key: cord-0995239-aa318zcu
authors: Öncü, Işın Nur Sultan; Güler, Dilara; Gürel, Gülhan
title: Exacerbation of psoriasis following hydroxychloroquine in a patient with suspected COVID‐19
date: 2021-02-24
journal: Dermatol Ther
DOI: 10.1111/dth.14806
sha: 8608c3231b380b30540421d5edb667d1e852eff2
doc_id: 995239
cord_uid: aa318zcu

nan

Exacerbation of psoriasis following hydroxychloroquine in a patient with suspected COVID-19

Dear Editor,

The World Health Organization identified a novel coronavirus in city of Wuhan in China that caused diseases of COV _ ID-19. The virus spread very quickly and has to date resulted in the deaths of thousands of people. Hydroxychloroquine (HCQ) has recently entered into clinical use the treatment of COVID-19 effect, both by inhibiting the viral entry into the cell and in the following stage. 1 HCQ is a drug with multiple effects that has long been in use for its antimalarial and antirheumatic features. 2 Previous studies have reported several dermatological side effects of HCQ, including drug eruption, pruritus, psoriasis, and alopecia. 3 Psoriasis is a chronic and systemic inflammatory skin disease with multiple comorbidities that can be induced or exacerbated by several drugs, including HCQ, which is a synthetic antimalarial drug. 4 We present here a case of psoriasis in a suspected COVID-19 patient that exacerbated following HCQ treatment, and that was treated successfully and rapidly with the IL-12/IL-23 inhibitor. To the best of our knowledge, this is the second case of psoriasis exacerbation following HCQ treatment for suspected COVID-19 to be reported on since the outbreak.

A 40-year-old male patient presented with a diffuse rash, pruritus and joint pain that had been increasing for 20 days. It was ascertained that the patient had presented at the hospital approximately 1 month previously with fever, cough and sore throat, when blood tests, lung tomography, and polymerase chain reaction (PCR) tests were requested due to suspicions of COVID-19 infection. An initial assessment revealed lesions consistent with COVID-19 infection on a lung tomography, and so treatment with azithromycin 500 mg daily and HCQ 200 mg BID was initiated. After a few days of treatment, the patient's rash and pruritus increased in severity and spread further.

The lung tomography was considered consistent with lobar pneumonia, and PCR tests at 3-day intervals were negative. The patient was hospitalized due to suspected COVID-19, and was discharged after treatment. This patient was not evaluated as a COVID-19 infection. 

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