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Erythema Multiforme and COVID-19: What Do We Know?

Luigi Bennardo1,2, Steven Paul Nisticò1, Stefano Dastoli1

  • 1Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.

Medicina (Kaunas, Lithuania)
|August 27, 2021
PubMed

Insights

Erythema multiforme (EM), a skin rash, rarely occurs with COVID-19, often due to a hypersensitivity reaction. This review suggests three types of EM linked to COVID-19: virus-related juvenile, virus-related older, and drug-induced.

Area of Science:

  • Dermatology
  • Infectious Diseases
  • Virology

Background:

  • Erythema multiforme (EM) is an acute skin eruption.
  • It is commonly linked to infections and occasionally drugs.
  • The association between EM and COVID-19 requires further investigation.

Purpose of the Study:

  • To systematically review and evaluate the association between erythema multiforme and COVID-19.
  • To analyze the characteristics of EM in COVID-19 patients.
  • To propose a classification for COVID-19-associated EM.

Main Methods:

  • A systematic literature search was conducted across PubMed/MEDLINE, Scimago Scopus, and ISI/Web of Science.
  • Original articles, case series, and case reports were selected for review.
  • Data from 14 selected articles involving 70 patients were analyzed.

Main Results:

  • Erythema multiforme rarely occurs in COVID-19 patients, usually due to hypersensitivity to the virus.
  • EM associated with COVID-19 appears in distinct age groups: under 30 or over 55.
  • Hydroxychloroquine is an infrequent drug-induced cause of EM in COVID-19 management.
  • Clinical characteristics and disease course differ among patient groups.

Conclusions:

  • COVID-19-associated EM can be preliminarily classified into three types: virus-related juvenile (<30 years), virus-related older (>55 years), and drug-induced.
  • Skin rash occurrence does not correlate with COVID-19 severity or clinical course.

Keywords:
COVID-19SARS-CoV-2erythema multiformehydroxychloroquine

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