{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:25:01Z","timestamp":1787243101074,"version":"build-2736575974"},"reference-count":12,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize cutaneous manifestations in patients with primary COVID-19 infection caused by the Omicron variant and corresponding management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>94 participants were included in this retrospective analysis, who developed dermatologic symptoms within one month of COVID-19 Omicron Variant infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean age was 38 years old, ranging from 7 to 89; with 66% aged within 25\u201350. A significantly higher incidence of skin manifestations was reported among females (males vs. females, 1:2.76, p\u2009=\u20090.001). Skin rashes typically appeared three days after the onset of COVID symptoms (ranging between 2\u20137 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 (&gt;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 (&gt;95%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0352201","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:29:31Z","timestamp":1784309371000},"page":"e0352201","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Skin manifestations of primary COVID-19 infection with the omicron variant"],"prefix":"10.1371","volume":"21","author":[{"given":"Chuan","family":"Ma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9578-229X","authenticated-orcid":true,"given":"Jiachen","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zilian","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuansheng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawang","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0123-9913","authenticated-orcid":true,"given":"Qing","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"issue":"8","key":"pone.0352201.ref001","doi-asserted-by":"crossref","first-page":"104759","DOI":"10.1016\/j.isci.2022.104759","article-title":"SARS-CoV-2 Delta spike protein enhances the viral fusogenicity and inflammatory cytokine production","volume":"25","author":"Z Ao","year":"2022","journal-title":"iScience"},{"issue":"5","key":"pone.0352201.ref002","doi-asserted-by":"crossref","first-page":"105954","DOI":"10.1016\/j.ijantimicag.2020.105954","article-title":"Cytokine release syndrome in severe COVID-19: Interleukin-6 receptor antagonist tocilizumab may be the key to reduce mortality","volume":"55","author":"C Zhang","year":"2020","journal-title":"Int J Antimicrob Agents"},{"issue":"55","key":"pone.0352201.ref003","doi-asserted-by":"crossref","DOI":"10.1126\/sciimmunol.abe4782","article-title":"Severely ill COVID-19 patients display impaired exhaustion features in SARS-CoV-2-reactive CD8+ T cells","volume":"6","author":"A Kusnadi","year":"2021","journal-title":"Sci Immunol"},{"issue":"6","key":"pone.0352201.ref004","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1111\/bjd.19489","article-title":"Chilblains and COVID-19: Why SARS-CoV-2 endothelial infection is questioned","volume":"183","author":"M Baeck","year":"2020","journal-title":"Br J Dermatol"},{"issue":"4","key":"pone.0352201.ref005","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1111\/bjd.19311","article-title":"SARS-CoV-2 infection: The same virus can cause different cutaneous manifestations","volume":"183","author":"F Drago","year":"2020","journal-title":"Br J Dermatol"},{"issue":"6","key":"pone.0352201.ref006","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1111\/bjd.19833","article-title":"SARS-CoV-2 spike protein positivity in pityriasis rosea-like and urticaria-like rashes of COVID-19","volume":"184","author":"E Welsh","year":"2021","journal-title":"Br J Dermatol"},{"key":"pone.0352201.ref007","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.ijid.2023.01.024","article-title":"Emergence and geographic dominance of Omicron subvariants XBB\/XBB.1.5 and BF.7 - the public health challenges","volume":"128","author":"TP Velavan","year":"2023","journal-title":"Int J Infect Dis"},{"issue":"4","key":"pone.0352201.ref008","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s00011-022-01555-5","article-title":"COVID-19 pandemic: The delta variant, T-cell responses, and the efficacy of developing vaccines","volume":"71","author":"B Biswas","year":"2022","journal-title":"Inflamm Res"},{"issue":"1","key":"pone.0352201.ref009","doi-asserted-by":"crossref","first-page":"167","DOI":"10.3390\/v15010167","article-title":"A detailed overview of SARS-CoV-2 omicron: Its sub-variants, mutations and pathophysiology, clinical characteristics, immunological landscape, immune escape, and therapies","volume":"15","author":"S Chatterjee","year":"2023","journal-title":"Viruses"},{"issue":"6","key":"pone.0352201.ref010","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1111\/bjd.21784","article-title":"Cutaneous manifestations of SARS-CoV-2 infection during the Delta and Omicron waves in 348\u2009691 UK users of the UK ZOE COVID Study app","volume":"187","author":"A Visconti","year":"2022","journal-title":"Br J Dermatol"},{"issue":"3","key":"pone.0352201.ref011","doi-asserted-by":"crossref","first-page":"357","DOI":"10.3390\/vaccines10030357","article-title":"Prediction of SARS-CoV-2 omicron variant immunogenicity, immune escape and pathogenicity, through the analysis of spike protein-specific core unique peptides","volume":"10","author":"E Kontopodis","year":"2022","journal-title":"Vaccines (Basel)"},{"issue":"2","key":"pone.0352201.ref012","doi-asserted-by":"crossref","DOI":"10.1093\/pnasnexus\/pgac067","article-title":"Omicron variant of SARS-CoV-2 exhibits an increased resilience to the antiviral type I interferon response","volume":"1","author":"L Shalamova","year":"2022","journal-title":"PNAS Nexus"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0352201","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:29:33Z","timestamp":1784309373000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0352201"}},"subtitle":[],"editor":[{"given":"Bala","family":"Munipalli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7,17]]},"references-count":12,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,17]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0352201","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,17]]}}}