Some useful clues are the rash morphology, the associated symptoms, and the presence of enanthem. The etiological diagnosis of exanthems can be challenging for dermatologists. Drug intake and laboratory findings were not associated with any enanthem type ( Table). Interestingly, this latency was shorter in patients with petechial enanthem compared with those with a macular lesion with petechiae appearance. The mean (range) time between the onset of COVID-19 symptoms and the appearance of mucocutaneous lesions was 12.3 days (range, −2 to 24 days). No patient presented with an erythemato-vesicular enanthem. The enanthem was macular in 1 patient, petechial in 2 patients, and macular with petechiae in 3 patients, and was located in the palate in all patients ( Figure). 6 No enanthem was observed in patients with urticarial or typical maculopapular rashes. The clinical and histologic findings of the erythema multiforme–like exanthem have been reported elsewhere. The morphology of the skin rash was papulovesicular, purpuric periflexural, and erythema multiforme–like in 1, 2, and 3 patients, respectively. The age range of these patients was between 40 and 69 years, and 4 of the 6 (66%) were women. Of 21 patients with COVID-19 and skin rash, 6 patients (29%) had enanthem. The invaluable study was conducted in the very early stages of the COVID-19 pandemic, when little was known about the original wild-strain SAS-CoV-2 virus, and without any knowledge as to when approved vaccines might be discovered, as well as the many mutated strains of the virus that are being being observed globally. Such a determination should be very helpful to healthcare specialists in dealing with exanthems and drug reactions, both of which are correlated with COVID-19, especially if a follow up clinical study could be extended to the end of 2020. Possibly infectious skin rashes and disorders can be highly correlated with a range of diseases, including COVID-19, and can also be closely associated with drug reactions.Īs skin disorders, diseases, and drug reactions can be highly correlated, it is crucial to determine the viral etiological (or causal) relationships among these variables.
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