Main Causes of Skin Damages during COVID-19 Pandemic

Coronavirus disease-2019 (COVID-19) can affect multiple organs including the heart and blood vessels, kidneys, gut, and brain. This study aimed to assess all aspects of skin damages during COVID-19. The main causes of skin damages during the COVID-19 pandemic and its consequences can be examined in four parts includingcutaneous manifestations that appear during COVID-19, drug reactions that occur during hospitalization or outpatient treatment of patients, skin damages resulting from over-washing or rinsing with inappropriate detergents, inappropriate use of personal protective equipment (e.g. protective eyewear, protective clothing, and gloves) and changes the course of COVID-19 in patients with autoimmune, chronic and inflammatory underlying skin diseases. The rate of skin manifestations in patients with COVID-19 ranged from 1.8% to 20.4%, including vascular lesions (petechiae, purpura, lividoreticularis, pernio and chilblain lesions), urticaria and maculopapular rash, and other less common skin manifestations such as erythema multiforme, pityriasis rosea, suite syndrome were commonly seen in men aged 45 to 89 years. The distribution of the most lesions (69.4%) was in the body, but in 19% of cases, lesions were observed in the hands and feet. Patients with COVID-19 receive multiple anti-viral drugs, antibiotics and various anti-inflammatory drugs. Receiving these drugs led to cutaneous manifestations in some patients. Moreover, medical staff is prone to various traumatic skin conditions due to long-term use of personal protective equipment. These conditions included itching, redness, skin irritation, contact dermatitis, and worsening of underlying diseases. The effects of COVID-19 on the skin can be serious and long-lasting, and adequate treatment and supportive therapy can prevent lasting consequences and disability of the patient.