Images in clinical medicine | Volume 37, Article 286, 30 Nov 2020 | 10.11604/pamj.2020.37.286.26740

Urticaria multiforme-like: a COVID-19 infection

Cristiana Canelas Mendes, Rita Pimenta

Corresponding author: Cristiana Canelas Mendes, Department of Internal Medicine 2, Centro Hospitalar Universitário de Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal

Received: 29 Oct 2020 - Accepted: 17 Nov 2020 - Published: 30 Nov 2020

Domain: Dermatology,Internal medicine

Keywords: COVID-19, cutaneous manifestations, skin

©Cristiana Canelas Mendes et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Cristiana Canelas Mendes et al. Urticaria multiforme-like: a COVID-19 infection. Pan African Medical Journal. 2020;37:286. [doi: 10.11604/pamj.2020.37.286.26740]

Available online at: https://www.panafrican-med-journal.com/content/article/37/286/full

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Images in clinical medicine

Urticaria multiforme-like: a COVID-19 infection

Urticaria multiforme-like: a COVID-19 infection

Cristiana Canelas Mendes1,&, Rita Pimenta2

 

1Department of Internal Medicine 2, Centro Hospitalar Universitário de Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal, 2Department of Dermatology, Centro Hospitalar Universitário de Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal

 

 

&Corresponding author
Cristiana Canelas Mendes, Department of Internal Medicine 2, Centro Hospitalar Universitário de Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal

 

 

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An 18-year-old, otherwise healthy woman, presented to the emergency department with a three-day history of acute-onset diffuse rash. She denied recent introduction of new drugs or dermocosmetic products and previously adverse drug reactions or allergies. She hadn't had any known contact with anyone with confirmed SARS-CoV-2 infection. On examination she had a temperature of 38.6°C. Physical examination showed a disseminated, asymptomatic and not evanescent annular erythematous urticarial papules and plaques, some with targetoid appearance, mostly located at the back (A), chest (B), inguinal zone (C), distal portions of upper (D) and lower limbs and forehead. The palmoplantar skin and mucous membranes were spared. Laboratory tests showed d-dimer elevation (0.43 μg/ml, normal range 0.0-0.25 μg/ml). Chest radiography and computed tomographic pulmonary angiography was normal. A reverse-transcriptase-polymerase-chain-reaction test for severe acute respiratory syndrome coronavirus 2, performed on a nasopharyngeal swab, was positive. A diagnosis of COVID-19 infection was made. On the sixth day of follow-up, fevers and rash were disappeared. The particular interest of this case is the inaugural appearance of a cutaneous manifestation, before any other symptom. It is essential to take into account and promote the recognition among clinicians of this possible skin manifestation of COVID-19, because an early diagnose, could contribute to break the chain of transmission immediately.

 

 

Figure 1: urticaria multiforme-like: a COVID-19 infection

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Images in clinical medicine

Urticaria multiforme-like: a COVID-19 infection

Images in clinical medicine

Urticaria multiforme-like: a COVID-19 infection

Images in clinical medicine

Urticaria multiforme-like: a COVID-19 infection

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Urticaria multiforme-like: a COVID-19 infection