An itchy erythematous papular skin rash as a possible early sign of COVID-19: a case report

Abstract

Background Several recent studies suggest the possibility of a skin rash being a clinical presentation of coronavirus disease 2019 (COVID-19). The purpose of this case report is to bring attention to skin manifestations in the early stage of COVID-19 in order to support frontline physicians in their crucial activity of case identification. Case presentation The patient is an Italian 32-year-old female nurse who had several close contacts with multiple patients with COVID-19 as part of her professional workload. On March 13, 2020, the patient developed an itchy, erythematous papular rash (sparing only her face, scalp, and abdomen), which lasted for 10 days. The rash was accompanied by a feeling of general fatigue that gradually worsened over the following days and has continued for 5 months (until the end of July 2020). During the first week of remote assessment carried out by her general practitioner, the patient gradually developed a dry cough, intermittent fever, and diarrhoea and then had a positive test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Her skin manifestations disappeared completely 48 days after the onset of the disease, followed by the disappearance of the dry cough. Conclusions In light of recent studies, this case report suggests that skin manifestations, when taken into account with other situational factors (such as profession and patient history) should be taken into proper consideration by frontline physicians as possibly being caused by SARS-CoV-2. Early identification of COVID-19 is a key part of the strategy of case detection and case isolation. To enhance this activity, further research is needed to establish frequency, symptoms, signs, and pathogenesis of skin manifestations in patients with COVID-19.

Rare Cutaneous Manifestation of COVID-19 Infection and Pfizer-BioNTech COVID-19 Vaccine With a Unique Pattern Similarity

“…As for the dermatological or cutaneous manifestations, many studies described and noted the presence of this presentation among patients contracting COVID-19 infection [ 2 , 4 , 5 ]. An itchy, erythematous rash was described as a COVID-19 symptom in a case report of an Italian nurse, and was the first primary care case report of a female patient who developed a skin rash as the first clinical manifestation of COVID-19 [ 6 ].…”

Cutaneous Manifestation in COVID-19: A Lesson Over 2 Years Into the Pandemic

“…Globally, cutaneous manifestations of COVID-19 were reported in cases from Asia including China, 9,36,47, Thailand, 76,77 Iran, 12,61,[78][79][80][81] Indonesia, 19,46,60,67,82,142 Malaysia, 60 Qatar, 77 India, 83 Turkey, 14,[84][85][86] and Kuwait; 87 from Africa including Morocco 20,88 Tunisia, 88 and Egypt; 89 from Europe including Austria, 90 Italy, 10,12,15,18,21,24,25,[32][33][34][35]43,52,53,57,65,69,75,[91][92][93]…”