COVID RASH ON FOOT SKIN

COVID RASH ON FOOT SKIN

Figs.Lisa Arkin saw more swollen, discolored toes during the early months of the pandemic than she had during her entire career.Īrkin, a pediatric dermatologist at the University of Wisconsin-Madison, treated just a couple of patients with temporary skin lesions called pernio, or chilblains, each year. We further confirm that any aspect of the work covered in this manuscript that has involved either experimental animals or human patients has been conducted with the ethical approval of all relevant bodies and that such approvals are acknowledged within the manuscript. In so doing we confirm that we have followed the regulations of our institutions concerning intellectual property. We confirm that we have given due consideration to the protection of intellectual property associated with this work and that there are no impediments to publication, including the timing of publication, with respect to intellectual property. We further confirm that the order of authors listed in the manuscript has been approved by all of us. We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed.

We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. This is an FDA reportable adverse reaction through MedWatch, given COVID-19 vaccine is a new entity developed during the pandemic to be administered under Emergency Use Authorization (EUA). Within 10 days from the first dose, the patient developed a self-resolving mild rash that subsequently expanded into bullous lesions following four days after second vaccination completed. There is a high probability that the rash is Moderna COVID-19 vaccine induced, given the temporal relationship between vaccination administration and rash development. The patient denied the addition of any new medications including soaps or detergents.

Risperidone-induced erythema multiforme have been reported in literature search, however it presents as a mild, self-limiting reaction needing only supportive treatment such as use of topical steroids, fluid and electrolyte replacement, and pain/analgesia management. There is a possibility this rash is drug induced by the patient's home medication of risperidone however, the patient has been stable on risperidone for several years and less likely to be the cause of a drug-induced erythema multiforme. Periodic acid–Schiff (PAS) and Grocott methenamine silver (GMS) stains were negative for fungal organisms. Biopsy also showed a presence of a significant number of eosinophils that could be suggestive of drug-induced erythema multiforme. Toxic epidermal necrolysis could be another differential however, no necrosis of epidermis was observed in the biopsy. Given no mucosal involvement, Stevens-Johnson Syndrome was less likely. The patient was admitted to the burns ICU and a skin biopsy of the left shoulder revealed findings consistent with erythema multiforme, bullous pemphigoid and Stevens-Johnson Syndrome. There were no infectious symptoms preceding this event and no associated fevers, chills, chest pain, shortness of breath, abdominal pain, nausea, vomiting, urinary or stool changes.

The patient denied any oral or facial mucosal involvement. Following the second dose of Moderna vaccine, he started developing worsening of the blisters and redness to the anterior chest, genitalia, bilateral hands, and bilateral lower feet with larger blisters involving the sole aspect of his feet. The patient reported that he developed a mild rash2 weeks after the first dose that resolved without intervention. He adamantly denied usage of new soaps or detergent. As per the patient's guardian, the patient received the Moderna COVID-19 vaccine within the month prior to hospital admission. Patient reported no new initiations of any medications nor changes in current medications which included risperidone 1 mg PO q12h, atorvastatin 10 mg PO qHS, and loratadine 10 mg PO q12h. The patient was found to have an allergy to peaches, of which the reaction is unknown. Patient past medical history is significant for seasonal allergies, hypercholesteremia, and mental retardation with guardian appointed personnel. A 62-year-old male patient was admitted with the chief complaint of a blistering rash on his anterior chest and upper torso for the past month.

Covid rash on foot