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COVID-19 Presenting as Papular Urticaria: A Case Report

Alexis R. Bernat, John Raymond Bernat III, Pamela Guerriere-Kovach

(Department of Dermatology, Advanced Dermatology and Skin Cancer Center, Boardman, OH, USA)

Med Sci Case Rep 2021; 8:e928650

ID: 928650


BACKGROUND: COVID-19, caused by the SARS-CoV-2 virus, has very unusual skin presentations. Italian dermatologists first reported the various skin manifestation of the SARS-CoV-2 virus. In addition, there have been reports of rashes resembling Dengue fever, with presumed micro-thrombosis. The early recognition of papular urticaria and its association with SARS-CoV-2 allows for early detection and appropriate isolation measures to prevent spread of SARS-CoV-2 virus and COVID-19 disease.
CASE REPORT: We report the case of a 40-year-old man who presented with papular rash consistent with papular urticaria, along with his 3-year-old daughter who had similar findings. Although the man had a corresponding positive antigen test for SARS-CoV-2 virus, the daughter was not tested. All requests to perform biopsies were refused. However, this unique presentation allows for strict isolation measures. To date, the adult patient is fully recovered and no known spread from him or his daughter has been detected.
CONCLUSIONS: Early detection of skin manifestations of the SARS-CoV-2 virus allows for isolation and prevention of disease spread. Urticarial reactions are reported as early signs of SARS-CoV-2 virus. This case report shows that the symptom of papular urticaria, in association with SARS-CoV-2 virus, allowed for identification of a presumptive positive case in the patient’s daughter and her subsequent isolation. This quick detection helps stop the spread of SARS-CoV-2 virus and prevents COVID-19 disease.

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