Cutaneous Manifestations of COVID-19

Dear Colleagues,

The COVID-19 pandemic impacted everyone and every area of life, and numerous articles address how the pandemic affected patients with cutaneous diseases, dermatological practice, dermatologists' habits and trends in their work, as well as dermatology patients' conditions. More specifically, they show how certain skin lesions might be associated with COVID-19 and how skin lesions also occurred due to pandemic-related public health measures that affected the skin. At the beginning of the pandemic, many countries imposed a quarantine, and thus many patients forwent doctors' visits, leading to the deterioration of their skin disease. Therapy dilemmas and new trends in practice also arose from the pandemic, such as the limitations of systemic immunosuppressant use for dermatology patients, the rationing of resources, and the involvement of dermatologists in COVID-19 patient care and assistance, among others. Additionally, some persons even developed skin lesions after COVID-19 vaccination.

Many studies show that patients infected with COVID-19 can experience various resulting skin manifestations, primarily maculopapular or papulovesicular rash, urticaria, painful acral red-purple papules, livedo reticularis, petechiae, and other manifestations. The observations included cutaneous lesions, which mostly appeared on the trunk but also on the hands and feet. The studies typically saw no correlation between the presence of lesions and infection severity, and lesions usually healed within a few days. For some dermatology patients not infected with COVID-19, their cutaneous lesions were related to pandemic-associated measures, such as the occurrence of hand eczema due to frequent hand washing and/or disinfection (e.g., irritant hand dermatitis due to alcohol-based hand sanitizer use). Protective equipment on the face (masks and goggles) may also be related to skin diseases. These contact reactions occur more frequently among those with previous lesions and those atopic. Additionally, an association was recorded between COVID-19 vaccination and skin lesion occurrence or dermatosis deterioration soon after. In practice, this association usually could not be confirmed during the pandemic, predominantly due to limited and reduced medical and healthcare activities, tests and resources. In addition, we see that, for patients with chronic skin diseases who use/take immunosuppressive therapy, there is a question about the efficacy and safety of vaccines against COVID-19. All these observations show that the new pandemic-related conditions affected various dermatology pathologies. So, in this Special Issue of COSMETICS, we would like to present the varied experiences and results of the authors of the following articles.

Dr. Liborija Lugović-Mihić
Guest Editor

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• cutaneous manifestations
• COVID-19
• pandemic
• hygienic measures
• rash
• eczema
• urticaria
• COVID-19 vaccination