A new mucocutaneous eruption was as soon as noticed in an in any other case minimally symptomatic child with COVID-19, researchers found.
The 17-year-frail boy presented to the emergency department with 3 days of mouth bother and “nonpainful penile erosions,” and after intensive testing, was as soon as diagnosed with SARS-CoV-2-associated reactive infectious mucocutaneous eruption, reported Zachary Holcomb, MD, of Boston Kid’s Well being facility, and colleagues.
Particularly, the patient most attractive skilled transient anosmia and ageusia, which resolved per week prior. He reported no fever, cough, dyspnea, rhinorrhea, or gastrointestinal indicators, however tested sure for SARS-CoV-2 at the time, they wrote in JAMA Dermatology.
“This case highlights what’s, to our data, the first portray of SARS-CoV-2-brought about RIME [reactive infectious mucocutaneous eruption] and distinguishes this entity from other mucocutaneous eruptions with critically diversified prognoses and treatment algorithms,” they added.
The patient’s crucial indicators had been normal, and a bodily examination published “shallow erosions of the vermilion lips and laborious palate, circumferential erythematous erosions of the periurethral glans penis, and 5 runt vesicles on the trunk and upper extremities.” Lab values had been largely normal, as antagonistic to light absolute lymphopenia and a runt elevated creatinine and C-reactive protein levels.
The patient tested sure for SARS-CoV-2 by the hiss of nasopharyngeal PCR testing, however opposed for Mycoplasma pneumoniae, adenovirus, Chlamydophila pneumoniae, human metapneumovirus, influenza A/B, parainfluenza 1 to 4, rhinovirus, and respiratory syncytial virus. M. pneumoniae IgG levels had been elevated, however IgM plasma was as soon as opposed. Therefore, the patient was as soon as diagnosed with SARS-CoV-2-associated reactive infectious mucocutaneous eruption.
After 3 days of worsening oral bother, the patient was as soon as prescribed 60 mg of oral prednisone as soon as day-to-day for 4 days, which improved his indicators. Holcomb’s crew famed that the patient was as soon as initially prescribed betamethasone valerate 0.1% ointment for the lips and penis, intraoral dexamethasone resolution, viscous lidocaine, and over-the-counter bother relief with acetaminophen or ibuprofen, if significant.
Oral mucositis recurred 3 months later, and the patient was as soon as prescribed 80-mg oral prednisone day-to-day for six days.
Holcomb and colleagues highlighted the contrast between reactive infectious mucocutaneous eruption, with SARS-CoV-2 because the infectious trigger, and other pores and skin eruptions. To illustrate, “the sparse cutaneous involvement and lack of dim targetoid lesions” distinguish it from Stevens-Johnson syndrome and erythema multiforme, which has been connected to SARS-CoV-2. It also differs from multi-scheme inflammatory syndrome in childhood (MIS-C), which is characterised by “mucocutaneous involvement, systemic indicators, and dramatically elevated systemic inflammatory markers,” they said.
The authors disclosed no conflicts of curiosity.