Cutaneous manifestations associated with COVID-19

<p>Coronavirus disease 2019 （COVID-19） is an infectious disease caused by the new coronavirus （SARS-CoV-2） that originated in China in December 2019, and it has been reported that it mainly causes respiratory symptoms but also exhibits various skin symptoms associated.</p><p>The skin lesions are classified into six patterns represented by the acronym “GROUCH” : Generalized maculo- popular.　Grover’s disease and other papulo-vesicular eruptions, livedo Reticularis, Other eruptions, Urticarial, and CHilblain-like.　Patients with chilblain-like lesions were younger and had a lower incidence of systemic symptoms.　Purpuric and livedoid lesions have been suggested to occur more frequently in elderly patients with severe COVID-19.</p><p>COVID-19 often leaves sequelae that last weeks to months after initial recovery.　It was estimated that 80％ of the infected patients developed one or more long-term symptoms.　The five most common symptoms were fatigue （58％）, headache （44％）, attention disorder （27％）, hair loss （25％）, and dyspnea （24％）.　A major cause of hair loss after COVID-19 is considered as telogen effluvium, defined by diffuse hair loss after the systemic stress or infections.　Most patients with hair loss recovers within 6 months.</p><p>Skin reactions have been reported after COVID-19 vaccination as well.　The most reported cutaneous finding was a delayed large local reaction “COVID-arm” a median of 7 days after vaccine.　The pathophysiological mechanism is still unknown, but it is overwhelmingly common in women, suggesting a cross-reaction between polyethylene glycol, a component of cosmetics, and injection components.　In additions, there have been reports of skin rashes similar to those after COVID-19 infection and the aggravation of psoriasis or other skin conditions.</p><p>The mechanism of the cutaneous manifestations is still unclear.　We must remember to ask about a history of COVID-19 infection and vaccination status at the time of consultation.</p>