There is a dearth of robust evidence regarding
coronavirus disease 2019 (COVID-19)-related coetaneous manifestations, complications and adverse treatment events. Upon review of the literature there are only a few cases reported of
acute generalized exanthematous pustulosis (AGEP) in
COVID-19 patients
after treatment. Therefore, we are reporting a case of a 34-year-old male not known to have any
chronic illness. His severe
COVID-19 infection resolved four days prior to presentation to the Emergency Department with pustular
rash on erythematous base over his face, neck, upper limbs, anterior and posterior trunk including oral cavity and tounge. The
rash started after he took
azithromycin,
oseltamivir,
ribavirin,
lopinavir,
hydroxychloroquine,
prednisolone,
ceftriaxone,
clindamycin,
interferon (IFN) beta, and
ceftazidime for
COVID-19. Skin punch biopsy was done and he was diagnosed with AGEP but it was still not known if it was related to
COVID-19 or a
drug-induced condition. Patient was treated with
betamethasone valerate 0.1%
ointment and lotion,
promethazine hydrochloride 25mg
tablet,
paracetamol 500mg
tablet,
calcipotriol 50mcg/g and
betamethasone 0.5mg/g gel. He discharged the same day to manage at home despite not improving. In the end, we found only a few studies that describe the cutaneous manifestations of
COVID-19 infection, which were mainly case reports. We can't be sure that AGEP is a late and severe complication of
COVID-19 infection. However, AGEP could be a rare adverse effect of
hydroxychloroquine therapy. Improving the knowledge about a wide range of different signs and symptoms of the disease and its severity in addition to all possible adverse treatment events and complications can improve patient safety, survival rate, and quality of life.