How Long Do the Dermatologic Signs of COVID-19 Last?

The features and duration of dermatologic manifestations in patients with COVID-19 were described in study data published in The Lancet Infectious Diseases. In a registry-based study of patients with COVID-19, common dermatologic symptoms were found to include urticarial and papulosquamous eruptions. Most dermatologic signs of COVID-19 in the registry resolved within 20 days of infection, although some lasted for 2 months or longer.

The study authors established an international registry for COVID-19-related dermatologic symptoms in April 2020. Briefly, physicians and other healthcare providers from around the world were invited to report dermatologic symptoms in patients with laboratory-confirmed or suspected COVID-19.

Descriptive statistics were used to summarize the characteristics of reported dermatologic symptoms. Patients with dermatologic symptoms persisting longer than 60 days after COVID-19 diagnosis were characterized as “long-haulers.”

From April 8, 2020, to October 8, 2020, information from 331 patients with dermatologic manifestations of COVID-19 was reported through the registry. Data on symptom duration were available for 234 of these patients. Median duration of dermatologic signs was 13 days (interquartile range [IQR], 7-21) for all patients and 7 days (IQR, 5-14) for patients with laboratory-confirmed disease.

The most commonly reported signs were morbilliform eruptions, urticarial eruptions, and papulosquamous eruptions, particularly pernio. Median (IQR) duration of morbilliform and urticarial eruptions was 7 days (5-10) and 4 days (2-10), respectively. The maximum recorded duration of urticarial eruptions was 28 days. Papulosquamous eruptions lasted the longest of all dermatologic manifestations, with a median of 20 days (IQR, 14-28) and a maximum of 70 days in laboratory-confirmed cases.

Pernio lasted a median of 15 days (IQR, 10-30) in patients with suspected COVID-19 and 12 days (IQR, 7-23) in patients with laboratory-confirmed COVID-19. A total of 7 patients with pernio experienced symptoms for 60 days or more. It was noted that 1 patient experienced pernio symptoms for more than 150 days.

These data outline several distinct dermatologic manifestations of COVID-19 and suggest that certain eruptions may persist in the long term, the researchers pointed out. Papulosquamous eruptions were longer lasting than urticarial and morbilliform eruptions.

Study limitations include the small cohort and relatively short follow-up period. Further research is necessary to clarify the dermatologic complications of COVID-19.

“Our analysis [reveals] a previously unreported subset of patients who experience long-hauler symptoms in dermatology-dominant COVID-19, raising questions about persistent inflammation even in patients who initially experienced relatively mild COVID-19,” investigators wrote.

Disclosure: Two study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

McMahon DE, Gallman AE, Hruza GJ, et al. Long COVID in the skin: a registry analysis of COVID-19 dermatological duration. Lancet Infect Dis. 2021;21(3):313-314. doi:10.1016/S1473-3099(20)30986-5