








key: cord-276549-r5l4pse8
authors: Dastoli, Stefano; Bennardo, Luigi; Patruno, Cataldo; Nisticò, Steven Paul
title: Are erythema multiforme and urticaria related to a better outcome of COVID‐19?
date: 2020-06-09
journal: Dermatol Ther
DOI: 10.1111/dth.13681
sha: 
doc_id: 276549
cord_uid: r5l4pse8

nan

gering factor, 2 while a little is known about such eruptions not clearly associated to drugs. Eosinophilic cells blood count seems to have a major role in COVID-19 diagnosis and prognosis. Eosinopenia has been associated in up to 81% of cases 3 and was proposed as possible diagnostic marker for the disease. 4 Persistent eosinopenia was associated to higher mortality. 3 On the other hand, an increase of eosinophils in blood was related to an improvement of the overall condition of the patient. 5 Furthermore, patients with pre-existing atopic disease (asthma, rhinitis, and atopic dermatitis) seem to be less affected by COVID-19. 4 Therefore, eosinophilia was associated with a protective effect toward the development of COVID-19. 6 Histopathology of some skin rashes arising during COVID-19 shows a perivascular and dermal infiltrate rich in eosinophilic cells. 7 Various theories have been proposed in order to explain these findings. Eosinopenia may be secondary to cell depletion due to the viral infection or to stress-induced glucocorticoid secretion. 8 Eosinophilia might be beneficial thanks to its antiviral effect, as demonstrated for influenza and parainfluenza virus. 5 We can speculate that the non-drug related EM and U might be associated to systemic eosinophilia secondary to a strong response to COVID-19, and therefore possibly to a better outcome of the disease. Indeed, nondrug-induced EM has been mostly reported in young healthy nonhospitalized COVID-19 patients. 9 U not related to drug reaction was reported in up to 4% of COVID-19 patients, 10 In conclusion, we might suppose that EM and U, when associated to eosinophilia, could be related to a better outcome of COVID-19.

However, more clinical data would be needed to prove this association.

Eosinophilic skin diseases: a comprehensive review

Dermatology staff participate in fight against COVID-19 in China

Clinical features of 85 fatal cases of COVID-19 from Wuhan: a retrospective observational study

Clinical characteristics of 140 patients infected with SARS-COV-2 in Wuhan

COVID-19, chronic inflammatory respiratory diseases and eosinophils-observations from reported clinical case series

Eosinophil responses during COVID-19 infections and coronavirus vaccination

Clinical and histopathological study of skin dermatoses in patients affected by COVID-19 infection in the Northern part of Italy

Patients of COVID-19 may benefit from sustained lopinavir-combined regimen and the increase of eosinophil may predict the outcome of COVID-19 progression

Characterization of acute acro-ischemic lesions in non-hospitalized patients: a case series of 132 patients during the COVID-19 outbreak

Cutaneous manifestations in COVID-19: a first perspective



