Severe urticarial rash as the initial symptom of COVID-19 infection

BMJ Case Rep. 2021 Mar 25;14(3):e241793. doi: 10.1136/bcr-2021-241793.

Abstract

A 54-year-old woman presented with pruritic rash and hives of 3 days' duration followed by shortness of breath for 1 day. SARS-CoV-2 PCR test for COVID-19 was positive. Cutaneous manifestations of COVID-19 include acral lesions, urticarial rash, erythematous maculopapular rash, vascular rashes and vesicular rash. The cutaneous manifestations are mostly described as self-limiting. Urticarial rashes are not reported as the initial presentation symptom of COVID-19 infection but mostly noted to occur at the same time or after the onset of non-cutaneous symptoms. Management of cutaneous manifestations of COVID-19 affecting quality of life has not been well studied. Antihistamine therapy is the primary recommended therapy. Role of antiviral therapy for severe cases of rash needs to be further assessed.

Keywords: COVID-19; dermatology.

Publication types

  • Case Reports

MeSH terms

  • Antiviral Agents / therapeutic use
  • Atrial Fibrillation / complications
  • COVID-19 / complications*
  • COVID-19 / therapy
  • Exanthema / pathology
  • Exanthema / therapy
  • Exanthema / virology*
  • Female
  • Histamine Antagonists / therapeutic use
  • Humans
  • Hypertension, Pulmonary / complications
  • Middle Aged
  • Obesity / complications
  • Renal Insufficiency, Chronic / complications
  • SARS-CoV-2
  • Skin / pathology
  • Sleep Apnea, Obstructive / complications
  • Treatment Outcome
  • Urticaria / pathology
  • Urticaria / therapy
  • Urticaria / virology*

Substances

  • Antiviral Agents
  • Histamine Antagonists