{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:33:18Z","timestamp":1760059998319,"version":"build-2065373602"},"reference-count":51,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","theclinics.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinics in Dermatology"],"published-print":{"date-parts":[[2021,5]]},"DOI":"10.1016\/j.clindermatol.2021.01.009","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T12:06:39Z","timestamp":1612267599000},"page":"374-379","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"title":["COVID-19\u2013specific skin changes related to SARS-CoV-2: Visualizing a monumental public health challenge"],"prefix":"10.1016","volume":"39","author":[{"given":"Robert A.","family":"Schwartz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. Clark","family":"Lambert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.clindermatol.2021.01.009_bib0001","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.ijid.2020.01.009","article-title":"The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health - the latest 2019 novel coronavirus outbreak in Wuhan, China","volume":"91","author":"Hui","year":"2020","journal-title":"Int J Infect Dis"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0002","doi-asserted-by":"crossref","first-page":"226","DOI":"10.7326\/M20-1565","article-title":"Caution warranted: using the Institute for Health Metrics and Evaluation model for predicting the course of the COVID-19 pandemic","volume":"173","author":"Jewell","year":"2020","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0003","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical characteristics of coronavirus disease 2019 in China","volume":"382","author":"Guan","year":"2020","journal-title":"N Engl J Med"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0004","first-page":"e212","article-title":"Cutaneous manifestations in COVID-19: a first perspective","volume":"34","author":"Recalcati","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0005","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jmii.2020.03.011","article-title":"Interrupting COVID-19 transmission by implementing enhanced traffic control bundling: implications for global prevention and control efforts","volume":"53","author":"Yen","year":"2020","journal-title":"J Microbiol Immunol Infect"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0006","unstructured":"World Health Organization. WHO Director-General's opening remarks at the media briefing on COVID-19. [Press release, March 11, 2020. Archived from the original on March11, 2020]. Accessed March 12, 2020. https:\/\/www.who.int\/director-general\/speeches\/detail\/who-director-general-s-opening-remarks-at-the-media-briefingon-covid-19---11-march-2020"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0007","unstructured":"World Health Organization. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). [Archived from the original on January 31, 2020]. Accessed February 11, 2020. https:\/\/www.who.int\/director-general\/speeches\/detail\/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020."},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0008","unstructured":"Johns Hopkins University. COVID-19 dashboard. Available at: https:\/\/coronavirus.jhu.edu\/map.html. Accessed August 26, 2020."},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0009","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1002\/alr.22587","article-title":"Smell dysfunction: a biomarker for COVID-19","volume":"10","author":"Moein","year":"2020","journal-title":"Int Forum Allergy Rhinol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0010","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1038\/s41564-020-0688-y","article-title":"Functional assessment of cell entry and receptor usage for SARS-CoV-2 and other lineage B betacoronaviruses","volume":"5","author":"Letko","year":"2020","journal-title":"Nat Microbiol"},{"issue":"5","key":"10.1016\/j.clindermatol.2021.01.009_bib0011","doi-asserted-by":"crossref","first-page":"e13544","DOI":"10.1111\/dth.13544","article-title":"COVID-19 with dermatologic manifestations and implications: an unfolding conundrum","volume":"33","author":"Almutairi","year":"2020","journal-title":"Dermatol Ther"},{"issue":"4","key":"10.1016\/j.clindermatol.2021.01.009_bib0012","doi-asserted-by":"crossref","first-page":"e13481","DOI":"10.1111\/dth.13481","article-title":"Cutaneous manifestations of a 21st century worldwide fungal epidemic possibly complicating the COVID-19 pandemic to jointly menace mankind","volume":"33","author":"Schwartz","year":"2020","journal-title":"Dermatol Ther"},{"issue":"6","key":"10.1016\/j.clindermatol.2021.01.009_bib0013","doi-asserted-by":"crossref","first-page":"e14053","DOI":"10.1111\/dth.14053","article-title":"Disseminated intravascular coagulation: a devastating systemic disorder of special concern with COVID-19","volume":"33","author":"Singh","year":"2020","journal-title":"Dermatol Ther"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0014","doi-asserted-by":"crossref","unstructured":"Schwartz RA, Kapila R, Pandemics over the Centuries. Clin Dermatol 2020 Dec 17, doi:10.1016\/j.clindermatol.2020.12.006. Online ahead of print.","DOI":"10.1016\/j.clindermatol.2020.12.006"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0015","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1111\/pde.14246","article-title":"Erythema multiforme-like lesions in children and COVID-19","volume":"37","author":"Torrelo","year":"2020","journal-title":"Pediatr Dermatol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0016","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1515\/cclm-2020-0188","article-title":"Prominent changes in blood coagulations of patients with SARS-CoC-2 infection","volume":"58","author":"Han","year":"2020","journal-title":"Clin Chem Lab Med"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0017","first-page":"302","article-title":"Clinical