key: cord-0782403-g139nb3r
authors: Bursal Duramaz, Burcu; Yozgat, Can Yilmaz; Yozgat, Yilmaz; Turel, Ozden
title: Appearance of skin rash in pediatric patients with COVID‐19: Three case presentations
date: 2020-05-25
journal: Dermatol Ther
DOI: 10.1111/dth.13594
sha: d9c62ef0b653d0a6df037b7204fa83d1838a6623
doc_id: 782403
cord_uid: g139nb3r

nan

,F). Therefore, we concluded that her skin rash occurred due to the usage of HCQ and her rash after the termination of HCQ treatment. Generally, all of the patients' rashes started on their faces and continued on the extremities and ended on the trunk. We did not detect any correlation between the exacerbation of the rash and the disease's severity. Three patients had normal coagulation patterns. All of the other viral markers were normal for these three patients.

The first scientific report about the relationship between COVID-19 and rashes was done in China and was about skin involvement. 2 Recalcati et al did a study on 88 patients, and 18 of them developed cutaneous manifestations. Clinical cutaneous manifestations of the patients were erythematous rash, chickenpox-like vesicles, and widespread urticaria. Also, itching was low, and all of the lesions ameliorated last than 5 days. 3 In our case, the frequency of appearance of skin rash in our pediatric COVID-19 patients was so much lower than

Recalcati et al's study. Unlike the study, which was done by Recalcati et al, one of our patients developed skin rash secondary to HCQ treatment. The skin rashes of our two cases were itchy, similar to those in this study.

HCQ is one of the most effective drugs against COVID-19. 4 However, there have been a few reported cases about the side effects of HCQ on the skin in dermatomyositis and lupus erythematosus patients. [4] [5] [6] The characteristic morphology of skin rashes was variable.

Generally, the form of intensely pruritic morbilliform eruptions occurred. Each reaction ameliorated once the drug regimen was terminated. 5 The eruptions that occurred in our patients were in the form of maculopapular. Our patient developed a maculopapular mild itchy rash on the third day of HCQ treatment. The rash resolved on discontinuation of the drug regimen. In conclusion, we concluded that skin rash might occur in pediatric patients with and/or without using HCQ for treatment in COVID-19. To the best of our knowledge, this is the first report of the appearance of the rash in pediatric patients with and/or without using HCQ for treatment in COVID-19. 

COVID-19 virus and children: what do we know?

Clinical characteristics of coronavirus disease 2019 in China

Cutaneous manifestations in COVID-19: a first perspective

Therapy and pharmacological properties of hydroxychloroquine and chloroquine in treatment of systemic lupus erythematosus, rheumatoid arthritis and related diseases

Adverse cutaneous reactions to hydroxychloroquine are more common in patients with dermatomyositis than in patients with cutaneous lupus erythematosus

Fatal toxic epidermal necrolysis associated with hydroxychloroquine