Retrospective View of Four Cases of Cutaneous Manifestations in COVID-19 Patients in an Acute Care Setting

Magali Rezende De Carvalho; Elmira Thomas; Barbara Shields-Johnson; Ivan Da Silva

doi:10.7759/cureus.23003

Retrospective View of Four Cases of Cutaneous Manifestations in COVID-19 Patients in an Acute Care Setting

Cureus. 2022 Mar 9;14(3):e23003. doi: 10.7759/cureus.23003. eCollection 2022 Mar.

Authors

Magali Rezende De Carvalho¹, Elmira Thomas², Barbara Shields-Johnson³, Ivan Da Silva⁴

Affiliations

¹ Wound and Ostomy Department, Loyola University Medical Center, Maywood, USA.
² Wound Care Department, The Loretto Hospital, Chicago, IL, USA.
³ Wound Care Department, Loretto Hospital, Chicago, USA.
⁴ Neurology Department, Rush University Medical Center, Chicago, USA.

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the etiologic agent of coronavirus disease 2019 (COVID-19), causes an excessive inflammatory response and hemostatic abnormalities in the lungs, kidney, and skin. Four patients with COVID-19 admitted to an acute care community hospital developed nonblanchable purpuric macules, patches, and retiform purpura-like lesions at the sacrum, buttocks, lower extremities, and upper back. These lesions can be misdiagnosed as deep tissue pressure injuries. One patient also developed a vesicular-like rash at the upper back and another one developed pernio (chilblains)-like lesions to the third toe of the left foot. Previous studies suggest that the vascular hyperinflammation status and microthrombosis may be responsible for the cutaneous manifestations in patients with SARS-CoV-2. These cutaneous manifestations observed in patients with SARS-CoV-2 may be related to progression of the disease.

Keywords: covid-19; pressure injury; pressure ulcer; severe acute respiratory syndrome coronavirus 2; skin manifestations; wounds and injuries.

Publication types

Case Reports