Erythema Multiforme and COVID-19: What Do We Know?

Bennardo, Luigi; Nisticò, Steven Paul; Dastoli, Stefano; Provenzano, Eugenio; Napolitano, Maddalena; Silvestri, Martina; Passante, Maria; Patruno, Cataldo

doi:10.3390/medicina57080828

Cited by 29 publications

(34 citation statements)

References 21 publications

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“…As a result, there is sequestration of lymphocytes and other mononuclear cells in adipose tissue. Most of the cutaneous lesions were restricted to the truncal region with maximum adiposity, resembling an erythema multiforme-like rash [ 32 ]. A similar, annular rash has been previously described in a patient with MIS-A and heart failure [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Multisystem Inflammatory Syndrome Associated with SARS-CoV-2 Infection in an Adult: A Case Report from the Maldives

et al. 2021

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The multisystem inflammatory syndrome in adults (MIS-A) is a novel syndrome observed during COVID-19 outbreaks. This hyper-inflammatory syndrome is seen predominantly in children and adolescents. The case of an adult from the Maldives who had asymptomatic SARS-CoV-2 infection three weeks before presenting to the hospital with fever, rash, and shock is presented. De-identified clinical data were retrospectively collected to summarize the clinical progression and treatment during hospitalization and the six-month follow-up. SARS-CoV-2 infection was confirmed by RT-PCR. Other laboratory findings included anemia (hemoglobin: 9.8 g/dL), leukocytosis (leukocytes: 20,900/µL), neutrophilia (neutrophils: 18,580/µL) and lymphopenia (lymphocytes: 5067/µL), and elevated inflammatory markers, including C-reactive protein (34.8 mg/dL) and ferritin (2716.0 ng/dL). The electrocardiogram had low-voltage complexes, and the echocardiogram showed hypokinesia, ventricular dysfunction, and a pericardial effusion suggestive of myocardial dysfunction compromising hemodynamics and causing circulatory shock. These findings fulfilled the diagnostic criteria of MIS-A. The case was managed in the intensive care unit and required non-invasive positive pressure ventilation, inotropes, and steroids. With the new surges of COVID-19 cases, more cases of MIS-A that require the management of organ failure and long-term follow-up to recovery are anticipated. Clinicians should therefore be vigilant in identifying cases of MIS-A during the pandemic.

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Section: Discussionmentioning

confidence: 99%

Multisystem Inflammatory Syndrome Associated with SARS-CoV-2 Infection in an Adult: A Case Report from the Maldives

et al. 2021

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“…Erythema multiforme is a multifactorial disease described for humans [ 1 , 24 , 25 ], pigs [ 3 , 4 , 5 , 6 ], dogs [ 7 ] and wild animals, such as ferrets and spotted hyenas [ 8 , 9 ]. The most studied risk factors are drugs, bacterial, viral and fungal infections and/or stress.…”

Section: Discussionmentioning

confidence: 99%

Virological Characterization of Pigs with Erythema Multiforme

et al. 2022

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Erythema multiforme in pigs is an acute, self-limiting disease characterized by red skin areas and often associated with anorexia, fever and respiratory problems. The cause of the disease remains unknown. In a recent study, animals of a commercial breeding herd in Greece were examined, and all animals were found seropositive for porcine reproductive and respiratory syndrome virus (PRRSV). However, neither PRRSV and porcine circovirus type 2 (PCV2) viremia nor antibodies against Aujeszky’s disease virus, African swine fever virus and classical swine fever virus were detected. Here, an extended examination of these pigs was performed on a wide range of porcine viruses using highly sensitive polymerase chain reaction (PCR)-based methods. Affected skin of five animals revealed the presence of porcine lymphotropic herpesvirus-1 (PLHV-1) in all cases, PLHV-2 in one animal and PLHV-3 in four animals. However, neither porcine cytomegalovirus (PCMV) nor porcine circoviruses (PCV1, PCV2, PCV3 and PCV4) were detected. In blood samples, PLHV-1 was present in two animals and PLHV-2, PCV2 and PCV3 in one individual, with PCMV, PCV1 and PCV4 in none of the animals. In one animal, four viruses were found in the blood (PLHV-1, PLHV-2, PCV2 and PCV3). A PRRSV viremia was also not detected. All animals carried porcine endogenous retrovirus C (PERV-C) in their genome, but recombinant PERV-A/C was not detected. The results suggest that porcine viruses may be involved in erythema multiforme in these animals and that further studies are needed to assess the role of these pathogens in the disease.

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“…On inquiry though, several physicians treating patients with COVID-19 have mentioned that they anecdotally see increased cutaneous manifestations in patients with COVID-19, and scientists from other countries have also reported such manifestations. 1–6 …”

Section: Discussionmentioning

confidence: 99%

Erythema multiforme in a young adult following COVID-19 infection and vaccination in Tanzania

Manji

Mwaniki²,

Simba

et al. 2022

BMJ Case Rep

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We report the case of a young female adult in her early 20s, who had COVID-19 infection for 8 weeks and COVID-19 vaccination 4 weeks prior to presentation with an extensive rash associated with erythema multiforme, resembling varicella zoster on initial presentation. After initial acyclovir therapy with no improvement, systemic corticosteroid treatment dramatically resolved the patient’s skin rash.

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Erythema Multiforme and COVID-19: What Do We Know?

Cited by 29 publications

References 21 publications

Multisystem Inflammatory Syndrome Associated with SARS-CoV-2 Infection in an Adult: A Case Report from the Maldives

Multisystem Inflammatory Syndrome Associated with SARS-CoV-2 Infection in an Adult: A Case Report from the Maldives

Virological Characterization of Pigs with Erythema Multiforme

Erythema multiforme in a young adult following COVID-19 infection and vaccination in Tanzania

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