Story at a glance

  • Researchers behind the small study published in JAMA Dermatology examined the mouths of 21 COVID-19 patients at Ramon y Cajal University Hospital in Madrid.
  • The researchers found six of the patients with skin rash had some form of enanthem in their mouths.
  • “This work describes preliminary observations and is limited by the small number of cases and the absence of a control group,” researchers cautioned in the study.

New research suggests the coronavirus may manifest itself as a rash inside the mouth of patients, as rash-like lesions were observed inside the mouths of a handful of COVID-19 patients in Spain. 

Researchers behind the small study published in JAMA Dermatology examined the mouths of 21 COVID-19 patients at Ramon y Cajal University Hospital in Madrid who experienced rashes on their skin to see if they had enanthem — a rash inside the body on the mucous membrane. 


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The researchers found six of the patients with skin rash had some form of enanthem in their mouths. The patients were aged between 40 and 69, and four of the six were female. 


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“This work describes preliminary observations and is limited by the small number of cases and the absence of a control group,” researchers wrote in the study.

“Despite the increasing reports of skin rashes in patients with COVID-19, 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,” the study said. 

The study noted that due to safety concerns around the spread of the coronavirus, many patients suspected or known to have COVID-19 do not have their mouths examined. Researchers said enanthems were previously found in some COVID-19 patients in Italy. 

The Centers for Disease Control and Prevention (CDC) says COVID-19 patients experience a wide range of symptoms, running from mild symptoms to severe illness. While symptoms include fever, cough, aches and respiratory issues, skin rashes are not currently listed by the CDC as a symptom. 

In April, some researchers reported coronavirus patients who experienced lesions on the feet or toes. 


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Published on Jul 20, 2020