A case of COVID-19 with papulovesicular rash that progressed to retiform purpura, accompanied by cherry angiomas
Keywords:
COVID-19 [supplementary concept], Purpura, EczemaAbstract
CONTEXT: Various skin manifestations have been reported in coronavirus disease. It may be difficult to determine the etiology ofthese lesions in view of the increased frequency of handwashing during the pandemic, along with occurrences of irritant contact dermatitis and allergic contact dermatitis due to disinfectant use; usage of herbal medicine and supplements to strengthen the immune system; and urticarial or maculopapular drug eruptions due to COVID-19 treatment. The variety of associated skin manifestations seen with COVID-19 makes it challenging to identify virus-specific skin manifestations. Petechiae, purpura, acrocyanosis and necrotic and non-necrotic purpura, which can be considered as manifestations of vascular involvement on the skin, have been reported. CASE REPORT: Here, we report a case of eruptive cherry angiomas, which was thought to have developed due to COVID-19, with a papulovesicular rash on distal extremities that progressed over time to reticular purpura. CONCLUSION: The case presented had a papulovesicular rash at the onset, which evolved to retiform purpura, and eruptive cherry angiomas were observed. It should be kept in mind that dermatological signs may vary in patients with COVID-19.
Downloads
References
Phelan AL, Katz R, Gostin LO. The Novel Coronavirus Originating in Wuhan, China: Challenges for Global Health Governance. JAMA. 2020;323(8):709- 10. PMID: 31999307; https://doi.org/10.1001/jama.2020.1097.
Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91(1):157-60. 2020. PMID: 32191675; https://doi.org/10.23750/abm.v91i1.9397.
Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382(13):1199-207. PMID: 31995857; https://doi.org/10.1056/NEJMoa2001316.
Magro C, Mulvey JJ, Berlin D, et al. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases. Transl Res. 2020;220:1-13. PMID: 32299776; https://doi.org/10.1016/j.trsl.2020.04.007.
Bosch-Amate X, Giavedoni P, Podlipnik S, et al. Retiform purpura as a dermatological sign of coronavirus disease 2019 (COVID-19) coagulopathy. J Eur Acad Dermatol Venereol. 2020;34(10):e548-9. PMID: 32491234; https://doi.org/10.1111/jdv.16689.
Bouaziz JD, Duong T, Jachiet M, et al. Vascular skin symptoms in COVID-19: a French observational study. J Eur Acad Dermatol Venereol. 2020. Published online ahead of print. PMID: 32339344; https://doi.org/10.1111/jdv.16544.
Galván Casas C, Català A, Carretero Hernández G, et al. Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases. Br J Dermatol. 2020;183(1):71-7. PMID: 32348545; https://doi.org/10.1111/bjd.19163.
Catalá Gonzalo A, Galván Casas C. COVID-19 y piel [COVID-19 and the Skin]. Actas Dermosifiliogr. 2020;111(6):447-9. PMID: 32401723; doi:10.1016/j.ad.2020.04.007.
Borghi A, Minghetti S, Battaglia Y, Corazza M. Predisposing factors for eruptive cherry angiomas: New insights from an observational study. Int J Dermatol. 2016;55(11):e598-e600. PMID: 27229271; https://doi. org/10.1111/ijd.13330.Varga Z, Flammer AJ, Steiger P, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417-8. PMID:32325026; https://doi.org/10.1016/S0140-6736(20)30937-5.
