Erythema nodosum‐like eruption in coronavirus disease 2019: A case report and literature review of Asian countries

Kuriyama, Yuko; Shimizu, Akira; Oka, Hironori; Sato, Masayuki; Makioka, Koki; Ikota, Hayato; Yanagisawa, Kunio; Tokue, Yutaka; Tsukagoshi, Hiroyuki; Motegi, Sei‐ichiro

In the worldwide coronavirus disease 2019 (COVID‐19) outbreak, skin manifestations were seen in COVID‐19 patients. We report a case in which a COVID‐19 patient developed cutaneous lesions that were diagnosed as erythema nodosum‐like lesions, which were associated with COVID‐19. Nasopharyngeal swab polymerase chain reaction (PCR) confirmed severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Histopathologically, extensive inflammation was seen from the epidermis to the fat tissue. An organized thrombus and disrupted inner elastic lamina were seen in an intradermal vessel. These findings suggest septal panniculitis with cutaneous polyarteritis nodosa. The results of PCR using the specimen of skin lesion was negative. The patient took non‐steroidal anti‐inflammatory drugs and the skin lesion improved in 3 weeks. To characterize the skin eruption, we reviewed previous reports on COVID‐19 (confirmed by the detection of SARS‐CoV‐2 infection) from Asian countries. The type of eruption and timing of its appearance in this case seemed rare. Differences in skin manifestations between Western and Asian countries were noted.