key: cord-0934749-ckfb7m6s
authors: Vincent K Ho, Bao; Seger, Edward W.; Kollmann, Kaitlyn; Rajpara, Anand
title: Dermatomyositis in a COVID-19 positive patient
date: 2021-05-26
journal: JAAD Case Rep
DOI: 10.1016/j.jdcr.2021.04.036
sha: cc007473f406c8e96a4cf3b9de1242220db98322
doc_id: 934749
cord_uid: ckfb7m6s

nan

Cutaneous manifestations of COVID-19 (SARS-CoV-2) infections are often atypical and 25 nonspecific, which raises the question if there exists a link between skin manifestations and the 26 virus. The most common and widely reported finding with or after COVID-19 infection is the 27 development of chilblain-like lesions, however this remains a contentious topic. 1 A number of 28 neuromuscular manifestations of COVID-19 infection have also been reported such as myalgia, 29 critical-illness myopathy and neuropathy. 2 The development of autoimmune sequelae during or 30 following COVID-19 infection is sparsely reported, with only isolated cases of autoimmune 31 myositis, Kawasaki disease in children, and rheumatic disease. 3, 4 The CDC has newly 32 recognized multi-system inflammatory syndrome in adults as an emerging association with 33 COVID-19, for which dermatologic findings were the presenting symptoms in recently reported 34 cases. 5 35

The association between COVID-19 infection and the development of multi-system 36 autoimmune disorders remains unclear, however it has been suggested that viral infections may 37 serve as a trigger. Given the expanding list of long-term sequelae which may develop following 38 COVID-19 infection, it is important to report unique presentations in order to aid clinicians in 39 prompt diagnosis. We present a case of a patient who developed dermatomyositis following 40 infection with COVID-19. 41

A 58-year-old previously healthy Hispanic male was diagnosed by polymerase-chain 43 reaction (PCR) with symptomatic COVID-19 infection (including fever, diaphoresis, and chills) 44 which did not require hospitalization and spontaneously improved with symptomatic treatment 45 over several days. Following this initial improvement, he began to develop fatigue, myalgias, 46 and generalized muscle weakness which was most severe in his proximal lower extremities. 47 These symptoms gradually worsened over a period of 1 month and were accompanied by an 48 unintentional 30-pound weight loss and progressive shortness of breath, which prompted his 49 presentation at our emergency department. He denied trauma or use of new medications or 50 substances preceding or during these symptoms. The patient improved in muscle strength and was ultimately discharged 3 days after beginning 88 oral steroids. Following discharge, a CT scan of the abdomen and pelvis was obtained for 89 internal malignancy screening which were negative. Additional studies to rule out malignancy 90 was deferred for outpatient rheumatology follow-up. 

Evaluation of Chilblains as a Manifestation of 123 the COVID-19 Pandemic

Neuromuscular presentations in patients with 126 COVID-19

Covid-19-Associated Myopathy Caused by Type I 128

The correlation between SARS-CoV-2 infection and 130 rheumatic disease

Two Adult Cases of Multisystem 133

Inflammatory Syndrome Associated with SARS-CoV-2

After Exposure to Epstein-Barr Virus Infection and Antibiotics Use

Cutaneous manifestations of SARS-CoV-2 -140 a two-center, prospective, case-controlled study

COVID-19 or clinical amyopathic dermatomyositis 144 associated rapidly progressive interstitial lung disease? A case report

Antibodies against immunogenic epitopes with 147 high sequence identity to SARS-CoV-2 in patients with autoimmune 148 dermatomyositis