Urticaria in COVID-19 Patient Treated with Lopinavir / Ritonavir : A Case Report
DOI:
https://doi.org/10.66344/jpad.v31i4.1773Abstract
The unknown pneumonia was first found in Wuhan, China in December 2019. A novel corona virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was isolated from lower respiratory tract swab in infected patient. The disease caused by this novel virus was then named as COVID-19 (Coronavirus Disease 2019). We report a male patient with urticarial lesions, varies on size and shape on the both arms and both legs and diagnosed with COVID-19 confirmed case. He was treated with powdered oral medicine containing combination of lopinavir and ritonavir. He developed urticarial lesions in three hours after administration of the drug. The lesions then dissapeared and resolved after 4 days of treatment using cetirizine. The conclusion of this case is still needed to be proven whether the urticarial lesion is related to COVID-19 or drugs used for COVID-19 therapy.
References
1. Jin Y-H, Cai L, Cheng Z-S, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res.2020;7(1):4. [PMID: 32029004].
2. Guan W-J, Ni Z-Y, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; 382(18): 1708–20. [DOI: 10.1056/NEJMoa2002032].
3. Glass CA, Cash JC, Mullen J. Coronavirus Disease (COVID-19). Fam Pract Guidel. 2020.
4. Recalcati S. Cutaneous manifestations in COVID-19: a first perspective. J Eur Acad Dermatol Venereol.2020;34(5):e212-e213. [PMID: 32215952].
5. Joob B, Wiwanitkit V. COVID-19 can present with a rash and be mistaken for dengue. J Am Acad Dermatol.2020;82(5): e177. [PMID: 32213305].
6. Zhang J, Dong X, Cao Y, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy.2020;75(7):1730-41.
[PMID: 32077115].
7. Kouotou EA, Nansseu JR, Ngono VN, et al. Prevalence and Clinical Profile of Drug Eruptions among Antiretroviral Therapy-Exposed HIV Infected People in Yaoundé, Cameroon. Dermatol Res Pract.2017;27:1-6. [DOI : 10.1155/2017/6216193]
8. Borrás-Blasco J, Navarro Ruiz A, Borras C, Casterá E. Adverse Cutaneous reactions associated with the newest antiretroviral drugs in patients with human immunodeficiency virus infection. J Antimicrob Chemother.2008;62:879–88. [PMID: 18653488].
9. Hide M, Takahagi S, Hiragun T. Urticaria and angioedema. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, Mcmichael AJ, et al., editors. Fitzpatrick’s Dermatology in General Medicine. New York: McGrawHill; 2019. p. 684–709.
10. Kulthanan K, Chiawsirikajorn Y, Jiamton S. Acute urticaria: etiologies, clinical course and quality of life. Asian Pacific J allergy Immunol.2008;26(1):1–9. [PMID: 18595524].
11. Wedi B, Raap U, Wieczorek D, Kapp A. Urticaria and infections. Allergy Asthma Clin Immunol. 2009;5(1):10. [DOI: 10.1186/1710-1492-5-10].
12. Wollina U, Karadağ AS, Rowland-Payne C, Chiriac A, Lotti T. Cutaneous Signs in COVID-19 Patients: A Review. Dermatol Ther.2020;e13549. [PMID: 32390279].
13. Henry D, Ackerman M, Sancelme E, Finon A, Esteve E. Urticarial eruption in COVID-19 infection. J Eur Acad Dermatol Venereol. 2020;34(6):e244–5. [PMID: 32294273].
14. Van Damme C, Berlingin E, Saussez S, Accaputo O. Acute urticaria with pyrexia as the first manifestations of a COVID-19 infection. J Eur Acad Dermatol Venereol. 2020;34(7):e300-e301. [PMID: 32329915].
15. Rodríguez-Jiménez P, Chicharro P, De Argila D, Muñoz-Hernández P, Llamas-Velasco M. Urticaria-like lesions in COVID-19 patients are not really urticaria – a case with clinicopathological correlation. J Eur Acad Dermatol Venereol.2020. [PMID: 32386447].
16. Aktaş H, Hamidi AA. Urticaria in a patient with COVID-19: Therapeutic and diagnostic difficulties. Dermatol Ther.2020;e13610. [PMID: 32418320].
17. Fernandez-Nieto D, Ortega-Quijano D, Segurado-Miravalles G, et al. Comment on: Cutaneous manifestations in COVID-19: a first perspective. Safety concerns of clinical images and skin biopsies. J Eur Acad Dermatol Venereol.2020;34(6):e252–4. [PMID: 32294262].
18. Gunawan C, Angela A, Widysanto A. Urticarial eruption in Coronavirus Disease 2019 (COVID‐19) infection: a case report in Tangerang, Indonesia. J Eur Acad Dermatology Venereol.2020;34(8):e372-e373. [PMID: 32386435].
19. Grattan CEH. Aetiopathogenesis of urticaria. In: Zuberbier T, Grattan C, Maurer M, editors. Urticaria and angioedema. Berlin: Springer Berlin Heidelbergs; 2010. p. 9–22.
20. Young S, Fernandez AP. Skin manifestations of COVID-19. Cleve Clin J Med.2020.
doi: 10.3949/ccjm.87a.ccc031.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Prof. Cita Rosita Sigit Prakoeswa, MD, PhD, Damayanti, MD, PhD, Sylvia Anggraeni, MD, Menul Ayu Umborowati, MD, Medhi Denisa Alinda, MD, Natalia Tanojo, MD, Jonggi Mathias Rajapikir Tamba, MD, Bernadya Yogatri, MD, Soedarsono, MD, PhD, Ariani Permatasari, MD, Bambang Pujo Semedi, MD

This work is licensed under a Creative Commons Attribution 4.0 International License.
Submission declaration
Authors retain the copyright to their work and grant the 'Journal of Pakistan Association of Dermatologists (JPAD)' the right of first publication under a Creative Commons Attribution 4.0 International (CC BY 4.0) license. This license allows others to share, adapt, and reuse the work for any purpose, including commercial use, as long as appropriate credit is given to the original authors and the journal.
By submitting a manuscript, authors confirm that the work has not been published previously (except as an abstract, lecture, or academic thesis), is not under review elsewhere, and has been approved by all authors and relevant authorities. Once accepted, the article will be openly accessible under the CC BY 4.0 license, ensuring wide dissemination and reuse with proper attribution.






