Skin manifestations of primary COVID-19 infection with the omicron variant

Although cutaneous manifestations of COVID-19 have been increasingly documented across earlier variants, the dermatological characteristics specifically associated with the Omicron variant, particularly in the Chinese population, remain insufficiently characterized in the literature.

To characterize cutaneous manifestations in patients with primary COVID-19 infection caused by the Omicron variant and corresponding management.

94 participants were included in this retrospective analysis, who developed dermatologic symptoms within one month of COVID-19 Omicron Variant infection.

Mean age was 38 years old, ranging from 7 to 89; with 66% aged within 25-50. A significantly higher incidence of skin manifestations was reported among females (males vs. females, 1:2.76, p = 0.001). Skin rashes typically appeared three days after the onset of COVID symptoms (ranging between 2-7 days), which were mostly mild to moderate. Common morphological types included wheals, erythema, and papular/papulovesicular eruptions. Generalized rashes occurred in 50% of cases, while localized rashes mainly affected the extremities. Pruritus was the most frequent symptom (>90%), particularly in patients presenting with wheals. Clinical management included topical steroid creams and antiviral treatment for COVID-19. No follow-ups were required for most participants (>95%).

Skin rashes associated with Omicron variant COVID-19 infection, predominantly affecting young and middle-aged women, are characterized by wheals, erythema, and papular/papulovesicular eruptions. Early identification and management of these cutaneous symptoms should be integrated in the overall treatment plan of Omicron variant COVID-19 infection.