Absence of images of skin of colour in publications of COVID‐19 skin manifestations

coma-associated bulla. 7 However, in our case, thrombi and even fibrinoid necrosis were observed not only in the upperdermis vessels but also in all the other vessels in the biopsy, even in the dermo-hypodermal junction. This unexpected finding could be related to more extensive endothelial damage secondary to COVID-19 infection, as this has recently been reported after observation of viral inclusion bodies in electron microscopy of the kidney, small bowel and lung of severely affected patients. 8 To our knowledge, this is the first report of a patient with COVID-19 where the presence of an occlusive vasculopathy at the cutaneous level has been demonstrated. In our case, we also observed a striking sweat gland necrosis, a finding previously reported as being associated with ketoacidosis coma but not with COVID-19 infection. Additional studies are needed to characterize completely the tissue damage associated with the virus, including within the gamut of lesions observed in the skin.