key: cord-0812937-ttwl3g5e
authors: Henry, D.; Ackerman, M.; Sancelme, E.; Finon, A.; Esteve, E.
title: Urticarial eruption in COVID‐19 infection
date: 2020-04-15
journal: J Eur Acad Dermatol Venereol
DOI: 10.1111/jdv.16472
sha: f0bd56262f6e4b30f4d8655db9a0ee81deb92140
doc_id: 812937
cord_uid: ttwl3g5e

Coronavirus disease (COVID‐19) is spreading quickly across the world, until a pandemic condition was announced by the WHO on March. Many clinical manifestations of this virus are described and new symptoms are emerging particularly outside respiratory sphere, such as anosmia and ageusia which are recent ORL published symptoms. About skin manifestation, few cases of rashes on patients with laboratory‐confirmed Covid‐19 were described in two Chineses cohorts.

Coronavirus disease (COVID-19) is spreading quickly across the world, until a pandemic condition was announced by the WHO on March 1, 2 . Many clinical manifestations of this virus are described and new symptoms are emerging particularly outside respiratory sphere, such as anosmia and ageusia 3 which are recent ORL published symptoms. About skin manifestation, few cases of rashes on patients with laboratory-confirmed Covid-19 were described in two Chineses cohorts 4, 5 .

We read with great interest the recent publication of S.RECALCATI 6 who explores the cutaneous manifestations in hospitalized COVID-19 patients in a hospital in Italy. The author remarks cutaneous manifestation in 20,4% of patients, some of them on the onset of disease and the other after the hospitalization, with 3 cases of widespread urticaria.

As him we observed some skin manifestations in COVID-19 infected patients and we write this letter in order to add a new element to these observations: one case of appearance of urticarial eruption before the onset of any fever or respiratory symptom.

A 27-year-old woman with no history, medical resident at the hospital, presented an odynophagia followed by diffuse arthralgia and pruritic disseminated erythematous plaques eruption with particular face and acral involvement (figure 1), without cough or fever. The diagnosis of urticaria was confirmed by a dermatologist. No triggers except for the viral context were found and common viral serology was

negative. An antihistaminic treatment was established.

lymphopenia, hepatic workup was normal and CRP level was 49 mg/l. She was tested positive for COVID-19 (PCR SARS-CoV-2). She was treated with paracetamol and antihistamines were kept with slow improvement of the symptoms.

The particular interest of this case is the inaugural appearance of a cutaneous manifestation, before fever or any respiratory symptom. It is essential to take into account and promote the potential recognition among clinicians of this possible skin manifestation of covid-19, and lead to think about testing COVID-19 in these cases.

WHO Declares COVID-19 a Pandemic

Coronavirus disease (COVID-19) situation reports

The Covid-19 pandemic and otolaryngology: What it comes down to? Laryngorhinootologie

Clinical Characteristics of Coronavirus Disease 2019 in China

Clinical characteristics of 140 patients infected with SARS-Cov-2 in Wuhan

Cutaneous manifestations in COVID-19: a first perspective

Figure 1: Erythematous plaques A. Forehead B. Hand C. Foot

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