LUGANO, 29 October, 2020 - Some COVID-19 patients experience long-lasting skin symptoms that vary according to type of COVID-19 skin rash, a late-breaking abstract will reveal today at the 29th EADV Congress, EADV Virtual.
Analysis of the largest registry of COVID-19 patients with dermatological symptoms has revealed a subset of patients, called 'long-haulers' or 'long COVID', who experience prolonged symptoms (lasting >60 days) on their skin (1).
Data from 990 cases from 39 countries input into the registry, a collaboration between the International League of Dermatological Societies and the American Academy of Dermatology, show an average duration of 12 days for all dermatological symptoms, with some lasting as long as >150 days (1).
Patients presented with a broad spectrum of dermatologic manifestations lasting for different lengths of time, including hives (urticaria), lasting for median 5 days, and pernio/chilblains (''COVID toes''), lasting 15 days but sometimes as long as 130-150 days, and papulosquamous eruptions, which are scaly papules and plaques, persisting for 20 days (1).
The identification of this unique subset of "COVID toes" patients with symptoms lasting long after the acute phase of COVID-19 may have implications for understanding the prolonged inflammatory response in some patients after infection.
Skin symptoms vary by COVID-19 severity. Some symptoms, such as retiform purpura, are associated with severe COVID-19, since 100% of these patients were hospitalised, while COVID toes travel with relatively mild disease, with only 16% hospitalised. Furthermore, although COVID toes often appear 1-4 weeks after initial infection, 15% were found to still be PCR positive for COVID-19.
Dr Esther Freeman, Principal Investigator of the International COVID-19 Dermatology Registry and Director, Global Health Dermatology, Massachusetts General Hospital says: "Our registry identified a previously unreported subset of patients with longstanding skin symptoms from COVID-19. We highlight patients with pernio/chilblains, also known as COVID toes, who have had symptoms for as long as 150 days. This data adds to our knowledge about how COVID-19 can affect multiple different organ systems, even after patients have recovered from their acute infection. The skin can provide a visual window into inflammation that may be going on elsewhere in the body."
At EADV 2020, COVID-19 is a key talking point and something that the world is learning more about every day. Dermatological symptoms of COVID-19 and the impact of COVID-19 on dermatology practitioners and patients is just beginning to be understood and is being explored at the Congress.
An EADV survey of 490 dermatologists has revealed that 35% saw patients presenting skin-signs of COVID-19 and that 4% of the dermatologists themselves tested positive for COVID-19 (2). These findings highlight the need for further research into the dermatological symptoms of COVID-19 and the interaction between COVID and underlying skin conditions. These data also stress the importance of using protection means such as facemasks during dermatological consultations.
Finally, Dr Asja Prohic, Medical Faculty University of Sarajevo, is presenting growing research investigating the possible association between male pattern baldness (androgenetic alopecia) and men hospitalised with COVID-19 (3).
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About androgenetic alopecia
Androgenetic alopecia is a genetically determined, progressive loss of hair from the scalp which occurs in both men and women (4). Men usually present hair thinning in the temporal areas that advances to the crown area as the alopecia progresses (4). Women usually have more diffuse thinning on the crown area, and less commonly present with a male-type pattern towards the forehead (4). It is the most common type of hair loss, affecting approximately 50% of men over the age of 50 and around 50% of women over the age of 65. Androgenetic alopecia can also affect younger men and women (5).
Founded in 1987, EADV is the leading community to further the knowledge of health professionals and advocates in the field of dermatology and venereology. It is a non-profit organisation with over 7,000 members, across 113 different countries in the world, providing a valuable service for every type of dermato-venereologist professional. The EADV is committed to improving the quality of patient care, continuing medical education for all dermato-venereologists within Europe and beyond, and advocacy on behalf of the speciality and patients.
To find out more visit https://www.eadv.org/.
About EADV Virtual:
This year's Congress is a first in EADV's history. EADV Virtual - New Frontiers in Dermatology and Venereology provides an exceptional opportunity for colleagues from around the world to explore the latest developments in science and patient care that are at the heart of the academy's mission. The user experience is immersive and simple to follow. To find out more visit https://eadvvirtualcongress.org/
(1) McMahon, D, Gallman, A, et al. COVID-19 "long-haulers" in dermatology? Duration of dermatologic symptoms in an international registry from 39 countries. Late breaking abstract no 3090, presented 29 October 2020 at EADV Virtual.
(2) Suppa, M, Orte Cano, C, et al. Impact of COVID-19 pandemic on dermatologists life and practices in Europe. Late-breaking abstract no 3182, presented 31 October 2020 at EADV Virtual.
(3) Prohic, A. Androgenetic alopecia. Presented 29 October 2020 at EADV Virtual.
(4) BMJ. Available at: https://bestpractice.bmj.com/topics/en-gb/223. Accessed October 2020
(5) Alopecia.org. Androgenetic Alopecia. Available at: https://www.alopecia.org.uk/androgenetic-alopecia-pattern-hair-loss Accessed October 2020