Dermatologic manifestations persist in COVID-19 ‘long-haulers’
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Some dermatologic manifestations of COVID-19 infection can persist for a long duration of time, according to a presentation at the European Academy of Dermatology and Venereology virtual congress.
The International Dermatology COVID-19 Registry evaluated 990 suspected COVID-19 cases with dermatologic symptoms in 39 countries, including 303 laboratory-confirmed cases.
The study analyzed cutaneous symptom type and duration and found that in some cases dermatologic symptoms of COVID-19 infection lasted 60 days or more.
“There is a subset of patients with skin manifestations of COVID that have long-hauler or long-COVID symptoms,” Esther E. Freeman, MD, PhD, director of global dermatology at Massachusetts General Hospital, Harvard Medical School, and principal investigator of the COVID-19 dermatology registry, said in her presentation. “This is particularly notable for pernio, or chilblains.”
The median duration of all dermatologic symptoms was 12 days. Morbilliform lasted a median of 7 days, while urticaria lasted an average of 4 days. Papulosquamous eruptions had an average duration of 20 days, and pernio/chilblains, also knows as “COVID toes,” lasted an average of 15 days.
However, one long-hauler patient experienced papulosquamous eruptions for 70 days, and five patients experienced pernio for more than 60 days, including two patients who have ongoing symptoms lasting more than 130 days and 150 days, respectively.
“We know that pernio or chilblains is inflammation, so these patients are really having persistent and long-standing inflammation,” Freeman told Healio.
This phenomenon is believed to be underreported, and she asked her colleagues to continue entering information into the registry to get a more accurate depiction of COVID-19’s long-hauler manifestations.
“If you are someone taking care of COVID patients, whether or not you are a dermatologist, ask your patients about their skin and examine their skin because it can be a sign of potentially ongoing inflammation in that patient,” she said.
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McMahon, E, et al. COVID-19 “long-haulers” in dermatology? Duration of dermatologic symptoms in an international registry from 39 countries. Presented at: European Academy of Dermatology and Venereology Congress; Oct 29-31, 2020 (virtual meeting).
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