Cutaneous Manifestations Associated with COVID-19 Infection in a COVID-Designated Hospital in North Chennai - A Descriptive Cross-Sectional Study

Parimalam Kumar; Guru Radha; Madhanchand Muthukrishnan; Balakumaran Chandrasekaran; Pravinkumar Subbiah; Jagan Raman

doi:10.4103/idoj.idoj_279_22

Cutaneous Manifestations Associated with COVID-19 Infection in a COVID-Designated Hospital in North Chennai - A Descriptive Cross-Sectional Study

Indian Dermatol Online J. 2022 Dec 29;14(1):67-71. doi: 10.4103/idoj.idoj_279_22. eCollection 2023 Jan-Feb.

Authors

Parimalam Kumar¹, Guru Radha², Madhanchand Muthukrishnan³, Balakumaran Chandrasekaran⁴, Pravinkumar Subbiah⁵, Jagan Raman⁶

Affiliations

¹ Prof & Head Department of Dermatology, Madras Medical College, Chennai, Tamil Nadu, India.
² Assistant Surgeon, Govt Leprosy Training Centre, Arangandanallur, Thirukkoilur, Tamil Nadu, India.
³ Consultant, Madhans Derma Clinic, Madurai, Tamil Nadu, India.
⁴ Senior Resident, Department of Dermatology Sri Balaji Medical College, Chennai, Tamil Nadu, India.
⁵ Assistant Surgeon, Govt Headquarters Hospital, Manaparai, Trichy, Tamil Nadu, India.
⁶ Assistant Prof, Department of Dermatology Indira Medical College, Thiruvallur, Tamil Nadu, India.

Abstract

Background: Coronavirus disease 2019 (COVID-19) affects different organ systems, including the skin. There are reports on cutaneous manifestations of COVID-19 available in the literature. In this study, we have tried to describe the dermatological signs of COVID-19 in different categories of patients.

Materials and methods: A descriptive cross sectional study was conducted to describe various cutaneous manifestations of COVID-19 in different categories of reverse transcriptase polymerase chain reaction (RT-PCR)-positive COVID-19 patients in a COVID-designated tertiary care hospital. Approval was obtained from the Institutional Ethical Committee, and 5460 RT-PCR-confirmed COVID-19-positive patients were included under five categories. Investigators following a strict COVID protocol examined and documented the findings. Investigations and treatment were carried out as per the protocol, and the study was conducted for a period of 6 months.

Results: Out of the 5460 patients studied, 1.9% patients had cutaneous manifestations. Vasculitis (24%) and maculo papular rash (19%) were the common findings. The incidence of vasculitis was 44.4%, 61%, and 6.6% in categories A, B, and C, respectively. Maculopapular rash and urticaria were the common findings in categories D and E, respectively. COVID digit was seen in only one case. Other manifestations such as acne, adverse drug reaction, erythroderma, and bullous disorders were also noted.

Conclusion: Cutaneous manifestations because of vascular pathology were the most common association in severe COVID-19, which indicates that the presence of vasculitic skin signs correlated with disease severity and elevated d-dimer values. Urticaria and maculo-papular rash were transient and did not give any clue to the diagnosis or severity of the disease.

Keywords: COVID-19; cutaneous manifestation; vasculitis.