Skin rashes are associated with having a positive test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and are the only clinical sign of COVID-19 in 21 percent of patients, according to a study published in the May issue of the British Journal of Dermatology.

Alessia Visconti, Ph.D., from King's College London, and colleagues used data from 336,847 U.K. users of the COVID Symptom Study app to examine the diagnostic value of body rash or an acral rash in SARS-CoV-2 infection. Skin-specific symptoms were investigated in an independent online survey with 11,544 respondents.

The researchers identified a significant correlation between skin rashes and a positive swab test result (odds ratio, 1.67) using data from the app. Among respondents of the independent online survey, skin rashes were reported as the first presentation by 17 percent of SARS-CoV-2-positive cases; 21 percent reported skin rashes as the only clinical sign of COVID-19. A catalogue of the most common skin manifestations of COVID-19 was compiled based on images from 400 individuals, which has been made publicly available.

"This study strongly supports the inclusion of skin rashes in the list of suspicious COVID-19 symptoms. Although they are less prevalent than fever, they are more specific and last longer, and can be easily spotted by patients," the authors write. "Importantly from the survey reported in this study, it was the only presentation in one-fifth of the patients diagnosed with COVID-19."

Several authors disclosed financial ties to Zoe Global Limited, which provided support for the app and service to users.

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