
This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (CC BY).
CLINICAL CASE
Difficulties in differential diagnosis of cutaneous manifestations in patients with coronavirus infection
1 Federal Center for Brain and Neurotechnology of FMBA of Russia, Moscow, Russia
2 Pirogov Russian National Research Medical University, Moscow, Russia
Correspondence should be addressed: Tatiana A. Gaydina
Ostrovityanova, 1, Moscow, 117997; ur.xednay@924cod
Compliance with ethical standards: the patient gave informed consent to medical treatment and publication of this case report.
Author contribution: Tairova RT, Gaydina TA: interpretation of the obtained data, manuscript draft; Dvornikov AS: literature analysis; Tazartukova AD: interpretation of the obtained data; Lyang OV: manuscript draft.
Patients with severe SARS-CoV-2 infection (COVID-19) and multiple comorbidities should be monitored for possible adverse reactions to prescribed drugs, including drug eruptions (DE) at any stage of treatment. Below, we describe a clinical case of a 92-year-old female patient with severe PCR-confirmed COVID-19. The patient was treated with amoxicillin/clavulanic acid, moxifloxacin, acetylcysteine, and sodium enoxaparin. On day 9 into treatment, the patient developed moderately itching macular rashes showing a tendency to coalesce, but overall showed no signs of deterioration. On day 15, the rashes regressed, following a short course of dexamethasone and chloropyramine. This kind of skin reaction might have been provoked by β-lactams and fluoroquinolones included in the treatment regimen, a secondary bacterial infection, compromised immunity due to advanced age, and high viral load associated with dermatological symptoms. Delayed onset of skin symptoms might be regarded as a marker of COVID-19 severity.
Keywords: COVID-19, SARS-CoV-2, coronavirus infection, skin manifestations, toxidermia, drug eruptions