Lucian Blaga University of Sibiu, Faculty of Medicine Sibiu, Academic Emergency Hospital Sibiu - Infectious Diseases Clinic, Sibiu.
Lucian Blaga University of Sibiu, Faculty of Medicine Sibiu, FOISOR Clinical Hospital of Orthopedics, Traumatology, and Osteoarticular TB Bucharest.
Medicine (Baltimore). 2021 Apr 9;100(14):e25352. doi: 10.1097/MD.0000000000025352.
Pityriasis rosea Gibert is an erythematous-papulosquamous dermatosis that frequently occurs in young adults. The etiopathogenesis of PR is still unknown, but is frequently associated with episodes of upper respiratory tract infections. It is likely that a new viral trigger of pityriasis rosea is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
We present the case of a female patient in whom the diagnosis of pityriasis rosea led to the investigation and diagnosis of the SARS-CoV-2 infection. The patient presented to the Department of Dermatology for a 3 week duration of an extremely pruritic erythematous-squamous lesion, initially on the trunk and upper limbs, with extension to the lower limbs in the last week and the lesion respected the cephalic extremity, palms, and soles. One week before the rash, respiratory tract infection symptomatology was observed by the patient. At home, she underwent systemic treatment with antihistamines and topical medication with dermatocorticosteroids. The evolution was unfavorable, with the spread of the lesions and the accentuation of the pruritus.
Considering the actual epidemiological context, we performed a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay from nasal and pharyngeal swabs for coronavirus disease 2019 (COVID-19) to investigate the PR etiology. The patient had a positive RT-PCR result, and was confirmed with SARS-CoV-2 infection.
Treatment was initiated with systemic corticosteroid therapy - hydrocortisone hemisuccinate 200 mg/day for 7 days, and loratadine 10 mg 2 times a day. Also, topical medication with dermatocorticosteroids and emollients was associated.
Under the treatment that was initiated a partial remission of the lesions after 7 days was observed.
Our reported case adds to the other findings regarding the association of PR with SARS-CoV-2 infection, in the context of the pandemic, suggesting the need to test patients with PR skin lesions for SARS-CoV-2 infection.
玫瑰糠疹 Gibert 是一种常发生于年轻人的红斑丘疹鳞屑性皮肤病。PR 的发病机制尚不清楚，但常与上呼吸道感染发作有关。玫瑰糠疹的新病毒诱因很可能是严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）。
我们报告了一例女性患者，其玫瑰糠疹的诊断导致了 SARS-CoV-2 感染的调查和诊断。该患者因持续 3 周的极度瘙痒性红斑鳞屑性皮损到皮肤科就诊，皮损最初位于躯干和上肢，最后 1 周扩展至下肢，皮损局限于头端、手掌和足底。皮疹前 1 周，患者出现呼吸道感染症状。在家中，她接受了抗组胺药和皮质类固醇外用药物的全身治疗。病情进展不佳，皮损扩散，瘙痒加剧。
考虑到当前的流行病学背景，我们对鼻和咽拭子进行了实时逆转录-聚合酶链反应（RT-PCR）检测以调查 PR 的病因。患者的 RT-PCR 结果为阳性，确诊为 SARS-CoV-2 感染。
我们开始采用全身性皮质类固醇治疗，即琥珀酸氢可的松 200mg/天，共 7 天，同时给予氯雷他定 10mg，每天 2 次。还联合使用了皮质类固醇外用药物和保湿剂。
经过 7 天的治疗，观察到皮损部分缓解。
我们报告的病例增加了在大流行背景下 PR 与 SARS-CoV-2 感染相关的其他发现，提示需要对有 PR 皮肤病变的患者进行 SARS-CoV-2 感染检测。
