Skin symptoms of COVID more predictive than fever
Skin rashes, alone or in combination with other symptoms, are helpful in the diagnosis of COVID-19.
A UK study, involving more than 335,000 users of the COVID Symptom Study app and 11,544 respondents to an independent online survey of COVID-19 related symptoms, found skin rashes were predictive of SARS-CoV-2 infection.
The study found 8.8% of people who tested positive for COVID-19 on swab test had reported skin-related changes.
Body rashes were associated with a SARS‐CoV‐2‐positive swab with an OR of 1·66 and acral rashes with an OR 1·74. In comparison, the OR for fever was 1·48.
Almost half (47%) of respondents to the online survey said skin changes appeared at the same time as other COVID‐19 symptoms, 35% said afterwards, and 17% said skin symptoms appeared before any other symptoms.
In 21% of cases, rash was the only COVID-19 symptom. Papular rashes were the most common and typically lasted for 14 days.
The study concluded skin rashes should be included in the list of suspicious symptoms for COVID-19 given they were more specific and last longer than fever and were easily spotted by patients.
Read more in British Journal of Dermatology
Check out COVID-19 skin signs
Fake news on sunscreens slapped down
Dermatologists, skin cancer researchers and Queensland Health have hit out at false claims about sunscreens that are irresponsibly perpetuated on social media feeds.
The myths include:
- It’s safe to not use sun protection outside
- Darker skin does not burn
- A tan prevents sunburn or people who tan easily do not get skin cancer
- Chemicals from sunscreen are more dangerous than UV rays
- Sun protection causes Vitamin D deficiencies
- Sunscreen causes cancer
- You don’t need sunscreen when it’s overcast
- Sunscreen causes coral bleaching.
Dermatologist Associate Professor Erin McMeniman, from the Princess Alexandra Hospital, said some of the myths were dangerous in a state with such a high rate of melanoma.
“We need to make it clear that sunscreen protects your skin from sun dangerous ultraviolet rays and can help prevent skin cancer, including life-threatening melanoma. That’s backed by science,” she said in a statement.
She added that people who get a reaction to sunscreen should seek advice about products designed for sensitive skin.
Psoriasis assessments not always on the same page
Discordance between patients and physicians in their psoriasis severity ratings occurs in a significant minority of cases (39%).
However the discordance is mediated by both mental health status of the patients and disease severity.
A UK study found that patients with milder psoriasis (PASI score ≤5) and concurrent depression or anxiety were more likely to overestimate their psoriasis severity compared to the physicians’ assessment.
“Conversely, patients with moderate to severe psoriasis (PASI score >10) and concurrent depression or anxiety were more likely to underestimate their psoriasis severity.”
The study said the data had clinical relevance as shared decision-making was so important in a life-long diagnosis and especially in a time of limited health care resources and virtual clinical reviews.
“Patient-reported disease severity scores should thus be interpreted in the context of comorbid anxiety and depression, which can be facilitated by the routine use of mental health screening tools,” the study concluded.