Cutaneous manifestations of COVID-19 and vaccines for its prevention: a review of the existing literature

Eleftheria Ladea, Department of Medicine, University of Thessaly and Hellenic Open University, Patra, Greece

The coronavirus severe acute respiratory syndrome coronavirus 2 first appeared in December 2019 in Wuhan, China, spreading rapidly as a novel pathogen primarily affecting the respiratory system. It soon evolved into a global pandemic that challenged healthcare systems worldwide. Intense research interest emerged early, revealing numerous cutaneous manifestations associated with both the virus itself – through its tropism for the angiotensin-converting enzyme 2 receptor – and the systemic complications it induced, such as cytokine storm and severe inflammatory reactions. Cutaneous findings were attributed to multiple mechanisms, including direct viral effects, immune dysregulation, drug reactions from early therapeutic regimens, and reactivation of autoimmune processes. Moreover, the vaccines developed to curb viral transmission and morbidity also presented certain dermatologic adverse effects, some resembling infection-induced manifestations, while others were linked to vaccine components and immune responses. This review summarizes the wide spectrum of skin manifestations associated with COVID-19 infection, vaccination, and the use of personal protective equipment, as well as the exacerbation of pre-existing dermatoses during the pandemic. Psychological stress and social isolation are also discussed as contributing factors to dermatologic morbidity. By synthesizing present scientific literature, this study provides a concise yet comprehensive overview of COVID-19- and vaccine-related skin manifestations, highlighting their clinical relevance and the need for further research on underlying mechanisms and management strategies.

Keywords: COVID-19 and the skin. Vaccination for COVID-19. Skin manifestations of COVID-19.