Angioedema and urticaria in a COVID-19 patient: A case report and review of the literature

Elhag, Shahad Abasaeed; Ibrahim, Halah; Abdelhadi, Shaden

doi:10.1016/j.jdcr.2020.07.042

Cited by 18 publications

(25 citation statements)

References 12 publications

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“…Similarly, an extensive review of 997 patients from 9 different countries analyzed by Jia et al found that approximately 22% of patients had urticarial eruptions [4••]. Urticaria with or without angioedema in the setting of confirmed or highly suspected COVID-19 infection has been observed in several reports and case series [2,5,[39][40][41][42][43][44][45][46][47]. Similar to other viral infections, urticarial rash may precede or occur simultaneously with COVID-19 systemic manifestations (i.e., fever, cough) and last for several days [5,39,43,44,47,48].…”

Section: Urticaria and Angioedemamentioning

confidence: 99%

Cutaneous Manifestations in Adult Patients with COVID-19 and Dermatologic Conditions Related to the COVID-19 Pandemic in Health Care Workers

Mawhirt

Frankel

Diaz³

2020

Curr Allergy Asthma Rep

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Purpose of Review COVID-19 (coronavirus viral disease 2019), due to the novel SARS-CoV-2, may present with different types of cutaneous manifestations of varying pathophysiology. During the ongoing pandemic, publications reporting dermatologic findings in COVID-19 continue to emerge. Recent Findings Cutaneous vasculopathy and microthrombus-related changes including acral and sacral lesions, retiform purpura, livedo reticularis, and cutaneous vasculitis are notable findings in adult patients. Other exanthems include urticaria or angioedema, morbilliform/maculopapular exanthems, erythema multiforme, and vesicular eruptions. Increased recognition of these findings, especially those consistent with cutaneous microthrombi or vasculitis, is of particular importance. Additionally, occupational dermatologic disease related to extended personal protective equipment (PPE) use, such as skin damage and irritant or allergic contact dermatitis (ACD), represents another emerging problem amidst the pandemic. Summary In this review, we highlight the various cutaneous manifestations associated with COVID-19 in adult patients and occupational dermatitis in health care workers (HCWs) caring for this patient population. Keywords COVID-19. SARS-CoV-2. Cutaneous manifestations. Dermatologic. Rash. Contact dermatitis Abbreviations AAD American Academy of Dermatology ACD Allergic contact dermatitis ACE2 Angiotensin-converting enzyme 2 AD Atopic dermatitis AGEP Acute generalized exanthematous pustulosis ARDS Acute respiratory distress syndrome COVID-19 Coronarvirus viral disease 2019 CSSV Cutaneous small vessel vasculitis DIC Disseminated intravascular coagulation DiHS/DRESS Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms HCW Health care worker ICD Irritant contact dermatitis ITP Immune thrombocytopenic purpura PPE Personal protective equipment PT Patch test RT-PCR Reverse transcriptase polymerase chain reaction SARS-CoV-2 Severe acute respiratory distress syndrome coronavirus 2 SDRIFE Symmetrical drug-related intertriginous and flexural exanthema This article is part of the Topical Collection on Allergic Skin Diseases

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Section: Urticaria and Angioedemamentioning

confidence: 99%

Cutaneous Manifestations in Adult Patients with COVID-19 and Dermatologic Conditions Related to the COVID-19 Pandemic in Health Care Workers

Mawhirt

Frankel

Diaz³

2020

Curr Allergy Asthma Rep

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“…30 The more recent reports documenting laboratory-confirmed SARS-CoV-2 infection can be seen in Table 5. [30][31][32][33][34][35][36][37][38][39][40][41][42] Although more reports have emerged, there is still limited evidence-based reports regarding the predictive prognosis and significance of timeline of these dermatologic signs.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of dermatologic manifestations among adult patients with COVID‐19 diagnosis

