key: cord-288584-wql253d8
authors: Rivera-Oyola, Ryan; Koschitzky, Merav; Printy, Rachel; Liu, Stephanie; Stanger, Roselyn; Golant, Alexandra; Lebwohl, Mark
title: Dermatologic findings in two patients with COVID-19
date: 2020-04-28
journal: JAAD Case Rep
DOI: 10.1016/j.jdcr.2020.04.027
sha: 
doc_id: 288584
cord_uid: wql253d8

nan

Cutaneous involvement was observed both at symptom onset (8 patients) and after hospitalization (10 patients).(4) A study from Thailand described a dengue-like rash in a COVID-19 patient who was initially misdiagnosed with dengue.(5) Additionally, a recent letter reported a COVID-19 patient who simultaneously developed a non-pruritic, diffuse body rash, myalgia and cephalgia. (6) It is worth noting the variability in clinical presentation of cutaneous findings following SARS-CoV-2 infection. Case 1 developed maculopapular lesions three days after symptom onset while 9 Case 2 presented with urticarial plaques 9 days after becoming symptomatic. Similarly, we observed a diversity of morphological presentations and variability in time to onset of cutaneous manifestations in the literature (4) (5) (6) . It is unlikely that our patients' rashes were due to a medication reaction as there had been no changes to their medication regimen, the rashes had an acute onset following COVID-19 symptom onset, and, in Case 1, the biopsy did not illustrate tissue eosinophilia.

At present, there is limited data regarding the cutaneous manifestations following SARS-CoV-2 infection. Given the importance of prompt COVID-19 diagnosis during a global pandemic, it is necessary to highlight the possible dermatologic manifestations and to characterize their morphology. COVID-19 should be considered in the initial differential diagnosis for a patient with acute skin changes following flu-like symptoms. Future studies are needed to further elucidate the relationship between cutaneous eruptions and SARS-CoV-2 infection. 

The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2

Clinical features of patients infected with 2019 novel coronavirus in Wuhan

Understanding SARS-CoV-2-Mediated Inflammatory Responses: From Mechanisms to Potential Therapeutic Tools

Cutaneous manifestations in COVID-19: a first perspective

COVID-19 can present with a rash and be mistaken for Dengue

Evidence of SARS-CoV-2 Infection in Returning Travelers from Wuhan, China

A. 20X, H&E: A perivascular infiltrate of predominantly mononuclear cells surrounds the vessels in the superficial dermis.