Retiform Purpura in the Setting of COVID-19: A Harbinger of Underlying Coagulopathy and Severe Disease Course

Main Article Content

Gabrielle Brody
Michael O. Nguyen
Delila Pouldar Foulad
Nathan W. Rojek

Keywords

Retiform Purpura, COVID-19, Cutaneous manifestation of disease

Abstract

While the majority of COVID-19 cases are mild and can be managed in the outpatient setting, more severe cases have proven to be a clinical challenge. While some cases demonstrate a more slow and indolent decline, others seem to deteriorate rapidly with little forewarning. The current literature has connected Retiform Purpura as a cutaneous manifestation associated with severe COVID-19 infections, however timing of cutaneous presentation and severe clinical COVID-19 symptoms has not been well described. Here we report a case of a 58-year-old female who developed Retiform Purpura nearly a week prior to the development of any significant COVID-19 symptoms. This case demonstrates that Retiform Purpura is not only associated with severe COVID-19 disease, but can present prior to symptom onset and should be seen as a harbinger for impending clinical deterioration.

References

1.Velavan TP, Meyer CG. Mild versus severe COVID-19: Laboratory markers. Int J Infect Dis. 2020;95:304-307. doi:10.1016/j.ijid.2020.04.061

2. Freeman EE, McMahon DE, Lipoff JB, et al. The spectrum of COVID-19–associated dermatologic manifestations: An international registry of 716 patients from 31 countries. J Am Acad Dermatol. 2020;83(4):1118-1129. doi:10.1016/j.jaad.2020.06.1016

3. Magro C, Mulvey J, Laurence J, et al. The differing pathophysiologies that underlie COVID-19-associated perniosis and thrombotic retiform purpura: a case series Conflicts of interest. Br J Dermatol. 2020. doi:10.1111/bjd.19415

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