A febrile exanthem revealing COVID-19

Younes Oujidi, Brahim Housni

Department of Anesthesia and Intensive Care, Mohammed VI University Hospital of Oujda- Medical School of Oujda, Mohammed First University of Oujda, Morocco

Corresponding author: Younes Oujidi, MD

Submission: 08.09.2020; Acceptance: 10.01.2021

DOI: 10.7241/ourd.20212.27

Cite this article: Oujidi Y, Housni B. A febrile exanthem revealing COVID-19. Our Dermatol Online. 2021;12(2):200-201.

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Sir,

We report the case of a 74-year-old male with no previous medical history admitted to the emergency department for an acute itchy febrile generalized rash present for the last three days. The patient reported no recent history of drug ingestion. A clinical examination revealed a generalized maculopapular exanthem (Figs. 1 and 2) and a fever of 39°C. There was no hypotension or respiratory symptoms. RT-PCR for SARS-CoV-2 was positive and serology revealed positive IgM and negative IgG. Normal paraclinical examinations and a thoracic CT scan revealed that 10% of the lesions were CO-RADS 6.

	Figure 1: An exanthem on the right lateral aspect of the thorax and abdomen.
	Figure 2: An exanthem on the anterior aspect of the thorax.

Since the beginning of the pandemic, numerous have authors described skin manifestations associated with COVID-19, including morbilliform and roseoliform exanthems [1], maculopapular rashes on the face, generalized hives [2,3], and rashes such as chickenpox [4–5], but erythema multiforme and purpuric rashes [6] have also been reported in the scientific literature [7] and in medical social networks [8]. These eruptions are, indeed, known to be associated with viral infections and are commonly referred to as viral rashes or paraviruses. However, they are not specific to SARS-CoV-2 and may also lie in other causes, especially in drugs. Patients affected by COVID-19 are, indeed, likely to develop unwanted responses to drugs administered for infections (including carrying drugs and anti-infectives) causing secondary skin reactions at any time during the evolution of the disease.

Consent

The examination of the patient was conducted according to the principles of the Declaration of Helsinki.

The authors certify that they have obtained all appropriate patient consent forms, in which the patients gave their consent for images and other clinical information to be included in the journal. The patients understand that their names and initials will not be published and due effort will be made to conceal their identity, but that anonymity cannot be guaranteed.

REFERENCES

1. Najarian DJ. Morbilliform exanthem associated with COVID-19. JAAD Case Rep. 2020;6:493-4.

2. Henry D, Ackerman M, Sancelme E, Finon A, Esteve E. Urticarial eruption in COVID-19 infection. J Eur Acad Dermatol Venereol. 2020;34:e244-5.

3. van Damme C, Berlingin E, Saussez S, Accaputo O. Acute urticaria with pyrexia as the first manifestations of a COVID-19 infection. J Eur Acad Dermatol Venereol. 2020;34:e300-1.

4. Marzano AV, Genovese G, Fabbrocini G, Pigatto P, Monfrecola G, Piraccini BM, et al. Varicella-like exanthem as a specific COVID-19-associated skin manifestation:Multicenter case series of 22 patients. J Am Acad Dermatol. 2020;83:280-5.

5. Genovese G, Colonna C, Marzano AV. Varicella-like exanthem associated with COVID-19 in an 8-year-old girl:A diagnostic clue?Pediatr Dermatol. 2020;37:435-6.

6. Joob B, Wiwanitkit V. COVID-19 can present with a rash and be mistaken for dengue. J Am Acad Dermatol. 2020;82:e177.

7. Recalcati S. Cutaneous manifestations in COVID-19:A first perspective. J Eur Acad Dermatol Venereol. 2020;34:e212-3.

8. Freeman EE, McMahon DE, Fitzgerald ME, Fox LP, Rosenbach M, Takeshita J, et al. The American Academy of Dermatology COVID-19 registry:Crowdsourcing dermatology in the age of COVID-19. J Am Acad Dermatol. 2020;83:509-10.

Notes

Source of Support: Nil,

Conflict of Interest: None declared.