Acral purpura and pityriasis rosea-like eruption following COVID-19 infection

Sir, A 74-year-old female patient treated with angiotensin-converting enzyme inhibitor for arterial hypertension metformin and atorvastatin insulin-independent diabetes mellitus hyperlipidemia, respectively, consulted the outpatient dermatological clinic a rash that appeared fifteen days prior to consultation. The received second dose of mRNA COVID-19 vaccine on July 29, 2021, was due receive third December yet she fell ill day 6 same month, probably being infected by one her grandchildren. eruption consisted erythematous, purpuric macules anterior face both tibia (Fig. 1a), solitary papule left hand 1b), erythematous papules scale border buttock 1c). collarette formed trailing edge advancing lesion, clinical sign pathognomonic pityriasis rosea. Intense pruritus accompanied eruption. No herald patch observed, nor lesions trunk, typical location rosea, while hands are absent in cases disease. oral genital mucosae were intact. cutaneous manifestations include purpuric, chilblain, vesicular, urticarial, rosea-like lesions. Acral most frequent associated infection [1]. An acral distribution is feature mouth, hand, foot disease Coxsackie A16 virus [2], although no reactivation this has been detected during pandemic, herpes 7 rosea occurred