LAUSR

Dear Editor, The COVID-19 pandemic continues its impact worldwide. Estimated prevalence of skin findings in patients with COVID-19 is estimated to be 5%, but the prevalence and clinical presentation varies greatly among series (0.1–60%). National registries have become an important tool to understand this highly contagious and potentially mortal infection. In this report, we aimed to describe the results of the Mexican Academy of Dermatology nationwide survey of dermatological manifestations of COVID19 infection in Mexico. On July 1, 2020, we established a national registry to collect demographic and clinical information of patients with COVID-19 cutaneous manifestations. Mexican dermatologists were invited to fill out an electronic survey. The survey was shared via the official social media accounts and the official website of the Mexican Academy of Dermatology. No protected health information was collected, and all data were deidentified. The survey collected demographic data, COVID-19 diagnosis type (PCR, serum antibodies, clinical, or otherwise unspecified), and dermatological manifestations related to the infection. Subjects with laboratory confirmation of COVID-19 or clinical suspicion of the infection were included in the study. Each physician was responsible for obtaining informed consent regarding clinical pictures uploaded to the survey webpage. The analysis was performed blindly by two of the authors with SPSS v. 23 (Armonk, NY, USA). Cases uploaded to the survey from July 9, 2020, to December 7, 2020, were included. A total of 164 cases were included in the final analysis. A total of 120 subjects (73.3%) were women. The most common age range was 31–40 with 23.8% of the total followed by 21–30 (18.3%) and 41–50 (17.1%). A total of 86 (52.4%) subjects had a confirmed diagnostic test by PCR. An additional nine (5.5%) has a positive test for serum antibodies. The rest of the subjects had a clinical COVID-19 diagnosis (29, 17.7%), or the information was unspecified (40, 24.4%). Demographic and clinical information of the cases are shown in Table 1. The dermatological manifestations of COVID-19 are shown in Table 1 and Figure 1. The most common manifestations were urticaria in 40 (24.4%), maculopapular eruption in 28 (23.2%), varicella-like eruption in 25 (15.2%), enanthema in 13 (7.9%), and a pernio-like eruption in 11 (6.7%). Of interest 10 (6.1%) patients presented palmar erythema and six (3.7%) elbow/knee erythema, manifestations seldom associated with COVID-19. In accordance with other COVID-19 dermatologic registries, the most common skin manifestations were urticaria and maculopapular eruptions. We highlight an unusually high number of cases with varicella-like eruptions, flexural rash similar to the one presented in symmetrical drug-related intertriginous and flexural exanthema (SDRIFE), extensor surface rash, alopecia,