and coagulation characteristics of 7 patients with critical COVID-2019 pneumonia and acro-ischemia [in Chinese]","volume":"41","author":"Zhang","year":"2020","journal-title":"Zhonghua Xue Ye Xue Za Zhi"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0018","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1111\/pde.14215","article-title":"Chilblains in children in the setting of COVID-19 pandemic","volume":"37","author":"Andina","year":"2020","journal-title":"Pediatr Dermatol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0019","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/bjd.19163","article-title":"Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases","volume":"183","author":"Galv\u00e1n Casas","year":"2020","journal-title":"Br J Dermatol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0020","doi-asserted-by":"crossref","first-page":"e14170","DOI":"10.1111\/dth.14170","article-title":"Maculopapular eruptions associated to COVID-19: a subanalysis of the COVID-Piel study","volume":"33","author":"Catal\u00e0","year":"2020","journal-title":"Dermatol Ther"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0021","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/j.jaad.2020.05.145","article-title":"Chilblain-like acral lesions during the COVID-19 pandemic (\u201cCOVID toes\u201d): histologic, immunofluorescence and immunohistochemical study of 17 cases","volume":"83","author":"Kanitakis","year":"2020","journal-title":"J Am Acad Dermatol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0022","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1111\/j.1365-2133.1973.tb07538.x","article-title":"The skin in disseminated intravascular coagulation: prospective analysis of thirty-six cases","volume":"88","author":"Robboy","year":"1973","journal-title":"Br J Dermatol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0023","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/j.1365-4362.1977.tb00740.x","article-title":"Disseminated intravascular coagulation: a dermatologic disease","volume":"16","author":"Colman","year":"1977","journal-title":"Int J Dermatol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0024","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1016\/j.jaad.2020.05.073","article-title":"Cutaneous manifestations related to coronavirus disease 2019 (COVID-19): a prospective study from China and Italy","volume":"83","author":"De Giorgi","year":"2020","journal-title":"J Am Acad Dermatol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0025","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.jaad.2020.04.044","article-title":"Varicella-like exanthem as a specific COVID-19-associated skin manifestation: multicenter case series of 22 patients","volume":"83","author":"Marzano","year":"2020","journal-title":"J Am Acad Dermatol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0026","doi-asserted-by":"crossref","first-page":"e251","DOI":"10.1111\/jdv.16469","article-title":"Viral exanthem in COVID-19, a clinical enigma with biological significance","volume":"34","author":"Su","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0027","doi-asserted-by":"crossref","first-page":"e244","DOI":"10.1111\/jdv.16472","article-title":"Urticarial eruption in COVID-19 infection","volume":"34","author":"Henry","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0028","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1111\/ced.14243","article-title":"Two cases of COVID-19 presenting in clinical picture resembling chilblains disease. First report from the Middle East","volume":"45","author":"Alramthan","year":"2020","journal-title":"Clin Exp Dermatol"},{"issue":"suppl 1","key":"10.1016\/j.clindermatol.2021.01.009_bib0029","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/ijlh.13230","article-title":"Thromboembolic events and apparent heparin resistance in patients infected with SARS-CoV-2","volume":"42","author":"Beun","year":"2020","journal-title":"Int J Lab Hematol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0030","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1111\/bjd.19415","article-title":"The differing pathophysiologies that underlie COVID-19 associated perniosis and thrombotic retiform purpura: a case series","volume":"184","author":"Magro","year":"2021","journal-title":"Br J Dermatol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0031","first-page":"e548","article-title":"Retiform purpura as a dermatological sign of covid-19 coagulopathy","volume":"34","author":"Bosch-Amate","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0032","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/j.jaad.2020.04.018","article-title":"A dermatologic manifestation of COVID-19: transient livedo reticularis","volume":"83","author":"Manalo","year":"2020","journal-title":"J Am Acad Dermatol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0033","doi-asserted-by":"crossref","first-page":"e246","DOI":"10.1111\/jdv.16471","article-title":"A distinctive skin rash associated with coronavirus disease 2019?","volume":"34","author":"Mah\u00e9","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0034","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.jdermsci.2020.05.002","article-title":"Unique skin manifestations of COVID-19: is drug eruption specific to COVID-19?","volume":"99","author":"Sakaida","year":"2020","journal-title":"J Dermatol Sci"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0035","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1111\/jocd.13443","article-title":"A preliminary observation: male pattern hair loss among hospitalized COVID-19 patients in Spain\u2014a potential clue to the role of androgens in COVID-19 severity","volume":"19","author":"Goren","year":"2020","journal-title":"J Cosmet Dermatol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0036","doi-asserted-by":"crossref","unstructured":"Shanshal