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• W3193644429 abstract "Dear Editor, The Coronavirus Disease 19 (COVID-19) is being increasingly associated with a wide spectrum of skin manifestations.1 Although their exact timing in the disease course is still not evident, an early recognition of these cutaneous manifestations would help in a prompt diagnosis and management of this new viral illness.2 Hence, identifying asymptomatic COVID-19 patients with only skin findings is of great public health value.3 To this extent, we report the case of a maculopapular exanthem and palmoplantar papulovesicular eruption as the sole presentation of COVID-19. A previously healthy 26-year-old man presented to our clinic with a 2-day history of a maculopapular pruritic exanthem that initially appeared on his legs and subsequently progressed to affect his trunk and arms, sparing the face (Fig. 1). History revealed a close contact with a confirmed COVID-19 infected person, 10 days prior to the eruption. There was no previous or intercurrent viral illness, no prior medication intake, and no other systemic signs and symptoms or mucosal involvement. A real-time reverse-transcription polymerase chain reaction test (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) performed from a nasopharyngeal swab was positive. The next day, the patient developed pruritic and painful erythematous-yellowish papules and vesicles on the palms and soles (Fig. 2a,b). A screening for syphilis was negative. The patient was treated with topical clobetasol 0.05% cream and an oral antihistaminic drug. On follow-up, the eruption resolved after 14 days with a negative RT-PCR test for COVID-19, and treatment was discontinued. To date, most reported skin findings have been preceded or followed by other COVID-19 signs.2 In a recent review article, Zhao et al.4 found that skin lesions occurred on average 10 days after the onset of systemic symptoms, however, 14.7% of patients had skin lesions as their first symptom. Interestingly, our patient's cutaneous findings were the only manifestation of this viral illness. He had no history of allergy or any similar hands or feet manifestations in the past, and his RT-PCR became negative concomitantly with the resolution of the dermatological manifestations. All in all, these findings are in favor of a viral-induced skin eruption associated with COVID-19. While recognition of COVID-19 in asymptomatic or minimally symptomatic patients is challenging, it is mandatory to public health.3, 5 Therefore, dermatologists should be conscious of their role during this pandemic as skin findings can be the first and sometimes only manifestation of COVID-19. The patients in this manuscript have given written informed consent to publication of their case details." @default.
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• W3193644429 date "2021-08-25" @default.
• W3193644429 modified "2023-10-18" @default.
• W3193644429 title "Cutaneous maculopapular and vesicular lesions as the only presentation of COVID‐19" @default.
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• W3193644429 doi "https://doi.org/10.1111/ijd.15876" @default.
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