Urticaria-like rash in a patient with COVID-19 associated pneumonia of moderate severity: aspects of pathogenesis

Abstract

In mid 2020, the number of new coronavirus (COVID-19) cases has exceeded globally six million. The clinical manifestations of COVID-19 infection are numerous mostly causing damage to the bronchopulmonary system in the form of a dry cough, rhinitis, dyspnea, fever, myalgia, and general weakness. Skin manifestations of COVID-19 are rare and currently include five types of skin lesions occurring during the infection process, which are reliably recorded in only a limited number of case reports and certain analytical publications. This article describes the clinical case of a 28-year-old patient with urticaria-like disseminated rash and confirmed COVID-19-associated pneumonia.

Keywords

COVID-19 / skin manifestations / urticaria-like rashes / DIC-syndrome / infectious erythema

References

[1] Li Q., Guan X., Wu P., Wang X., Zhou L., Tong Y., et al. Early transmission dynamics in Wuhan, China, of novel coronavirus –

[2] infected pneumonia. N Engl J Med. 2020; 382(13): 1199-207.

[3] Zhu N., Zhang D., Wang W., Li X., Yang B., Song J., et al.; China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019.

[4] N. Engl. J. Med. 2020; 382(8): 727-33.

[5] World Health Organization Press Conference. The World Health Organization (WHO) Has Officially Named the Disease Caused by the Novel Coronavirus as COVID-19. [Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed on 11 Febr 2020].

[6] Gorbalenya A.E., Baker S.C., Baric R.S., de Groot R.J., Drosten C., Gulyaeva A.A., et al. Severe acute respiratory syndrome-related coronavirus: The species and its viruses – a statement of the Coronavirus Study Group. BioRxiv. 2020. [Available at: https://www.biorxiv.org/content/10.1101/2020.02.07.937862v1. Accessed on 11 Febr 2020]. DOI: https://doi.org/10.1101/2020.02.07.937862

[7] The World Health Organization (WHO) Coronavirus Disease (COVID-2019) Dashboard. [Available on: https://covid19.who.int. Access on 30 May 2020].

[8] Temporary Methodical Recommendations “Prevention, diagnosis and treatment of new coronavirus infection (COVID-19)” of the Ministry of Health of the Russian Federation (Ver. 6, 24.04.2020). Available on: https://www.rosminzdrav.ru/ministry/med_covid19. Access on 30 April 2020]. (in Rissian)

[9] Временные методические рекомендации «Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID19)» Минздрава РФ (вер.6 24.04.2020). [Доступно на: https://www.rosminzdrav.ru/ministry/med_covid19. Дата доступа 30.04.2020].

[10] Guan W.J., Ni Z.Y., Hu Y., Liang W.H., Ou C.Q., He J.X., et al.; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020; 382(18): 1708-20.

[11] Hedou M., Carsuzaa F., Chary E., Hainaut E., Cazenave-Roblot F., Masson Regnault M. Comment on “Cutaneous manifestations in COVID-19: a first perspective” by Recalcati S. J Eur Acad Dermatol Venereol. 2020. DOI: 10.1111/jdv.16519. Online ahead of print.

[12] Mahe A., Birckel E., Krieger S., Merklen C., Bottlaender L. A distinctive skin rash associated with Coronavirus Disease 2019? J Eur Acad Dermatol Venereol. 2020. DOI: https://doi.org/10.1111/jdv.16471. Online ahead of print.

[13] Mollaret G. Covid-19: les dermatologues appellant à la vigilance sur les acrosyndromes et érythèmes faciaux. Le quotidien du medecin. 2020. [Available on: https://www.lequotidiendumedecin.fr/specialites/dermatologie/covid-19-les-dermatologues-appellent-la-vigilance-sur-les-acrosyndromes-et-erythemes-faciaux. Access on 30 April 2020].

[14] Redford T., Al-Dissi A.N. Feline infectious peritonitis in a cat presented because of papular skin lesions. Can Vet J. 2019; 60(2): 183-185.

[15] Casas C.G., Catala A., Hernandez Carretero G., Rodriguez-Jimenez P., Fernandez Nieto D., Rodríguez-Villa Lario A., 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. DOI: 10.1111/bjd.19163. Online ahead of print.

[16] Gianotti R., Zerbi P., Dodiuk-Gad R.P. Clinical and histopathological study of skin dermatoses in patients affected by COVID-19 infection in the Northern Part of Italy. J Dermatol Sci. 2020; S0923-1811(20)30143-2. DOI: 10.1016/j.jdermsci.2020.04.007. Online ahead of print.

[17] Sachdeva M., Gianotti R., Shah M., Lucia B., Tosi D., Veraldi S., et al. Cutaneous manifestations of COVID-19: Report of three cases and a review of literature. J Dermatol Sci. 2020.

[18] Sachdeva M., Gianotti R., Shah M., Lucia B., Tosi D., Veraldi S., et al. Cutaneous manifestations of COVID-19: Report of three cases and a review of literature. J Dermatol Sci. 2020. DOI: 10.1016/j.jdermsci.2020.04.011. Online ahead of print.

[19] DOI: 10.1016/j.jdermsci.2020.04.011. Online ahead of print.

[20] Manalo I.F., Smith M.K., Cheeley J., Jacobs R. A dermatologic manifestation of COVID-19: transient livedo reticularis,

[21] Manalo I.F., Smith M.K., Cheeley J., Jacobs R. A dermatologic manifestation of COVID-19: transient livedo reticularis,

[22] J. Am. Acad. Dermatol. 2020. DOI: https://dx.doi.org/10.1016/j.jaad.2020.04.018. [Available on: https://www.researchgate.net/publication/340559100_A_Dermatologic_Manifestation_of_COVID-19_Transient_Livedo_Reticularis]

[23] J. Am. Acad. Dermatol. 2020. DOI: https://dx.doi.org/10.1016/j.jaad.2020.04.018. [Available on: https://www.researchgate.net/publication/340559100_A_Dermatologic_Manifestation_of_COVID-19_Transient_Livedo_Reticularis]

[24] Magro C., Mulvey J., Berlin D., Nuovo G., Salvatore S., Harp J., et al. Complementary associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases. Transl Res. 2020; S1931-5244(20)30070-0. DOI: 10.1016/j.trsl.2020.04.007. Online ahead of print.

[25] Magro C., Mulvey J., Berlin D., Nuovo G., Salvatore S., Harp J., et al. Complementary associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases. Transl Res. 2020; S1931-5244(20)30070-0. DOI: 10.1016/j.trsl.2020.04.007. Online ahead of print.

RIGHTS & PERMISSIONS

Eco-Vector