The skin, the least thought organ COVID-19 can affect

The symptoms of COVID-19 are plentiful and many of them go almost unnoticed by those who walk through the picture in a gentle way.

In the case of dermatological conditions, which specialists warn more and more patients, they can arise because of the virus. They also appear more often in people who have been vaccinated.

However, according to experts, in either case, these are usually not very worrying symptoms and in most cases they go away without the need for treatment.

Since the start of the pandemic, the relationship between the coronavirus and dermatological problems has been studied and the affectation was found to be very low. It is that certain dermatological manifestations would be reactive to the infection of SARS-CoV-2, in fact to any infection, and this is due to the activation of the immune system.

“Of the first 2,761 patients who consulted the emergency room or were admitted to the Barcelona hospital clinic presenting symptoms of COVID-19 during the first wave of the pandemic in March 2020, only 2.1% presented skin lesions induced by SARS-CoV-2 ”. According to the doctor of this health center Priscila Giavedoni, the most common type of injury in admitted patients was rash, which could be caused by the virus itself or by the treatments given.

“On an outpatient basis, we see many cases of frostbite in the spring, a time of year when they are generally rare. At the start of the pandemic, skin manifestations often went unnoticed in critically ill patients who could not even breathe on their own, ”added the specialist.

The rash is a pinkish rash that usually occurs as a result of certain infectious diseases.

It is precisely for this reason that Giavedoni pointed out that “Looking at the skin is the key, because it can be the protagonist that detects the disease, because it is the first or the only sign of infection. This has been observed in patients who consulted for frostbite on the hands and feet or hives ”.

And after adding that “this tendency of cutaneous involvement by SARS-CoV-2 was still observed in subsequent studies and it seems that the cutaneous manifestations are isolated in mild cases and in hospitalized patients they can reach up to 8%, “the specialist suggested that” in those more severe patients who require admission, the most frequent lesions continue to be rashes which also continue to be attributed to both the virus and the treatments used. “

In general, skin lesions associated with COVID-19 are mild and self-limiting. In a few cases, symptomatic treatment is necessary and cases of patients requiring hospitalization solely for skin manifestations are exceptional.. This group includes patients with thrombosis, a known complication of this disease which, in addition to affecting the lungs, can damage the vessels that supply blood to the skin and cause necrosis. After the acute period of infection, some patients experience persistent symptoms, referred to as long COVID or prolonged COVID. The most common skin manifestation in this group is hair loss, which is mostly mild and self-limiting, requiring only topical treatment for a few weeks.

Dermatological changes are more frequent after vaccination. At this point, Giavedoni stressed: “We know that vaccines are in the social and medical spotlight. In dermatology, we also put the magnifying glass and observed that the cutaneous side effects of vaccines are for the most part mild and transient. In Spain, a study was recently conducted with more than 400 patients with adverse effects to vaccines, it was confirmed that erythema at the injection site was the most common reaction and also that in the vast majority of cases skin side effects were not required treatment”.

In this direction, the different skin reactions are related to the type of severity of the disease. Among the less serious, we can locate acral rashes that generally affect the youngest, in general. While in those with more complications, we can cite hives lesions, which are characterized by the sudden onset of hives that usually produce intense itching. Maculopapules and livedo-reticulars are also included in this group. And in those with an intermediate level of difficulty, vesicular rashes and vasculitis could be listed.

Giavedoni, who has published articles on the relationship between COVID-19 and the skin in prestigious international magazines such as Journal of Clinical Medicine o British Journal of Dermatology, concluded: “Since the start of the pandemic, numerous research projects have been carried out to try to understand a little better this new disease, in particular its cutaneous manifestations. Additionally, telecommuting is here to stay in many areas, and in dermatology it has also changed the way we take care of our patients. Image evaluation is part of our usual practice and in cases of suspicious COVID-19 lesions, image evaluation reduces patient exposure and possible infections ”.

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