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Reactive Infectious Mucocutaneous Eruption Associated With SARS-CoV-2 Infection

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

As COVID-19, caused by SARS-CoV-2, spreads worldwide, various patterns of associated dermatologic diseases continue to emerge. Early reports classified multiple cutaneous manifestations of SARS-CoV-2 infection.1 In this article, we report the observation of a newly associated mucocutaneous eruption in a pediatric patient with confirmed SARS-CoV-2 infection.

A previously healthy 17-year-old male presented to the emergency department with 3 days of mouth pain and nonpainful penile erosions. One week prior, he experienced transient anosmia and ageusia that had since spontaneously resolved. At that time, he was tested for SARS-CoV-2 infection via nasopharyngeal polymerase chain reaction (PCR), the results of which were positive. He denied fever, cough, dyspnea, rhinorrhea, and gastrointestinal symptoms at any time. Although he had taken acetaminophen and ibuprofen before presenting to the emergency department, he took no medications before the onset of his mucocutaneous eruption.

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Article Information

Corresponding Author: Zachary E. Holcomb, MD, Dermatology Program, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115 (zholcomb09@gmail.com).

Published Online: April 7, 2021. doi:10.1001/jamadermatol.2021.0385

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank the patient’s mother for granting permission to publish this information.

References
1.
Galván Casas  C , Català  A , Carretero Hernández  G ,  et al.  Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases.   Br J Dermatol. 2020;183(1):71-77. doi:10.1111/bjd.19163 PubMedGoogle ScholarCrossref
2.
Ramien  ML , Bruckner  AL .  Mucocutaneous eruptions in acutely ill pediatric patients—think of mycoplasma pneumoniae (and other infections) first.   JAMA Dermatol. 2020;156(2):124-125. doi:10.1001/jamadermatol.2019.3589 PubMedGoogle ScholarCrossref
3.
Mazori  DR , Nagarajan  S , Glick  SA .  Recurrent reactive infectious mucocutaneous eruption (RIME): Insights from a child with three episodes.   Pediatr Dermatol. 2020;37(3):545-547. doi:10.1111/pde.14142 PubMedGoogle ScholarCrossref
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Jimenez-Cauhe  J , Ortega-Quijano  D , Carretero-Barrio  I ,  et al.  Erythema multiforme-like eruption in patients with COVID-19 infection: clinical and histological findings.   Clin Exp Dermatol. 2020;45(7):892-895. doi:10.1111/ced.14281 PubMedGoogle ScholarCrossref
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Demirbaş  A , Elmas  ÖF , Atasoy  M , Türsen  Ü , Lotti  T .  A case of erythema multiforme major in a patient with COVID 19: The role of corticosteroid treatment.   Dermatol Ther. 2020;33(6):e13899. Published online July 13, 2020. doi:10.1111/dth.13899PubMedGoogle Scholar
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Whittaker  E , Bamford  A , Kenny  J ,  et al; PIMS-TS Study Group and EUCLIDS and PERFORM Consortia.  Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2.   JAMA. 2020;324(3):259-269. doi:10.1001/jama.2020.10369PubMedGoogle ScholarCrossref
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