1/23/2024 0 Comments Covid rash neck![]() ![]() Histological features of our case were consistent with those of eosinophilic cellulitis, an eosinophilic dermatitis that may show urticarial and vesicular features and has been reported as a rare adverse event following vaccines. 2 Eosinophils were reported in some of the few available histological examinations of COVID‐19‐associated skin manifestations 3 and blood eosinophilia is possibly associated with urticarial manifestations of COVID‐19. ![]() Interestingly, the skin lesions of our patient had similarities with the COVID‐19‐related papulovesicular varicella‐like exanthema. Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome diagnostic criteria were not fulfilled and cutaneous parasitoses were excluded due to negative skin scrapings and dermoscopy examinations. Parasitological stool examination was also negative. Tzanck smear from a fresh vesicle and reflectance confocal microscopy examination of the affected skin did not show any sign of herpetic infection. Viral serology did not show any reactivation of previous Herpes Simplex 1 and 2 virus and Varicella‐Zoster virus infections, and HIV test was negative. Chest radiography and abdomen ultrasound were negative. The patient had been receiving lercanidipine chlorhydrate for arterial hypertension for many years and it was not discontinued. We could not find any cause for the skin rash and acute eosinophilia other than the vaccination. Skin histology revealed spongiosis, intraepidermal vesicles and a superficial and deep dermal interstitial and perivascular CD4 + and CD8 + T lymphocyte and histiocyte infiltrate with numerous eosinophils consistent with an initial phase of eosinophilic cellulitis (Wells syndrome). Fever (38.5☌) was observed the day before the eosinophilia peak. These blood tests reverted to normal after 3 days. The patient was hospitalized and received 0.5 mg/kg/day methylprednisolone for one week tapered in the following 3 weeks, with complete resolution of the skin lesions.ĭuring the hospitalization, we observed increased blood leukocyte and eosinophil counts, and C reactive protein up to a peak of 14.13 × 10 3/µl, 4.76 10 3/µl and 11 mg/dl, respectively. The lesions could have been consistent with a COVID‐19‐associated cutaneous manifestation, but the infection was excluded by a history of COVID‐19 6 months before our observation and a negative molecular test. Histopathological examination (hematoxylin and eosin stain, b 20× and c 80×) shows spongiosis with intraepidermal vesicles and dermal inflammatory infiltrate of lymphocytes and numerous eosinophils. Clinical (a) and histological (b, c) aspect of the eosinophilic dermatosis developed after AstraZeneca COVID‐19 vaccination.
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