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The clinical spectrum of COVID-19-associated cutaneous manifestations: An Italian multicenter study of 200 adult patients.
Marzano, Angelo Valerio; Genovese, Giovanni; Moltrasio, Chiara; Gaspari, Valeria; Vezzoli, Pamela; Maione, Vincenzo; Misciali, Cosimo; Sena, Paolo; Patrizi, Annalisa; Offidani, Annamaria; Quaglino, Pietro; Arco, Renato; Caproni, Marzia; Rovesti, Miriam; Bordin, Giorgio; Recalcati, Sebastiano; Potenza, Concetta; Guarneri, Claudio; Fabbrocini, Gabriella; Tomasini, Carlo; Sorci, Mariarita; Lombardo, Maurizio; Gisondi, Paolo; Conti, Andrea; Casazza, Giovanni; Peris, Ketty; Calzavara-Pinton, Piergiacomo; Berti, Emilio.
  • Marzano AV; Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy. Electronic address: angelo.marzano@unimi.it.
  • Genovese G; Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
  • Moltrasio C; Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.
  • Gaspari V; Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
  • Vezzoli P; Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy.
  • Maione V; Department of Dermatology, Spedali Civili, Brescia, Italy.
  • Misciali C; Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
  • Sena P; Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy.
  • Patrizi A; Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
  • Offidani A; Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy.
  • Quaglino P; Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy.
  • Arco R; Statistician, Italian Ministry of Universities and Research, Milan, Italy.
  • Caproni M; Division of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
  • Rovesti M; Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy.
  • Bordin G; Internal Medicine, Piccole Figlie Hospital, Parma, Italy.
  • Recalcati S; Dermatology Unit, ASTT Lecco, Alessandro Manzoni Hospital, Lecco, Italy.
  • Potenza C; D. Innocenzi Dermatology Unit, Sapienza University of Rome, Polo Pontino, Rome, Italy.
  • Guarneri C; Department of Dermatology, University of Messina, Messina, Italy.
  • Fabbrocini G; Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy.
  • Tomasini C; Institute of Dermatology, Department of Clinical-Surgical, Diagnostic, and Pediatric Science, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
  • Sorci M; Dermatology Unit, Department of Surgery, Infermi Hospital Rimini, AUSL Romagna, Rimini, Italy.
  • Lombardo M; Dermatology Department, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
  • Gisondi P; Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy.
  • Conti A; Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncological and Regenerative Medicine, Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy.
  • Casazza G; L. Sacco Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy.
  • Peris K; Institute of Dermatology, Catholic University of Rome, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Calzavara-Pinton P; Department of Dermatology, Spedali Civili, Brescia, Italy.
  • Berti E; Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
J Am Acad Dermatol ; 84(5): 1356-1363, 2021 05.
Article in English | MEDLINE | ID: covidwho-1131418
ABSTRACT

BACKGROUND:

COVID-19 is associated with a wide range of skin manifestations.

OBJECTIVE:

To describe the clinical characteristics of COVID-19-associated skin manifestations and explore the relationships among the 6 main cutaneous phenotypes and systemic findings.

METHODS:

Twenty-one Italian Dermatology Units were asked to collect the demographic, clinical, and histopathologic data of 200 patients with COVID-19-associated skin manifestations. The severity of COVID-19 was classified as asymptomatic, mild, moderate, or severe.

RESULTS:

A chilblain-like acral pattern was significantly associated with a younger age (P < .0001) and, after adjusting for age, significantly associated with less severe COVID-19 (P = .0009). However, the median duration of chilblain-like lesions was significantly longer than that of the other cutaneous manifestations taken together (P < .0001). Patients with moderate/severe COVID-19 were more represented than those with asymptomatic/mild COVID-19 among the patients with cutaneous manifestations other than chilblain-like lesions, but only the confluent erythematous/maculo-papular/morbilliform phenotype was significantly associated with more severe COVID-19 (P = .015), and this significance disappeared after adjustment for age.

LIMITATIONS:

Laboratory confirmation of COVID-19 was not possible in all cases.

CONCLUSIONS:

After adjustment for age, there was no clear-cut spectrum of COVID-19 severity in patients with COVID-19-related skin manifestations, although chilblain-like acral lesions were more frequent in younger patients with asymptomatic/pauci-symptomatic COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Skin Diseases, Viral / COVID-19 Type of study: Diagnostic study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Adult / Aged / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: J Am Acad Dermatol Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Skin Diseases, Viral / COVID-19 Type of study: Diagnostic study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Adult / Aged / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: J Am Acad Dermatol Year: 2021 Document Type: Article