Erythematous Papular Rash: A Dermatological Feature of COVID-19

Sousa Gonçalves, Catarina; Reis Carreira, Nuno; Passos, Dúlio; Barbosa, Ana Luísa; Baltazar, Ana Maria; Wahnon, Alexandra; Abrantes, Ana Mafalda; Garrido, Pedro Miguel; Ferreira, Teresa; Teixeira Silva, Marisa; Alvoeiro, Lourdes

COVID-19 is the clinical expression of the highly contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection. Most patients have mild symptoms, but a significant proportion have severe or critical disease, which can include cardiac injury, sepsis, acute kidney failure and respiratory failure. It is also worth highlighting the increasing number of reported COVID-19 cases with dermatological disease/manifestations. The cutaneous clinical spectrum is wide and includes maculopapular, urticarial, varicelliform and petechial rashes, pseudo perniosis, livedo reticularis, and pityriasis rosea-like, violaceous and pustular lesions. Until the physiological mechanism is fully understood, it is important to describe these manifestations, which could help identify a typical pattern. This report describes a cutaneous manifestation in a COVID-19 patient. LEARNING POINTS: SARS-CoV-2 presents with multiple symptoms with the dermatological manifestations currently under-recognized. Clinicians should be aware of patients presenting only with cutaneous symptoms, which in some cases are the initial clinical feature of COVID-19.