PMC10010120_01
Extraoral features at the first visit. Multiple crusts on the neck, buttocks, and upper and lower extremities (A-C).
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She had multiple crusts on the neck, buttocks, and upper and lower extremities (Figure 1). 
Intraoral features at the first visit. A yellowish white layer on the right and left buccal mucosa (A and B). Hemorrhagic purpura on the right and left buccal mucosa and right lateral tongue (B and C). An ulcer with a diameter of 0.5 cm on the left lateral border of the tongue (D).
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Intraoral examination showed erosion covered by a yellowish white layer on the right and left buccal mucosa, haemorrhagic purpura on the right and left buccal mucosa and right lateral tongue, an ulcer with a diameter of 0.5 cm on the left lateral border of the tongue, and the root remnants of 12, 14, 15, 16, 17, 26, 27, 33, 34, 35, and 36 teeth (Figure 2).
Histopathological examination showed a subepidermal blister containing eosinophil cells and neutrophil cells (A-C).
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The results of histopathological examination showed a formation of a subepidermal blister containing eosinophil and neutrophil cells (Figure 3).  
Intraoral features at the second visit, 10 days of treatment. The oral lesions showed significant improvement (A-D).
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The oral lesions showed significant improvement at the second visit, 10 days after treatment (Figure 4).
Acute exacerbation of dermatitis herpetiformis lesions after exposure to COVID-19 infection two months later. There was crusting on the perioral and an erosive lesion covered by a white-yellowish plaque on the vermillion border of the upper lip (A-C).
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Extraoral examination revealed crusts on the perioral, erosive lesions covered by white-yellowish plaque on the vermillion border of the upper lip (Figure 5).
A chest x-ray image showed a ground glass appearance from the mid to the bottom of the right lung.
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C-reactive protein (2 mg/dl), quantitative D-dimer (3.72 microg/mL) during hospitalization. Chest X-ray image depicted a ground-glass appearance from the mid to the lower right lung (Figure 6).
The oral lesions healed after a month of treatment (A-D).
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The intraoral lesions healed after a month of the treatment (Figure 7).