Exuberant bullous vasculitis associated with SARS-CoV-2 infection
Pedro Alves da Cruz Gouveia,
Ingrid Cardoso Cipriano,
Marina Acevedo Zarzar de Melo,
Helena Texeira Araujo da Silva,
Matheus Augusto de Oliveira Amorim,
Clezio Cordeiro de Sá Leitão,
Maria Magalhães Vasconcelos Guedes,
Daniela Mayumi Takano,
Norma Arteiro Filgueira,
Cláudia Elise Ferraz
Affiliations
Pedro Alves da Cruz Gouveia
Federal University of Pernambuco, Department of Internal Medicine, Recife, Brazil; Corresponding author at: Av. Prof. Moraes Rego, 1235 - Cidade Universitária Recife, Pernambuco, 50670-901, Brazil.
Ingrid Cardoso Cipriano
Federal University of Pernambuco, Department of Internal Medicine, Recife, Brazil
Marina Acevedo Zarzar de Melo
Federal University of Pernambuco, Department of Internal Medicine, Recife, Brazil
Helena Texeira Araujo da Silva
Federal University of Pernambuco, Department of Internal Medicine, Recife, Brazil
Matheus Augusto de Oliveira Amorim
Federal University of Pernambuco, Department of Internal Medicine, Recife, Brazil
Clezio Cordeiro de Sá Leitão
Federal University of Pernambuco, Department of Internal Medicine, Recife, Brazil
Maria Magalhães Vasconcelos Guedes
Federal University of Pernambuco, Department of Internal Medicine, Recife, Brazil
Daniela Mayumi Takano
Federal University of Pernambuco, Department of Pathology, Recife, Brazil
Norma Arteiro Filgueira
Federal University of Pernambuco, Department of Internal Medicine, Recife, Brazil
Cláudia Elise Ferraz
Federal University of Pernambuco, Department of Dermatology, Recife, Brazil
We described a case of exuberant cutaneous small-vessel vasculitis in a 27-year-old male with mild CoVID-19 in Brazil. The patient presented painful purpuric papules and vesicobullous lesions with hemorrhagic content located in the larger amount in the lower limbs and, to a lesser extent in the region of the back and upper limbs, saving palms and soles of the feet. Influenza-like syndrome with anosmia and ageusia was reported seven days before the skin lesions. A real-time reverse transcription polymerase chain reaction was positive on a nasopharyngeal swab for SARS-CoV-2. Histopathological study showed leukocytoclastic cutaneous vasculitis affecting small vessels and microthrombi occluding some vessels. The patient presented an improvement in skin lesions by the fifth day of prednisone therapy. This case highlights the importance of the SARS-CoV-2 test in investigating the etiology of cutaneous vasculitis during this pandemic.
