Revista de la Facultad de Medicina (Jan 2021)

Cutaneous manifestations in a patient with COVID-19 treated at a hospital in the Peruvian jungle. A case report

  • Ronald Rainer Echeverría,
  • Onice Jimena Cáceres,
  • Dante Manuel Quiñones-Laveriano,
  • Jennifer Harumi Sueyoshi

DOI
https://doi.org/10.15446/revfacmed.v69n1.88723
Journal volume & issue
Vol. 69, no. 1

Abstract

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Introduction: Most patients infected with the coronavirus disease 2019 (COVID-19) experience mild to moderate symptoms. This condition may affect multiple organs and systems, including the skin, and cutaneous manifestations are varied. Although several studies on COVID-19 have been conducted in Peru, to date, this type of manifestation has not been described in the Peruvian population, especially in environments with high prevalence of viral diseases that cause similar dermatological lesions, such as the Peruvian jungle. Case presentation: A 16-year-old male patient with no relevant medical history was admitted to a hospital in the Peruvian jungle due to headache, chills, general malaise, and respiratory distress. On physical examination, oxygen saturation was 89-90%, and a skin rash was observed; it was characterized by non-evanescent, confluent, pruritic, and symmetrical morbilliform lesions in the limbs, abdomen, thorax, and face, without mucous membrane involvement. Due to the shortage of molecular tests in the region where he was treated, he was diagnosed with COVID-19 based on serological (serological tests for SARS-CoV-2 (IgM+ and IgG+)) and radiological criteria (imaging findings compatible with COVID-19 atypical pneumonia). The initial treatment included the administration of ceftriaxone, azithromycin, dexamethasone, cetirizine, as well as the use of oxygen by binasal cannula. After 5 days and given the persistence of symptoms and respiratory and skin signs, treatment with ivermectin was started. 48 hours after the introduction of this treatment, the cutaneous and respiratory manifestations had completely resolved. Conclusions: Patients with COVID-19 may develop several cutaneous manifestations similar to those produced by other viruses or adverse drug reactions. Therefore, it is necessary to appropriately interview the patient and establish the chronological order of symptom onset to diagnose this disease correctly.

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