Diagnosis of COVID‐19 using skin rashes

Several studies have observed that patients hospitalized with COVID‐19 experienced unusual skin rashes, such as urticaria (‘nettle rash’), chickenpox‐type rash, and reddish and purplish bumps on the fingers or toes. Using data from about 336,000 UK users of the COVID Symptom Study app, we observed that 8.8% of people reporting a positive SARS‐CoV‐2 swab test had experienced a skin rash, compared with 5.4% of those with a negative test result. Next, we analysed data collected using an independent online survey in nearly 12,000 people with skin rashes and a suspected or confirmed SARS‐CoV‐2 infection. We observed that 17% of respondents testing positive reported a rash as the first symptom of the disease, while for 21% of them this was their only symptom. Taking these observations together, we advise that skin rashes should be considered when diagnosing COVID‐19 infection. To increase awareness regarding these symptoms we have created, in collaboration with the British Association of Dermatologists, an online catalogue of images of the most common skin manifestations of COVID‐19, available at https://covidskinsigns.com. Linked Article: Visconti et al. Br J Dermatol 2021; 184:880–887.