Morbilliform rashes in a patient with COVID-19 infection: A case report

• Published in: Journal of Nepal Medical Association Vol. 59; no. 236; pp. 399 - 401
• Main Authors: Ghimire, Kiran, Adhikari, Nabin
• Format: Journal Article
• Language: English
• Published: Journal of the Nepal Medical Association 01.04.2021; Nepal Medical Association
• Subjects: Case Report; coagulopathy; COVID-19; cytokine release syndrome; D-dimer; morbilliform
• ISSN: 0028-2715; 1815-672X
• DOI: 10.31729/jnma.5128

As the current COVID-19 pandemic is evolving, skin lesions are being reported more, the most common skin manifestation being morbilliform rashes. We describe a patient of severe COVID-19 infection, 48-year-old who initially presented with fever, cough and constitutional symptoms who developed morbilliform macular rashes during his illness. The rash appeared on 6th day of illness in the trunk, arms with sparing of palms and soles, associated with itching. He later developed features of the cytokine-storm syndrome. The exact mechanism for the rashes is yet to be elaborated, however, it is postulated that it is either due to immune-mediated vasodilation or micro thrombosis secondary to low-grade-coagulopathy associated with COVID-19. Recognition of rashes as a feature of this disease is particularly significant to clinicians as it aids in early diagnosis, particularly in resource-poor countries. There is no evident association, however, between the severity and the rashes in COVID-19 infection.