rash

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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dermatitis, eczema, contact dermatitis, rash, hands

what is contact dermatitis?

I have contact dermatitis. Help!

Contact dermatitis is a type of eczema that usually presents as red, uncomfortable, itchy, usually raised rashes (which dermatologists call papules and plaques). In severe cases, one may develop vesicles or blisters, and wounds. It can occur in any age group. Direct contact of your skin with a suspected substance causes this type of rash.

The two variants of contact dermatitis are ALLERGIC and IRRITANT contact dermatitis.

ALLERGIC CONTACT DERMATITIS is an immunologic reaction. Your skin mounts a delayed hypersensitivity reaction to the foreign substance your skin has been in contact with.

IRRITANT CONTACT DERMATITIS is non-immunologic; rather it is a cytotoxic skin reaction to a substance your skin has been exposed to.

AlLERGIC CONTACT DERMATITIS

This is a type of rash that you will experience every instance you are exposed to an allergen that you are sensitive to.

            Do you have a recurring itchy rash on your earlobes every time you wear your favorite fancy earrings?  You might be allergic to the material of your earrings. It may be due to nickel, even silver and gold can also cause contact dermatitis.

            Some people have stubborn itchy rash on their belly near the belly button. This area usually corresponds to the buckle of your belt or the button of your jeans pants, skirt or shorts. This is also a common sign of nickel allergy. Patients usually have a long-standing history and patients come in with thickened plaques. These can be erythematous (red) or hyperpigmented (brownish).

            Some patients suffer from contact dermatitis caused by chemicals or substances that they are exposed to at work. You might have noticed an improvement in your rash when you are on holiday or vacation? For example, a teacher who has frequent exposure to chalk or chemicals in whiteboard markers might have active rashes during the school year but experience relief on school breaks. Hair colorists may experience improvement of their rashes on their hands when they rest from work, similar to people who does laundry or dishwashing as an occupation. Most patients notice improvement of their rash when they take a break from work (when the suspected allergen is from their workplace).

IRRITANT contact dermatitis

Constant exposure to substances will eventually irritate our skin and cause irritant contact dermatitis. This type of rash is more common and most substances can cause this.

            What are the common irritants?

            Water, alcohol rubs, sweat, saliva!

            Common presentations of irritant contact dermatitis are: diaper rash (so don’t let your baby soak his precious skin in wet nappies), lip dermatitis (stop licking your lips!), dry, cracked hands due to chronic exposure to water.

            You may also develop irritant contact dermatitis when a toxic substance such as bleach comes in contact with your skin. Hence dermatologists recommend you wear protective gloves when you use bleach and other strong chemicals.

            Some also develop irritant contact dermatitis from handling food and soap!

            People who always get their hands wet at work (dishwashers, bartenders, healthcare workers, etc.) are more prone to developing dry, cracked hands. These can be itchy, stinging and tender. With the pandemic, we are all doing frequent and adequate hand hygiene, and in our clinic we see a growing number of cases with irritant contact dermatitis. So don’t forget to moisturize your hands with a bland moisturizer after every hand wash or hand rub with alcohol or sanitizing gel.

Consult with your dermatologist if your rash persists. You and your dermatologist will work together to find out your triggers and identify whether your rash is allergic or irritant. Seek medical advice on how best to treat your eczema and avoid flare-ups.

Stay tuned to learn more about contact dermatitis! Blog entries are coming up in the next few days.

Cheers to healthy skin!

For inquiries and to set your appointment, CONTACT us here.

Stay tuned for updates and promos, follow and like us on Facebook, Instagram and Twitter.

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