Pharmacists Asked to Help Document Dermatologic COVID-19 Manifestations

BOSTON – With reports of “COVID toes” in children, a manifestation of the novel coronavirus that supposedly looks like frostbite, and other cutaneous responses, the American Academy of Dermatology is creating a registry to keep track of those symptoms.

According to an article in the academy’s journal, JAAD, “There have been increasing reports of dermatologic manifestations of coronavirus disease 2019 (COVID-19). The first case series of dermatologic manifestations included 18 Italian patients with erythematous, urticarial, and vesicular rashes, often on the trunk. Other reports include drug hypersensitivity, urticaria, a petechial rash mimicking dengue, and acro-ischemia.”

Authors of the report, led by dermatologists from Massachusetts General Hospital and Harvard Medicine School, emphasize the importance of further characterizing dermatologic manifestations of COVID-19 “to understand the relationship between the virus and skin, and determine whether cutaneous manifestations of COVID-19 may assist with early disease detection.”

The article notes, however, that collecting cases of dermatologic manifestations of COVID-19 has been difficult because of their relative infrequency and the rapid spread of COVID-19. Instead, the authors say they’ve had to rely on informal networks, including social media, for the information.

In response, the AAD has launched an online COVID-19 dermatology registry, inspired by a similar registry created by the COVID-19 Global Rheumatology Alliance. The goal is to rapidly collect COVID-19 cutaneous manifestations to inform dermatologists and other healthcare professionals.

The registry is available online through the AAD website at The International League of Dermatological Societies (ILDS) is collaborating with the AAD on this registry with the aim of extending its reach internationally.

Cases can be entered by any healthcare worker, including pharmacists. AAD says data entry takes 5 to 7 minutes and requires no patient protected health information. Requested data includes patient demographics, new onset dermatologic conditions in the setting of COVID-19, dermatologic and medical history, and the patient’s COVID-19 diagnosis and treatment. COVID-19 diagnosis may be based on clinical suspicion alone or laboratory confirmation, the AAD adds.

“Ultimately, the success of this international effort depends on the active participation of all health-workers caring for patients with COVID-19,” according to the authors. “Together, we hope to use this registry to compile a more complete and representative case series of potential dermatologic manifestations of COVID-19 and outcomes of established dermatology patients who develop COVID-19.”

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