M. COVID-19 related anagen effluvium. J Dermatol Treat, in press. doi:10.1080\/09546634.2020.1792400.","DOI":"10.1080\/09546634.2020.1792400"},{"issue":"4","key":"10.1016\/j.clindermatol.2021.01.009_bib0037","doi-asserted-by":"crossref","first-page":"e13785","DOI":"10.1111\/dth.13785","article-title":"Azithromycin and COVID-19: prompt early use at first signs of this infection in adults and children, an approach worthy of consideration","volume":"33","author":"Schwartz","year":"2020","journal-title":"Dermatol Ther"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0038","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1111\/jdv.14297","article-title":"Topical antiviral and antifungal medications in pregnancy: a review of safety profiles","volume":"31","author":"Patel","year":"2017","journal-title":"J Eur Acad Dermatology Venereol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0039","doi-asserted-by":"crossref","first-page":"889","DOI":"10.36849\/JDD.2020.5323","article-title":"Systemic medications of dermatological importance in COVID-19","volume":"19","author":"Schwartz","year":"2020","journal-title":"J Drugs Dermatol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0040","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/j.ijid.2020.06.099","article-title":"Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19","volume":"99","author":"Arshad","year":"2020","journal-title":"Int J Infect Dis"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0041","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.therap.2020.05.002","article-title":"Off-label\u201d use of hydroxychloroquine, azithromycin, lopinavir-ritonavir and chloroquine in COVID-19: a survey of cardiac adverse drug reactions by the French Network of Pharmacovigilance Centers","volume":"75","author":"G\u00e9rard","year":"2020","journal-title":"Therapie"},{"issue":"3","key":"10.1016\/j.clindermatol.2021.01.009_bib0042","doi-asserted-by":"crossref","first-page":"e13380","DOI":"10.1111\/dth.13380","article-title":"Generalized pustular figurate erythema. A newly delineated severe cutaneous drug reaction linked with hydroxychloroquine","volume":"33","author":"Schwartz","year":"2020","journal-title":"Dermatol Ther"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0043","first-page":"e5","article-title":"Generalized pustular figurate erythema. First report in two COVID-19 patients on hydroxychloroquine","volume":"35","author":"Adad\u00edas-Granado","year":"2021","journal-title":"J Eur Acad Dermatol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0044","article-title":"Do Not Resuscitate (DNR)\u201d status determines mortality in patients with COVID-19","author":"Alhatem","year":"2020","journal-title":"Clin Dermatol"},{"issue":"1","key":"10.1016\/j.clindermatol.2021.01.009_bib0045","doi-asserted-by":"crossref","DOI":"10.1111\/dth.14624","article-title":"The Goldman-Fox syndrome: treating and preventing green Pseudomonas nails in the era of COVID-19","volume":"34","author":"Schwartz","year":"2021","journal-title":"Dermatol Ther"},{"issue":"4","key":"10.1016\/j.clindermatol.2021.01.009_bib0046","doi-asserted-by":"crossref","first-page":"e13806","DOI":"10.1111\/dth.13806","article-title":"Shifting dermatology market strategies from cosmetics to moisturizers and sanitizers treatments in the COVID-19 era","volume":"33","author":"Schwartz","year":"2020","journal-title":"Dermatol Ther"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0047","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4103\/ijd.IJD_277_19","article-title":"Chloronychia: the Goldman-Fox syndrome: implications for patients and health care workers","volume":"65","author":"Schwartz","year":"2020","journal-title":"Indian J Dermatol"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0048","unstructured":"Carlton P.K. Jr, Johanigman J., Janniger E.J., Schwartz R.A. COVID-19 and the urgent need to render spaces safer. Global Policy. Available at: https:\/\/www.globalpolicyjournal.com\/blog\/15\/05\/2020\/covid-19-and-urgent-need-render-spaces-safer. Accessed Month February 20, 2021."},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0049","first-page":"581","article-title":"Encephalitis lethargica","volume":"30","author":"von Economo","year":"1917","journal-title":"Wien Klin Wochenschr"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0050","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1136\/bmj.2.5108.1311","article-title":"Neurological and hepatic disorders associated with influenza","volume":"2","author":"Kapila","year":"1958","journal-title":"Br Med J"},{"key":"10.1016\/j.clindermatol.2021.01.009_bib0051","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.npbr.2020.05.008","article-title":"Neurological manifestations of COVID-19 and other coronaviruses: a systematic review","volume":"37","author":"Correia","year":"2020","journal-title":"Neurol Psychiatry Brain Res"}],"container-title":["Clinics in Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0738081X21000109?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0738081X21000109?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:16:30Z","timestamp":1760033790000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0738081X21000109"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":51,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["S0738081X21000109"],"URL":"https:\/\/doi.org\/10.1016\/j.clindermatol.2021.01.009","relation":{},"ISSN":["0738-081X"],"issn-type":[{"type":"print","value":"0738-081X"}],"subject":[],"published":{"date-parts":[[2021,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"COVID-19\u2013specific skin changes related to SARS-CoV-2: Visualizing a monumental public health challenge","name":"articletitle","label":"Article Title"},{"value":"Clinics in Dermatology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.clindermatol.2021.01.009","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}