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How Dermatologists Can Learn and Contribute at the Leading Edge of the COVID-19 Global Pandemic

Educational Objective
To understand how dermatologists can learn and contribute to managing the COVID-19 pandemic
1 Credit CME

In this issue of JAMA Dermatology, clinical cases and images of rashes in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are presented.1,2 Although these early observations are not comprehensive of all skin manifestations seen, our intention in publishing them is to help dermatologists recognize emerging patterns of rashes in patients with coronavirus disease 2019 (COVID-19). The reported prevalence of cutaneous signs in association with this pandemic is conflicting; one study reported a rash in only 0.2% of a cohort of Chinese patients,3 whereas the estimated prevalence in a cross-sectional Italian study was 20.4%.4 In the latter study, performed by dermatologists, the cutaneous manifestations were most commonly described as an erythematous rash; however, a range of additional morphologic features were observed, including generalized urticaria and vesicular eruptions. A predilection for the trunk was also noted.4 It may not be possible to determine the exact prevalence of skin findings in infected patients until serologic testing is more widely available, given that some individuals may lack the typical respiratory signs of COVID-19.5

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Article Information

Corresponding author: Kanade Shinkai, 1701 Divisadero St, 3rd Floor, San Francisco, CA 94115 (kanade.shinkai@jamanetwork.org).

Published Online: April 30, 2020. doi:10.1001/jamadermatol.2020.1438

Conflict of Interest Disclosures: None reported.

Disclaimer: The views expressed herein are those of the authors and do not necessarily represent the perspectives of the Society of Dermatology Hospitalists.

References
1.
Diaz-Guimaraens  B , Dominguez-Santas  M , Suarez-Valle  A ,  et al.  Petechial skin rash associated with severe acute respiratory syndrome coronavirus 2 infection.   JAMA Dermatol. Published online April 30, 2020.Google Scholar
2.
Sanchez  A , Sohier  P , Benghanem  S ,  et al.  Digitate papulosquamous eruption associated with severe acute respiratory syndrome coronavirus 2 infection.   JAMA Dermatol. Published online April 30, 2020.Google Scholar
3.
Guan  WJ , Ni  ZY , Hu  Y ,  et al; China Medical Treatment Expert Group for Covid-19.  Clinical characteristics of coronavirus disease 2019 in China.   N Engl J Med. Published online February 28, 2020. doi:10.1056/NEJMoa2002032PubMedGoogle Scholar
4.
Recalcati  S .  Cutaneous manifestations in COVID-19: a first perspective.   J Eur Acad Dermatol Venereol. 2020. Published online March 26, 2020. doi:10.1111/jdv.16387PubMedGoogle Scholar
5.
Bai  Y , Yao  L , Wei  T ,  et al.  Presumed asymptomatic carrier transmission of COVID-19.   JAMA. 2020;323(14):1406-1407. doi:10.1001/jama.2020.2565PubMedGoogle ScholarCrossref
6.
Wu  X , Cai  Y , Huang  X ,  et al.  Co-infection with SARS-CoV-2 and influenza A virus in patient with pneumonia, China.   Emerg Infect Dis. 2020;26(6). doi:10.3201/eid2606.200299PubMedGoogle Scholar
7.
Mazzotta  F , Troccoli  T . Acute acro-ischemia in the child at the time of COVID-19.  Dermatologia Pediatrica. March 2020. Accessed April 23, 2020. https://img.beteve.cat/wp-content/uploads/2020/04/acroischemia-ENG.pdf
8.
Wu  P , Duan  F , Luo  C ,  et al.  Characteristics of ocular findings of patients with coronavirus disease 2019 (COVID-19) in Hubei Province, China.   JAMA Ophthalmol. Published online March 31, 2020. doi:10.1001/jamaophthalmol.2020.1291PubMedGoogle Scholar
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