Introduction: The COVID-19 pandemic, caused by SARS-CoV-2, has impacted global health across various medical domains, including dermatology. Dermatological manifestations are increasingly recognized in COVID-19 patients. This study aimed to evaluate the risk of developing dermatological conditions in patients with COVID-19 compared to non-COVID patients.

Methods: This retrospective cohort study analyzed electronic health records (EHRs) from January 1, 2020, to January 1, 2022, including two cohorts: COVID-19 patients with confirmed diagnoses and non-COVID patients. The primary outcome was the development of new dermatological conditions within three months of the index date. Risk differences and risk ratios (RRs) were calculated to compare the cohorts. Confounding factors such as age, sex, race, and ethnicity were controlled during the statistical analysis. Statistical significance was set at p < 0.05.

Results: COVID-19 patients exhibited a significantly reduced risk for various dermatological conditions, including acne vulgaris (RR = 0.671), atopic dermatitis (RR = 0.649), and seborrheic dermatitis (RR = 0.606), among others. Certain rarer conditions, such as lichen planus (RR = 0.585) and basal cell carcinoma (RR = 0.517), also showed a decreased incidence. However, pallor was significantly more prevalent in COVID-19 patients (RR = 2.328), suggesting systemic vascular involvement.

Conclusion: The findings indicate a reduced risk for many dermatological conditions in COVID-19 patients, possibly due to immune modulation and vascular alterations by the virus. Pallor’s increased prevalence in these patients underscores the broader systemic effects of COVID-19. These results contribute to our understanding of COVID-19's dermatological impacts, offering insights for better patient management and future research into the long-term effects on skin health.