Systemic lupus erythematosus and varicella‐like rash following COVID‐19 in a previously healthy patient

Abstract

Emerging reports show that coronavirus disease 2019 (COVID-19) may lead to autoimmune and autoinflammatory diseases. However, COVID-19 triggered systemic lupus erythematosus (SLE) has never been reported to our knowledge. COVID-19 also has associated cutaneous manifestations. Here we present a case of SLE with antiphospholipid antibody syndrome in a previously healthy patient with COVID-19, who subsequently developped a varicella-like exanthem on the trunk. The disease resulted in death of the patient. The pathophysiological mechanisms resulting in overlapping disorders in our patient remain unknown, adding to the growing mystery of this virus and raising questions about the nature of its link with cutaneous, autoimmune, and autoinflammatory manifestations. Sharing the images of this case may benefit physicians dealing with similar patients during this pandemic.

The JANUS of chronic inflammatory and autoimmune diseases onset during COVID-19 – A systematic review of the literature

“… Patients number Sex Age (years) Manifestations Treatment Outcome Ref. 1 F 18 Pericardial tamponade with shock, ventricular dysfunction, pleural serositis, nephritis, ANA, dsDNA, secondary APS, anemia, thrombocytopenia, low complement Glucocorticoids, plasma exchange, HCQ, anticoagulation Death [ 161 ] 1 F 23 Nephritis, ANA, dsDNA, low complement, aPL, direct Coombs, varicella-like rash Glucocorticoids Death [ 162 ] 1 F 85 Thrombocytopenia, pleural effusion, proteinuria, ANA, low complement, finger vasculitis Glucocorticoids, HCQ Improvement [ 163 ] 1 M 62 Nephritis, neuropsychiatric symptoms, lymphopenia, ANA Glucocorticoids, TCZ Improvement [ 164 ] 1 (flare) M 62 During flare: low complement, aPL, thrombocytopenia with cerebral hemorrhage, hemolytic anemia Glucocorticoids, IVIg, rituximab Death [ 165 ] 1 (flare) M 63 During flare: APS. Glucocorticoids, HCQ, anticoagulation Death [ 166 ] Abbreviations.…”

Rheumatological complications of Covid 19

“…It is commonly recognised that SLE, antiphospholipid syndrome (APS) and antiphospholipid antibodies (aPL) can be triggered by viral illnesses [ [46] , [47] , [48] ]. There are a small number of cases of Systemic Lupus Erythematous (SLE) that have been reported in association with COVID-19 [ [49] , [50] , [51] , [52] , [53] ] ( Table 2 ). All these patients responded well to immunosuppression except the first patient in this series who died.…”

A concomitant diagnosis of COVID‐19 infection and systemic lupus erythematosus complicated by a macrophage activation syndrome: A new case report

“…The literature data concerning the association of lupus and COVID‐19 is sparse. To our knowledge, few cases reported the onset of SLE following COVID‐19, 2,3 but only one case report prior to this one documented the concomitant occurrence of clinical manifestations of SLE and COVID‐19 infection in an 18‐year‐old female 4 …”