Schwartzberg

Advani

Clancy

et al. 2021

Skin Health and Disease

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Background: Infection with COVID-19 is characterized by respiratory, gastrointestinalandneurologicsymptoms.However,limitedevidenceexistsof the involvement of the integumentary system among COVID-19 patients and evidence suggests that these symptoms may even be the first presenting sign. Objective: To systematically evaluate the literature published on dermatologic signs of COVID-19 in order to educate doctors about the dermatologic signs of COVID-19 infection. Methods: Lit COVID, World Health Organization COVID-19 database and PubMed were searched using terminology to identify adult patients with confirmed COVID-19 infection and dermatologic manifestations of disease. The last search was completed on 13 July 2020. Results: There were 802 reports found. After exclusion, 20 articles were found with 347 patients with confirmed COVID-19 infection. Within these articles, 27 different skin signs were reported. Limitations: Limitations of this review include the recency of COVID-19 infection; so, there are limited published reports and that many reports are not by dermatologists, and so, the cutaneous signs may be misdiagnosed or misdescribed. Conclusion: Dermatologic manifestations of COVID-19 may be the first presenting sign of infection; so, dermatologists and doctors examining the skin should be aware of the virus's influence on the integumentary system in order to promptly diagnose and treat the infected patients. K E Y W O R D S evidence-based dermatology, infection, virologyThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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“…When the medical literature is examined, a variety of dermatologic eruptions thought to be related to COVID-19 has been reported, but angioedema has rarely been reported [5][6][7][8][9][10] . Najafzadeh et al 8 was reported similar case as and suggested that angioedemaas possible early diagnostic indicator of COVID-19 infection.…”

Section: Discussionmentioning

confidence: 99%

“…SARS-CoV-2 is thought to induce a mast cell activation, leading to histamine discharge. [5][6][7][8] Many hypotheses have been proposed in angioedema type 1 hypersensitivity reaction, often leading to an increase in vascular permeability or cross reaction between viral IgM and IgG promotes mast cell degranulation of mast cell Ig E or circulating immune complexes stimulate the production of vasoactive amines by basophils and activate com-…”

Section: Discussionmentioning

confidence: 99%

Angioedema and acute urticaria in a patient with COVID 19 pneumonia: Favipiravir side effect or COVID-19 cutaneous manifestation

Çevıker

Şener

Yüksel

et al. 2021

Journal of Emergency Medicine Case Reports

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Introduction: Coronavirus disease 2019 (COVID-19) has caused thousands of deaths since it was declared as a pandemic. Recently it continues to be one of the most followed topics in the world in terms of its course and treatment.Favipiravir is a broad-spectrum anti-viral agent that has been shown to be effective against various Coronaviruses in vitro. However, as with any drug use, side effects may develop with the use of favipravir treatment. Case Report:We reported a 55-year-old female patient with acute urticarial with angioedema whom had COVID-19 pneumonia. She had no history of allergy, atopy, previous similar episodes or family history of hereditary angioedema. There is no drug or food consumption that may be suspicious in terms of allergy described by the patient other than favipravir. Conclusion:As far as we know, it is the first case reported from our country. Since there is no specific examination for differential diagnosis, we cannot distinguish as a rare side effect due to favipiravir treatment or COVID-19 cutaneous manifestation. As a result, studies involving more cases of COVID-19 skin findings are needed.

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Angioedema and urticaria in a COVID-19 patient: A case report and review of the literature

Cited by 18 publications

References 12 publications

Cutaneous Manifestations in Adult Patients with COVID-19 and Dermatologic Conditions Related to the COVID-19 Pandemic in Health Care Workers

Cutaneous Manifestations in Adult Patients with COVID-19 and Dermatologic Conditions Related to the COVID-19 Pandemic in Health Care Workers

A systematic review of dermatologic manifestations among adult patients with COVID‐19 diagnosis

Angioedema and acute urticaria in a patient with COVID 19 pneumonia: Favipiravir side effect or COVID-19 cutaneous manifestation

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