The skin symptoms associated with COVID-19 have almost completely disappeared: why is this mystery?

Since the COVID-19 pandemic began, there has been much discussion about whether the coronavirus has changed. Throughout the summer and later, with the onset of the second wave, it was said that it could have mutated into a less serious disease. This is what we would all like to think about. However, many experts were quick to clarify that it most likely appears milder simply because there is now better diagnostic ability. Before, the pathology was only detected in people with severe symptoms, now they are also diagnosed mild or asymptomatic patients, so the percentage of income and death is much lower. But it does seem that the disease is changing, either due to the virus or due to circumstances. It is something that can be seen in skin symptoms caused by coronavirus.

During the first wave, numerous dermatologists alerted to a new manifestation of SARS-CoV-2. Apparently a large number of patients, especially children and adolescents, exhibited skin symptoms such as chilblains or rashes. Many cases were detected, but as this first blow of the coronavirus ceased, so did these skin features. However, now that the disease is returning hard, with thousands of daily cases in our country, the logical thing would be to see them again. And it is not being so.

What are the skin symptoms caused by the coronavirus?

During the first wave, five skin symptoms caused by the coronavirus, or at least the circumstances, were established. These are the manifestations maculopapular, consisting of redness in specific areas of the skin, vesicular, urticarial, pseudopernious, similar to chilblains, and livedo-reticularis-necrosis. The latter is a cutaneous sign, consisting of the red-purplish coloration of the skin, which is usually due to some type of vascular condition, especially in the area of ​​the extremities.

Five different skin symptoms caused by coronavirus were found

These symptoms varied between patients and also differed based on the severity of pathology. However, they were very frequent. Today, however, they are almost non-existent.

All this supposes a mystery that is being discussed in the I AEDV Virtual Congress Autumn 2020, organized by the Spanish Academy of Dermatology and Venereology. It will take place between November 19 and 21 and will take place through 40 scientific sessions and 500 communications. But what are the theories so far?

It is not a matter of temperatures

Since the first wave occurred between late winter and early spring, it would be expected that certain symptoms, such as chilblains, commonly associated with cold, they stopped in summer. However, they have not returned with the arrival of autumn, so that does not seem to be the reason.

If it was related to the temperatures in summer, the rashes would have increased

“We do not have a proven explanation about why each of these manifestations has occurred,” explains the doctor to Cristina Galván Casas, a dermatologist at the University Hospital of Móstoles and the Spanish Academy of Dermatology and Venereology and principal investigator of the CovidPiel study. “However, clinical experience makes us suspect other possibilities. The chilblain-like lesions, for example, were very numerous in a very mild spring and we are not seeing them in this much colder fall. On the other hand, common urticaria can be triggered by sweat associated with heat, and also with cold. It is implausible that the summer has caused its disappearance ”.

Therefore, the reason seems to be another. Nothing is clear, but it is quite likely that it has to do with the fact that in the first wave we only saw the tip of the iceberg. “The number of cases of this second wave is much lower, in relation to the first”, clarifies the dermatologist. “Let us remember that, in the first months of the pandemic, very few patients had access to diagnostic tests. And it is only those tested cases that reflect the curve. This time, the tests are of very high use, if not massive, so the figure reflected by the curves is more similar to the real numbers of infected. If the percentage of infected people with skin manifestations has not changed, the normal thing is that we find far fewer cases than in the first wave ”.

But there are more possible reasons for the skin symptoms caused by the coronavirus.

acral injuriesAcral injuries (AEDV)

Mutations and drugs

Aside from the above, the dermatologists attending the conferences value other possibilities. For example, that the virus has mutated. All viruses do, especially RNA ones. It has been proven that SARS-CoV-2 does not mutate as much as others with this type of genetic material, but it does.

It is theorized with a possible relationship with hydroxychloroquine

This, in the same way that it happens to other living beings (although viruses are not strictly considered as such), serves to evolve and adapt to the environment. In the last few months he’s having to adapt to human. And this could be one of the modifications.

“It is known that the virus undergoes mutations and may be developing phenomena of adaptation to man that make the percentage of manifestations on the skin lower, ”says Dr. Galván. “It is conjecture, but it seems more plausible than the arrival of summer and the heat.”

Finally, experts suggest that the skin symptoms caused by the coronavirus might not actually be caused directly by it, but by the drugs. It should be remembered that a lot of drugs were tried by trial and error in the beginning, looking for effective antiviral effects. Well known is the example of hydroxychloroquine, the use of which spread rapidly, only to decline abruptly after several studies showed that it was of no benefit. “It is known that this drug can cause skin rashes,” says the specialist. “Therefore, if some eruptions that we saw were favored by its use, in this phase of the pandemic they will no longer be seen.”

Livedo reticularisLivedo reticularis (AEDV)

Beyond Spain

Although these conferences on skin symptoms caused by the coronavirus are being held in Spain, it is important to observe if the phenomenon has occurred in other countries. In the chaos of the dermatologist interviewed by this means, she has been able to speak with colleagues from Italy, who are observing a similar phenomenon. “They continue to find skin manifestations of COVID-19, but much less frequently than before.”

There is still much to investigate to solve this mystery, but these scientists are determined to do it. Dr. Galván has already stated: “We still have a lot to know about this virus and we are not going to tire of continuing to investigate.”

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