A Case of Flexural Exanthema as a Presenting Sign for COVID-19

• Autor(a) principal: Oliveira, Raquel
• Data de Publicação: 2020
• Outros Autores: Gonçalo, Margarida, Faria, Carlos, Donaire, David, Barbosa, Benilde, Cardoso, José Carlos, Julião, Maria José, Moura, José, Carvalho, Armando
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• DOI: 10.29021/spdv.78.3.1248
• Texto Completo: https://doi.org/10.29021/spdv.78.3.1248
• topic: Coronavirus Infections; COVID-19; Exanthema; SARS-CoV-2; COVID-19; Exantema; Infecções por Coronavírus; SARS-CoV-2

We report a case of a 84-year-old male hospitalized for bacterial pneumonia who, during hospitalization, developed a flexural exanthema in parallel with a positive swab for SARS-CoV-2. Supportive therapy was instituted, the rash disappeared in 7 days and the patient fully recovered. At the same time, two other cases of SARS-CoV-2 infection occurred in the same ward. Histopathology and immunohistochemistry of a skin biopsy showed a scarce predominantly perivascular lymphocytic infiltration in the upper dermis, predominantly by CD4+ T cells, a slight epidermotropism, spongiosis and focal parakeratosis, compatible with a viral exanthema or a maculopapular drug eruption. Patch testing with possible culprit drugs were negative. We seek to add value in understanding all the manifestations of SARS-CoV-2 infection and to draw attention to the importance of early identification of skin manifestations in association with COVID-19.