SDRIFE‐like rash in COVID‐19 patient: drug reaction or another cutaneous manifestation of SARS‐CoV‐2?

Abstract

SDRIFE-like rash in COVID-19 patient: drug reaction or another cutaneous manifestation of SARS-CoV-2?Dear Editor,We report a particular case of skin rash in a patient with COVID-19. Symmetrical drug-related intertriginous and flexural

Systemic drug‐related intertriginous and flexural exanthema like eruption after CoronaVac vaccine

“…However, it has not been clearly revealed whether it is related to the drugs used to treat COVID-19 or to COVID-19 infection itself. 8,9 In this case report, we are presenting a case of SDRIFE-like eruption due to COVID-19 vaccine. On the other hand, we could not fully understand the culprit allergen that causes the eruption.…”

Systemic drug-related intertriginous and flexural exanthema induced by the Pfizer-BioNTech COVID-19 vaccine: A report of 2 cases

“…2 Although SDRIFE is uncommon, cases in the literature document SDRIFE caused by antibiotics, asthma medications, radiocontrast media, chemotherapeutic agents, and biologics. 3 To date, there has been only one other report of SDRIFE associated with a COVID-19 vaccine. 4 In this report, SDRIFE developed 4 days after the patient received the CoronaVac vaccine (it is unknown whether it was the first or the second dose) developed by SinoVac Biotech.…”

“…For SDRIFE specifically, there are already a few reported cases associated with symptomatic COVID-19 infection. 3,8,9 However, in some of these reports, it is unclear whether the SDRIFE-like eruption could be due to COVID-19 itself or the drugs used to treat the COVID-19 infection. In our presented cases, the absence of documented COVID-19 infection and systemic symptoms favors a reaction to the vaccine rather than to infection.…”

Bullous SDRIFE and Covid‐19

“…There are only two reports of SDRIFE-like rash associated with COVID-19, both without blister formation and vasculitis, but it is important to remember that SARS CoV-2 is an inducer of thromboembolic events and vasculitis. 3,4 It appears that this skin reaction may present with different histopathological findings and clinical morphology, 1 and SARS-CoV-2 infection would be an additional trigger to accentuate this characteristic. 3,4 Interestingly, in the present case, the vasculitis and intravascular thrombi found on histopathology did not translate into a suggestive clinical feature, since the exanthema could be explained by the inflammatory reaction common to drug reactions.…”

“…Unfortunately, after 15 days, a second respiratory infection led to respiratory failure, and the patient had an unresponsive cardiorespiratory arrest. [2][3][4] In addition to well-defined clinical criteria, patients with SDRIFE may present with mucosal lesions, clinical and histopathological features of vasculitis, and spongiform pustules and/or subcorneal vesicopustules. 1,2 To the date this letter was written, no similar report of SDRIFE had been found, with marked spongiosis, dermal edema, and leukocytoclastic vasculitis with thrombus formation.…”