The results of a study published as a research letter in the British Journal of Dermatology today, provide further evidence to support the case that oral lesions and skin rashes, also known as mucocutaneous manifestations, are an important sign of COVID-19.

The study included 666 COVID-19 patients with mild to moderate pneumonia, being treated in a temporary field hospital set up during the pandemic’s peak in Madrid, Spain. The mean age of the patients was 56, 58% of them were female.

Forty-six per cent of patients had some form of mucocutaneous manifestation, with issues with the skin on the hands and feet being particularly common (40%), as well as findings inside the mouth (26%). The most common hand and foot issue was diffuse skin peeling (25%), and most common issue found in the mouth was transient lingual papillitis, also known as lie bumps, characterised by the appearance of small red or white bumps on the tongue.

Urticaria (6.9%), rash (2.9%) and vesicular eruptions (1.6%) were observed in a minority of patients.

The higher prevalence of COVID-19 associated mucocutaneous manifestations in this study compared to prior ones may be because this study included manifestations not previously described, particularly lesions inside the mouth. Conversely, skin rashes alone were relatively uncommon (11%) in this study compared to previous studies, the authors hypothesise several reasons for this, including the age of the group being studied.

The British Association of Dermatologists has set up an online gallery highlighting some of the common skin symptoms of COVID-19, to help improve understanding of the disease amongst healthcare professionals, researchers, and the public.