Erythema annulare centrifugum in the setting of COVID-19 infection: A case report and literature review

ABSTRACT

The lesional skin pathology showing dense lymphocytic infiltration with scant eosinophils (C, ×20, H & E;D, ×200, H&E) Most cases with EAC are clinically idiopathic, although the current concept regarding the disease pathogenesis suggests a delayed-type hypersensitivity to various antigens, including viral, bacterial, or fungal infections, drugs, foods, malignancy or other systemic diseases. 6 This is supported by evidence that the skin manifestation of EAC is alleviated by treatment of the underlying disease. EAC associated with viral infection has been reported to be triggered by various viruses, such as EB virus, poxvirus, HIV, varicella-zoster virus, and influenza virus, and is mostly transient like our case or displays a fluctuating skin lesion in parallel with the viral disease activity. To our knowledge, there have been only four case reports, including ours, for EAC encountered in association with COVID-19 infection;one of whom resolved with oral doxycycline, 7 and three others improved with topical steroids and/or antihistamine. 8,9 Except one child case, 8 their skin lesions appeared about 1 week after the onset of COVID-19 infection and disappeared within 1 month, suggesting the consequence of viral infection itself and/or preceded antiviral therapy.