Skin Manifestations of Covid-19

Are you familiar with the possible skin manifestations of Covid-19?

Covid-19 or Coronavirus-19 affects people in many different ways. You may know someone who had only mild disease, with one day sore throat. Some may even have no symptoms at all! Some people are at higher risk for developing moderate to severe disease hence requiring hospitalization. The people at risk are those with a medical condition such as obesity, hypertension, diabetes, or asthma. Also the elderly, pregnant, and the young children.

WHO provides the following list of Covid-19 symptoms:

  • The most common symptoms: fever, cough, tiredness, and loss of taste or smell.
  • The less common symptoms are sore throat, headache, aches and pains, diarrhoea, rash on skin, and red or irritated eyes.
  • Serious symptoms include difficulty of breathing, loss of speech, mobility or confusion, and chest pain.

Two years in the pandemic, the case reports from all over the world have identified the some of the cutaneous manifestations of Covid-19.

According to UpToDate, among the 171 laboratory-confirmed Covid-19 patients with skin manifestations, these are the common presentations:

Exanthematous or morbiliform rash (22%) – predominantly involving the trunk. Rash may appear at disease onset or more frequently upon recovery. Rash appears similar to other non-specific viral rash.

Pernio-like acral lesions or “Covid toes” (18%) – usually seen in those with a relatively mild disease. These present as red-violaceous or purpuric macule on fingers, toes, elbows, and lateral aspect of feet.

Urticaria (16%) – this may be a presenting sign of Covid-19 infection. Important to note, these some patients reported no fever.

Macular erythema (13%)

Vesicular eruption (11%)

Papulosquamous eruption (9.9%)

Retiform purpura (6.4%) – associated with severe illness

Multi system inflammatory syndrome in children (MIS-C) – may present as an erythematous, polymorphic rash involving hands, feet, mouth and eyes, with findings of severe Kawasaki disease.

The frequency and timing of the skin lesions of Covid-19, and the association of the manifestations with diseases severity however are not yet certain.

In summary…

Skin lesions may be seen in those with Covid-19 though it is not that common. Skin manifestations of Covid-19 have different presenting symptoms ranging from a morbiliform rash to retiform purpura. In the near future, more date will hopefully shed more light on the relationship of skin manifestations of Covid-19 and the disease itself. Some patients may present with or without cough, with or without fever. Some skin manifestations are seen with those with mild disease, or severe disease.

If you have a high index of suspicion and you are unsure why you have a rash, it is best to consult your doctor. Especially if you have been exposed or know that you have been in an unsafe situation, it is recommended to isolate yourself. Proceed with scheduling an appointment right away. Now is not the time for self-diagnosing and self-medicating.


– dr. amy chua

Let us take this chance to remind everyone of the simple yet effective ways of preventing Covid-19 transmission.

  1. Firstly, wear your mask. Moreover, choose your mask properly and make sure it is the right fit for you.
  2. Secondly, sanitise hands regularly and avoid touching your face.
  3. Thirdly, keep social distance from other people. Avoid enclosed spaces.
  4. Hey wait, are you planning to attend a party? You know it is best to avoid gatherings. In other words, stay at home unless absolutely necessary.

Keep safe and stay healthy! Cheers to healthy skin!

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