For patients with psoriasis, vitiligo, atopic dermatitis (AD), and chronic urticaria (CU), COVID-19 severity does not differ, but treatment of COVID-19 may affect the course of skin disease, according to a letter to the editor published in the January 2022 issue of the Journal of the European Academy of Dermatology and Venereology.
Paulo Ricardo Criado, M.D., Ph.D., from the Centro Universitario Faculdade de Medicina do ABC in Brazil, and colleagues conducted a survey to examine acute COVID-19 symptoms, treatment, and changes in the clinical manifestation of psoriasis, vitiligo, AD, and CU in Brazil. Data were analyzed from 6,614 confirmed COVID-19 cases; 843 reported one of the four active skin diseases.
The researchers observed no difference in hospitalization due to COVID-19 for respondents with and without skin diseases (9 versus 11 percent). The conditions most severely influenced by COVID-19 were CU and arthralgia; however, the clinical courses of the dermatoses were not associated with COVID-19 hospitalization. Of the symptoms reported during COVID-19, high fever was associated with CU exacerbation and severe dyspnea was associated with worsening of arthralgia in psoriasis and AD lesions. There was an association for use of antimalarials in COVID-19 with exacerbation of vitiligo, but corticosteroids, anticoagulants, and antimicrobials were not associated with modification in the clinical course of the dermatoses. Patients with vitiligo using oral antioxidants had a lower rate of hospitalization, while greater clinical impairment was seen with use of oral corticosteroids for vitiligo and CU treatment and for use of antihistamines for AD.
"The severity of COVID-19 does not differ among patients with AD, CU, psoriasis, and vitiligo, but acute COVID-19 and its treatments can affect the course of skin diseases," the authors write.