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Case report
Severe urticarial rash as the initial symptom of COVID-19 infection
  1. Sandeep Pagali1 and
  2. Riddhi S Parikh2
  1. 1Department of Medicine, Division of Hospital Internal Medicine & Division of Geriatric Medicine and Gerontology, Mayo Clinic, Rochester, Minnesota, USA
  2. 2Department of Medicine, Division of Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr Sandeep Pagali; pagali.sandeep{at}mayo.edu

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.

  • COVID-19
  • dermatology

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-241793

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    Footnotes

    • Contributors SP cared for the patient directly through her hospitalisation and drafted the manuscript. RSP was part of the care team along with SP, who was involved in regular discussion about the patient care and further edited the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.