Letter to the Editor Unique skin manifestations of COVID-19: Is drug eruption specific to COVID-19? COVID-19 is associated with specific skin manifestations and drug eruption in some affected patients. Here, we report a case of suspected COVID-19-related drug eruption and specific clinical features.A 52-year-old woman visited our dermatology clinic with itchy erythematous lesions on her limbs and erosions on her lips and buccal mucosa. She had no flu symptoms or fever. She had been treated at a dental clinic 3 days prior (Day À3) and given antibiotics (cefcapene pivoxil hydrochloride hydrate) and the non-steroid anti-inflammatory drug (NSAID) loxoprofen sodium hydrate. Erythematous lesions and erosions on the lips appeared 2 days later (Day À1). Her blood counts were normal. The skin lesions Fig. 1. Clinical features of her trunk and leg Day 0, indurated erythema on her leg, and red papules and erythema on her trunk Day 8, dark red colored papules and indurated erythema were largely observed on her leg and trunk.

Myocarditis and subsequent dilated cardiomyopathy are major causes of heart failure in young adults. Myocarditis in humans is highly heterogeneous in etiology. Recent studies have indicated that a subgroup of myocarditis patients may benefit from immune-targeted therapies, because autoimmunity plays an important role in myocarditis as well as contributing to the progression to cardiomyopathy and heart failure. Suppressor of cytokine signaling (SOCS) 1 plays a key role in the negative regulation of both TLR- and cytokine receptor-mediated signaling, which is involved in innate immunity and subsequent adaptive immunity. In this study, we investigated the therapeutic effect of SOCS1 DNA administration on experimental autoimmune myocarditis (EAM) in mice. EAM was induced by s.c. immunization with cardiac-specific peptides derived from α myosin H chain in BALB/c mice. In contrast to control myocarditis mice, SOCS1 DNA-injected mice were protected from development of EAM and heart failure. SOCS1 DNA administration was effective for reducing the activation of autoreactive CD4+ T cells by inhibition of the function of Ag-presenting dendritic cells. Our findings suggest that SOCS1 DNA administration has considerable therapeutic potential in individuals with autoimmune myocarditis and dilated cardiomyopathy.

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