Manifestation Clinical description Relative frequency* Specificity References
1. Skin manifestations similar to those in other viral infections 1. Skin manifestations similar to those in other viral infections 1. Skin manifestations similar to those in other viral infections 1. Skin manifestations similar to those in other viral infections 1. Skin manifestations similar to those in other viral infections
Acute urticaria Sudden appearance of wheals with a fleeting nature. Continual appearance and disappearance of new lesions is characteristic. Moderate Unspecific for COVID-19; infections are common elicitors for acute urticaria 4,22,23,28
Maculopapular exanthem (“erythematous rash”) Acute erupting, widespread distribution of multiple small, round to oval erythematous macules and/or papules with different degrees of confluence. Mostly trunk, low pruritus. High Unspecific for COVID-19; infections are common elicitors for maculopapular exanthem 4,21,22,24,28,29
Varicella-like exanthem (“chickenpox-like rash”) Monomorphic papulovesicular skin eruption. Erythematous papules and vesicles bilaterally and symmetrically mostly on the trunk. High May be more specific, vesicles are quite uncommon for virus exanthems and more specific for varicella 4,22,25,26
Symmetrical intertriginous exanthem Flexural erythematous maculopapular exanthem on axillary lesions and trunk +/-antecubal fossae. Two case reports Unclear 27
2. Skin manifestations associated with vascular pathologies 2. Skin manifestations associated with vascular pathologies 2. Skin manifestations associated with vascular pathologies 2. Skin manifestations associated with vascular pathologies 2. Skin manifestations associated with vascular pathologies
Purpuric exanthem (“purpuric rash”)
Skin rash with petechiae.
Moderate
Unclear, potentially more specific as uncommon in other viral exanthems, except e.g. Parvovirus B19
22,30
Erythema ab igne (“livedo reticularis”) Transient macular erythema in a broad reticular pattern on thigh unilaterally. Case report Unclear, may be more specific, if causality can be confirmed 31
Chilblain-like lesions Acute-onset, violaceous, infiltrated and painful plaques on the toes and lateral feet. Vesicles and erosions may be present. High Probably more specific, if causality can be confirmed 22, 32,33,34
Cutaneous acro-ischemia Finger and toe cyanosis, purpura, hematoma, skin bulla and dry gangrene. Moderate, critically ill patients with coagulation crisis and microvascular injury More specific, as uncommon for viral disease 35,36