Dermatologist are seeing more and more #skin symptoms related to #COVID19 . Acral lesions (i.e. hands and feet) are particularly frequent, specially in #children and #youngadult with no or few COVID symptoms. After seeing many cases, here is my vision: #Thread 👇 
I think that these kind of lesions can be classified in four types. 1. Chilblain-like lesions, which are the most described, usually affecting many fingers / toes, either symmetrically or not. Pruritic and/or painful.
2. Insect-bite like lesions, that may also appear in the palm and the soles. Very #itchy and persistent (more than 2 weeks in some cases)
3. Hematoma like lesions, without previous trauma. Can be the evolution of the previous ones. Slightly painful.
4. Frictional like lesions (personally have seen these only in the heels). Slightly painful.
It is no clear that all these skin manifestations are caused by #COVID19; neither its pathophysiology, nor its practical implications. Many of us think that it can be a late manifestation of the disease but more #investigation is needed!
What I have seen is that normally appear within 2-21 days after symptoms or 15-21 days after contacting with a #Covid_19 patient. This dermoscopy of a periungual lesion suggest damage of the micro-vasculature that may be either #thrombotic or due to #endothelial damage.
It is important to notice that most of this cases do not represent an important #health problem and the lesions are self-limited. At this moment we do not have consensus recommendations regarding #Isolation, #PCR , #serological test or specific #treatment, among others.
We need to continue investigating about this curious phenomena. The Spanish clinical #study #covidpiel may bring some explanations. Meanwhile, we will continue observing and reporting cases. Thank you for your interest! #skin #dermatology
