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

BACKGROUND: 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. OBJECTIVE: To characterize cutaneous manifestations in patients with primary COVID-19 infection caused by the Omicron variant and corresponding management. METHODS: 94 participants were included in this retrospective analysis, who developed dermatologic symptoms within one month of COVID-19 Omicron Variant infection. RESULTS: 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%). CONCLUSION: 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.