PMC9554330_01
(a) Diffuse erythema and papules on the left thigh; (b) In detail, erythematous-brown follicular papules over erythema on the lateral-posterior aspect of the left trunk.
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Two weeks after household contact with COVID-19, she developed a maculopapular rash (Fig. 1).
(a) Finely desquamative, parchment-like erythematous-brown plaques on the distal third of the left thigh and knee; (b) and on the right scapular region, after 2 months.
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After 15 days, the condition persisted, with mild pruritus in areas with erythema and fine desquamation, where reduction or flattening of the papules ocurred, which developed after two months into parchment-like plaques on the trunk, abdomen and limbs (Fig. 2).
(a) Interstitial and superficial perivascular infiltrate of atypical lymphocytes, with lymphocyte exocytosis (Hematoxylin & eosin, x100); (b) In detail, atypical cellular infiltrate in the epidermis (Hematoxylin & eosin, x400); (c) On immunohistochemistry, CD3 positivity in T-lymphocytes (x400); (d) Low expression of CD7 in T-lymphocytes (x400).
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CoV-2 nucleoproteins) was observed (COI: 94.40; COI-Cutoff Index < 1: non-reactive); D-dimer elevation (1,876 ng/mL; positive > 500 ng/mL); non-reactive serologies for human T lymphotropic viruses 1 and 2; and chest X-ray within the normal range. Skin histopathology showed lymphocytic exocytosis and cellular atypia in the epidermis (Fig. 3a-b), whereas immunohistochemistry showed the predominance of TCD4 lymphocytes and loss of expression of TCD7 lymphocytes (Fig. 3c-d). Clinical staging was established at Ib (T2bN0M0B0).