key: cord-0929242-ox46kifl
authors: Dominguez‐Santas, Miguel; Diaz‐Guimaraens, Borja; Burgos‐Blasco, Patricia; Garcia‐Mouronte, Emilio; Azcarraga‐Llobet, Carlos; Suarez‐Valle, Ana
title: Spiny keratoderma, a late COVID‐19 manifestation?
date: 2021-09-08
journal: Int J Dermatol
DOI: 10.1111/ijd.15891
sha: bdd99a88e545017352f3e9773a6facb4f44393e5
doc_id: 929242
cord_uid: ox46kifl

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urticaria were thought to be resistant to treatment. Vitamin D (1,000 U/day) was added empirically to the patient's treatment.

The patient's fever did not recur. The patient was discharged on the 5th day, after examinations for COVID-19 returned to normal and urticaria regressed. Overall, the therapy lasted 10 days. After discharge, hydroxyzine and phenyramine treatments were continued to the follow-up visit. On the 10th day, no pathology was observed in the physical examination and laboratory tests in the outpatient clinic control. Then, all medications were discontinued. elIn most pediatric cases, the diagnosis of COVID-19 may be delayed because of the cases presenting as an asymptomatic individual or with rare symptoms such as skin findings initially, or these patients may be missed without any diagnosis. [2] [3] [4] [5] Our case presented with isolated symptoms such as urticarial rash that started suddenly and had fever of 38°C for 1 day, and COVID-19 was not considered by the pediatricians in which it was seen in the first place, and the patient was sent home with an antihistamine. This With this presentation, when acute urticaria and/or angioedema is encountered and rarely occurs in the patient, it is of great importance to bring the COVID-19 viral infection to mind and to narrow the contact circle and to treat the disease. 3, 4 The mechanism by which these triggers may produce spiny keratoderma is still unknown. 3 In our case, malignancy was ruled out, and no other plausible triggers for spiny keratoderma were present. The fact that the temporality criterion for causality is present and being that spiny keratoderma is such a rare disease, we believe these two findings might be correlated.

By sharing this case, we hope to further complement the knowledge we have on this disease.

(a) (b) (c) Figure 1 Millimetric keratotic spiny papules in the ventral right hand, predominantly along the palm and digit lateral margins (a). Close-up view of the fifth finger (b) and hypothenar eminence (c)

COVID-19 and multisystem inflammatory syndrome in children and adolescents

Angioedema and COVID-19: a new dermatological manifestation?

Acute urticaria as the initial presentation of COVID-19 in a pediatric patient

Sick-Samuels AC. Acute COVID-19 and multisystem inflammatory syndrome in children

Acute urticaria preceding other COVID-19-associated manifestations-A case report

COVID-19 and cutaneous manifestations: a systematic review

Hereditary palmoplantar keratodermas. Part I. Non-syndromic palmoplantar keratodermas: classification, clinical and genetic features

Spiny keratoderma: case series and review

Palmoplantar spiny keratoderma associated with chronic lymphoid leukaemia

The patient in this manuscript has given written informed consent to the publication of his case details.