Review of adverse cutaneous reactions of pharmacologic interventions for COVID-19: A guide for the dermatologist

J Am Acad Dermatol. 2020 Dec;83(6):1738-1748. doi: 10.1016/j.jaad.2020.08.006. Epub 2020 Aug 7.

Abstract

The new coronavirus, severe acute respiratory syndrome coronavirus 2, is associated with a wide variety of cutaneous manifestations. Although new skin manifestations caused by COVID-19 are continuously being described, other cutaneous entities should also be considered in the differential diagnosis, including adverse cutaneous reactions to drugs used in the treatment of COVID-19 infections. The aim of this review is to provide dermatologists with an overview of the cutaneous adverse effects associated with the most frequently prescribed drugs in patients with COVID-19. The skin reactions of antimalarials (chloroquine and hydroxychloroquine), antivirals (lopinavir/ritonavir, ribavirin with or without interferon, oseltamivir, remdesivir, favipiravir, and darunavir), and treatments for complications (imatinib, tocilizumab, anakinra, immunoglobulins, corticosteroids, colchicine and low molecular weight heparins) are analyzed. Information regarding possible skin reactions, their frequency, management, and key points for differential diagnosis are presented.

Keywords: COVID-19 drug treatment; drug eruptions; drug-related side effects and adverse reactions; review.

Publication types

  • Review

MeSH terms

  • Antimalarials / adverse effects
  • Antiviral Agents / adverse effects
  • Betacoronavirus / immunology
  • Betacoronavirus / pathogenicity
  • COVID-19
  • COVID-19 Drug Treatment
  • Colchicine / adverse effects
  • Coronavirus Infections / complications
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / immunology
  • Coronavirus Infections / virology
  • Diagnosis, Differential
  • Drug Eruptions / diagnosis*
  • Drug Eruptions / etiology
  • Drug Therapy, Combination / adverse effects
  • Drug Therapy, Combination / methods
  • Exanthema / diagnosis
  • Exanthema / immunology
  • Exanthema / virology
  • Glucocorticoids / adverse effects
  • Humans
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / immunology
  • Pneumonia, Viral / virology
  • SARS-CoV-2
  • Urticaria / diagnosis
  • Urticaria / immunology
  • Urticaria / virology

Substances

  • Antimalarials
  • Antiviral Agents
  • Glucocorticoids
  • Colchicine