatment. CONCLUSIONS: Cutaneous symptoms are part of the COVID-19 disease spectrum. Early identification, diagnosis, and management through a multidisciplinary approach can facilitate safe disease resolution for patients. J Drugs Dermatol. 2021;20(1):76-83. doi:10.36849/JDD5676.

Recommendations for Dermatology Office Reopening in the Era of COVID-19.

The COVID-19 pandemic, originating in Wuhan, China, has become a major public health and economic challenge for countries around the world. As of May 08, 2020, there are over 3 million COVID-19 cases, and 250,000 COVID-19- associated deaths in 215 countries. As more data is collected, updated infection control measures are continuously released and published by government, public health authorities, and physician specialty associations. Across the globe, dermatological practices have had to limit their operations to varying degrees to facilitate disease control, but as the pandemic subsides, they will broaden their operations. In light of the uncertainty surrounding safe and effective practice of medical and aesthetic dermatology in the era of COVID-19, fourteen international experts in the field contributed to recommendations for effective infection control protocols and practice management modifications. While guidance from the World Health Organization and local public health officials comes first, these recommendations are crafted as a starting point for dermatologists worldwide to commence either reopening their doors to patients or expanding available service offerings. This can help ensure that patients receive needed care in the short term and improve long term practice viability. J Drugs Dermatol. 2020;19(7):e-1-e-9. doi:10.36849/JDD.2020.5293.