ABSTRACT Skin is one of target organs affected by the novel coronavirus SARS-CoV-2 and in response to the current COVID-19 pandemic, a fast body of literature has emerged on related cutaneous manifestations Current perspective is that the skin is not only a bystander of the general cytokines storm with thrombophylic multiorgan injury, but it is directly affected by the epithelial tropism of the virus, as confirmed by the detection of SARS‐CoV‐2 in endothelial cells and epithelial cells of epidermis and eccrine glands In contrast with the abundance of epidemiologic and clinical reports, histopathologic characterization of skin manifestations is limited Without an adequate clinico-pathologic correlation, nosology of clinically similar conditions is confusing, and effective association with COVID-19 remains presumptive Several patients with different type of skin lesions, including the most specific acral chilblains-like lesions, showed negative results at SARS-CoV-2 nasopharyngeal and serologic sampling We have provided an overview of what has currently been reported worldwide, with a particular emphasis on microscopic patterns of the skin manifestations in patient exposed to or affected by COVID-19 Substantial breakthroughs may occur in the near future from more skin biopsies, improvement of immunohistochemistry studies, RNA detection of SARS-CoV-2 strain by real-time PCR-based assay, and electron microscopic studies
Clinico-pathologic Correlations of Covid19-related Cutaneous Manifestations with Special Emphasis on Histopathologic Patterns