COVID-19 shows an array of symptoms that include cough, fever and difficulty in breathing. As the disease evolved, many patients reported the loss of smell and taste as other accompanying symptoms.

A new study recently revealed that the virus may also trigger the appearance of a rash inside the mouth which was found in a few patients in Spain.

In this Article

Study Method

To arrive at the findings in this new study, the researchers examined 21 consecutive patients that had presented with both a skin rash and COVID-19 at the Ramon y Cajal University Hospital in Madrid between March 30 and April 8.

The aim of this study was to determine whether the patients developed the enamthem ie lesions on mucous membranes, inside the oral cavity.

The oral cavities of the patients who had the enamthems were systematically examined and categorised into four groups – petechial, macular, macular with petechiae, or erythematovesicular.

Results

Out of the 21 patients examined in the study, six of them showed the presence of oral lesions. All of these patients were in the age group of 49-60 years and four out of six patients were female.

The enanthem was macular in 1 patient, petechial in 2 patients, and macular with petechiae in 3 patients, and was located in the palate in all patients. No patient presented with an erythemato-vesicular enanthem.

The mean time between the onset of COVID-19 symptoms and the appearance of mucocutaneous lesions was 12.3 days (range, −2 to 24 days).

Conclusion

Pustular morphology and dusky lesions are suggestive of drug etiology, while petechial or vesicular pattern suggest an infectious etiology, especially viral. Hence it can be concluded that the lesions observed in these patients are more likely to be of infectious origin rather than the adverse reaction of drugs used in treatment.

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“This work describes preliminary observations and is limited by the small number of cases and the absence of a control group. Despite the increasing reports of skin rashes in patients with COVID-19, establishing an etiological diagnosis is challenging. However, the presence of enanthem is a strong clue that suggests a viral etiology rather than a drug reaction, especially when a petechial pattern is observed,” the team concluded in the study.

Source: JAMA Dermatology