Got mouth rash? It might be Coronavirus!
While rashes on the skin have long been tied to Coronavirus, doctors in Spain report that rashes on the inside of the mouth are also occurring in some cases. In clinical terms the rash is referred to as Enanthem, an US dermatologist not attached to the study says they are not surprised at the occurrence of these rashes.
Enanthem is a rash (small spots) on the mucous membranes. It is characteristic of patients with viral infections causing hand, foot and mouth disease, measles, and sometimes chicken pox. In addition, bacterial infections such as Scarlet fever may also be a cause of enanthem.
Researchers led by Dr. Juan Jimenez-Cauhe, University Hospital Ramon y Cajal in Madrid, examined 21 patients diagnosed in early April with Coronavirus and associated skin rashes. The Spanish study was published in JAMA dermatology on 15th July.
Interestingly six (29%) out of those 21 patients had enanthem on the inside of their mouths. The age of the patients varied from 40 to 69, the team said. And four out of those 6 patients were women.
The mouth rash appeared anywhere from two days before the onset of other Coronavirus symptoms to 24 days after, with an average time of about 12 days after onset of symptoms.
Since in most cases the enanthem did not appear to be tied to any medicines that the patients were taking, further strengthened the notion that the it is an illness caused by the Coronavirus making the red spots to occur.
Just how widespread this symptom is with Coronavirus is still unknown, since “owing to safety concerns, many patients with suspected or confirmed COVID-19 do not have their oral cavity examined,” Jimenez-Cauhe’s group noted.
There are researchers around the world, who are conducting oral cavity examinations and have also reported the manifestations of these mouth rashes. This work describes preliminary observations and is limited by the small number of cases and the absence of a control group.
Despite the increasing reports of skin rashes in patients with Coronavirus, establishing an etiological diagnosis is challenging. However, the presence of enanthem is a strong clue that suggests a viral etiology rather than a drug reaction, especially when a petechial pattern is observed.
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