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Cutaneous eruption in COVID-19-infected patients in Thailand: An observational descriptive study
Preawphan Punyaratabandhu1, Pornchai Chirachanakul1
1Department of Disease Control, Ministry of Public Health, Bamrasnaradura Infectious Diseases Institute, Nonthaburi, Thailand.
Insights
Skin manifestations in COVID-19 patients are uncommon in Thailand. Most reported rashes were linked to medications, suggesting drug allergy as a potential cause requiring further investigation.
Area of Science:
- Dermatology
- Infectious Diseases
- Epidemiology
Background:
- Coronavirus disease 2019 (COVID-19) has presented globally since January 2020.
- Thailand reported the first confirmed COVID-19 case outside China.
- Cutaneous manifestations of COVID-19 are documented but underrepresented in tropical regions like Thailand.
Observation:
- An observational study at Bamrasnaradura Infectious Diseases Institute analyzed 204 COVID-19 patients.
- Six instances of skin eruptions were observed across five patients.
- The study documented various dermatological presentations including maculopapular rash, acute generalized exanthematous pustulosis, Stevens-Johnson syndrome, and urticarial vasculitis.
Findings:
- The incidence of cutaneous eruptions in COVID-19 patients at this Thai institute was low.
- Maculopapular rash was the most frequent presentation (50%).
- A significant proportion of eruptions were associated with COVID-19 treatments, raising suspicion of drug allergies.
Implications:
- Drug allergy should be considered and ruled out in COVID-19 patients presenting with skin rashes.
- Further research is needed to understand the relationship between COVID-19, its treatments, and dermatological side effects.
- Enhanced surveillance of skin manifestations in COVID-19 patients is recommended, particularly in tropical settings.
Abstract:
Coronavirus disease 2019 (COVID-19) emerged in Thailand in January 2020. Thailand was the first to report a confirmed case outside China. Cutaneous eruption in COVID-19 has been reported since the disease became pandemic but limited in tropical countries such as Thailand. The aim of this study was to observe the incidence, characteristics and relation of cutaneous eruption with COVID-19 at Bamrasnaradura Infectious Diseases Institute, a referral center of emerging infectious diseases in Thailand. An observational descriptive study observed the incidence and characteristics of cutaneous eruption in 204 COVID-19-infected patients at Bamrasnaradura Infectious Diseases Institute. We report five patients, who represented six incidences of skin eruption with four characteristics: maculopapular rash (50%), acute generalized exanthematous pustulosis (16.67%), Stevens-Johnson syndrome (16.67%) and urticarial vasculitis (16.67%). Incidences of cutaneous eruption in COVID-19 at Bamrasnaradura Infectious Diseases Institute were low. Most of the incidents were associated with medication used to treat COVID-19 infection, so drug allergy cannot be excluded as a cause of the rashes. Therefore, drug allergy should always be ruled out, and skin manifestation in COVID-19-infected patients should be further observed.
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