The American Academy of Dermatology COVID-19 registry: Crowdsourcing dermatology in the age of COVID-19
Authors: Esther E. Freeman, Devon E. McMahon, Matthew E. Fitzgerald, Lindy P. Fox, Misha Rosenbach, Junko Takeshita, Lars E. French, Bruce H. Thiers, George J. Hruza
Journal: Journal of the American Academy of Dermatology (2020)

There have been increasing reports of dermatologic manifestations of COVID-19. The first case series of dermatologic manifestations included 18 Italian patients with erythematous, urticarial, and vesicular rashes, often on the trunk.1Recalcati S. Cutaneous manifestations in COVID-19: a first perspective [Epub ahead of print].J Eur Acad Dermatol Venereol. 2020; (Published online March 26, 2020)https://doi.org/10.1111/jdv.16387Crossref Scopus (928) Google Scholar Other reports include drug hypersensitivity,2Zhang J.J. Dong X. Cao Y.Y. et al.Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China [Epub ahead of print].Allergy. 2020; (Published online February 19, 2020)https://doi.org/10.1111/all.14238Crossref Scopus (2586) Google Scholar urticaria,2Zhang J.J. Dong X. Cao Y.Y. et al.Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China [Epub ahead of print].Allergy. 2020; (Published online February 19, 2020)https://doi.org/10.1111/all.14238Crossref Scopus (2586) Google Scholar a petechial rash mimicking dengue,3Joob B. Wiwanitkit V. COVID-19 can present with a rash and be mistaken for dengue.J Am Acad Dermatol. 2020; 82: e177Abstract Full Text Full Text PDF PubMed Scopus (337) Google Scholar and acro-ischemia.4Zhang Y. Cao W. Xiao M. et al.Zhonghua Xue Ye Xue Za Zhi. 2020; 41: E006PubMed Google Scholar It is important to further characterize dermatologic manifestations of COVID-19 to understand the relationship between the virus and skin and to determine whether cutaneous manifestations of COVID-19 may assist with early disease detection. To date, collecting cases of dermatologic manifestations of COVID-19 has been challenging given their relative infrequency and the rapid spread of COVID-19. Dermatologists are relying on informal networks, including social media, to share cutaneous manifestations of the disease. To rapidly and centrally collate these cases from a global network and inform colleagues on the front lines combatting the virus, the American Academy of Dermatology (AAD) COVID-19 Task Force has launched an online COVID-19 dermatology registry. This registry was inspired by a similar registry created by the COVID-19 Global Rheumatology Alliance.5Robinson P.C. Yazdany J. The COVID-19 Global Rheumatology Alliance: collecting data in a pandemic [Epub ahead of print].Nat Rev Rheumatol. 2020; : 1-2https://doi.org/10.1038/s41584-020-0418-0Crossref PubMed Scopus (76) Google Scholar The registry's primary purpose is to rapidly collect COVID-19 cutaneous manifestations to enable prompt dissemination of the findings to the dermatology community and front-line health care workers. Given early reports of COVID-19 disparities across racial and socioeconomic groups in the United States, we encourage submission of COVID-19 cases across all ages, races, and socioeconomic statuses. A secondary objective is to report how COVID-19 affects patients with pre-existing dermatologic conditions, particularly those receiving immunosuppressive therapies. We expect that these results will generate ideas for further epidemiologic studies on COVID-19 in dermatology. The registry is available online through the AAD website at www.aad.org/covidregistry. The International League of Dermatological Societies is collaborating with the AAD on this registry with the aim of extending its reach internationally. Cases can be entered by any health care worker, including nondermatologists and non–AAD members, from around the world. Data entry takes 5 to 7 minutes and requires no patient protected health information. Patient demographics, new-onset dermatologic conditions in the setting of COVID-19, dermatologic and medical history, and the patient's COVID-19 diagnosis and treatment are requested. COVID-19 diagnosis may be based on clinical suspicion alone or laboratory confirmation. The registry was reviewed by the Partners Healthcare (Massachusetts General Hospital) institutional review board. Data are housed securely through Partners REDCap, and is not housed at the AAD. We recognize the limitations of such a registry, including selective reporting, duplicate case entries, and lack of a denominator, that preclude us from accurately estimating incidence or prevalence. This registry does not replace rigorous epidemiologic studies. However, we believe this registry will allow the global community to rapidly share observations without the institutional or national boundaries that often limit scientific collaboration. Ultimately, the success of this international effort depends on the active participation of all health workers caring for patients with COVID-19. Together, we hope to use this registry to compile a more complete and representative case series of potential dermatologic manifestations of COVID-19 and outcomes of established dermatology patients who develop COVID-19. The authors would like to thank the COVID-19 Global Rheumatology Alliance for sharing their experience with registry development. We would also like to thank staff at the American Academy of Dermatology for their logistical and administrative support. We also appreciate comments from Drs Kenneth Katz, Matthew Mansh, and Adewole Adamson regarding collecting demographic information in the registry. We thank Megan Wenger for her assistance with REDCap. Big data and cutaneous manifestations of COVID-19Journal of the American Academy of DermatologyVol. 83Issue 2PreviewIn this issue of the JAAD, Freeman et al1 discuss the new COVID registry launched by the American Academy of Dermatology with the support of the International League of Dermatological Societies. Big data has tremendous potential to answer key questions about manifestations of the infection, the influence of pre-existing disease and immunomodulating therapy, and the potential protective or negative effects of other drugs administered for the treatment of chronic diseases. Without such data, we can only guess at the effects of biologics, antimalarials, and other agents. Full-Text PDF