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When COVID-19 manifests in the skin

A look at the way that skin may react to COVID-19 and the vaccine for the disease.

Although COVID-19 may be primarily thought of as a respiratory disease, it has been found to impact a variety of organs in the body, including the skin. At the 2022 American Academy of Dermatology annual meeting in Boston, Massachusetts, Esther Ellen Freeman MD, PhD, FAAD, director, global health dermatology, Massachusetts General Hospital, Harvard Medical School, in Boston shared the latest on skin reactions caused by COVID-19 and the vaccines, culled from a large COVID-19 dermatology registry.

The registry includes several large European studies that found that 10% of patients who have COVID-19 will have some form of skin reaction. Among the patients who developed a rash, 20% of them will either have the rash as the first symptom of the disease or as the only symptom. She noted that people were more likely to develop a skin reaction from COVID-19 than a serious skin reaction to a COVID-19 vaccine.

The form of reaction will help guide the treatment and estimate of during, but many reactions will resolve within a month. Some skin reactions, like the well-known COVID test, can last 6 to 12 months following illness, but a duration that long is not common. Variant type has been linked to different overall symptoms, but the jury is still out on whether different variants are responsible for certain skin reactions.

Skin reactions have been noted with the COVID-19 vaccine. One of the most common is “COVID arm,” which is a delayed local reaction that usually occurs a week after administration and causes a discolored, raised area at the sight of injection. The reaction does resolve on its own and doesn’t not prevent the patient from getting additional doses. Skin reactions become rarer with addition doses, with less than 50% of patients who had a reaction for dose 1 having one to dose 2. A reaction following the booster is even rarer. Dr Freeman stressed the safety of the vaccines, saying, “After 10 billion doses of the vaccine given worldwide, there’s a lot of safety data. Vaccines are safe and effective, and we encourage the public to consider getting their vaccines and booster to protect themselves against COVID-19.”

Reference

American Academy of Dermatology. Skin reactions to COVID-19 and its vaccines. Published March 25, 2022. Accessed March 26, 2022. https://www.aad.org/news/skin-reactions-to-covid