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COVID-19 Mouth Lesions

Although cough, fever, and shortness of breath remain the most common COVID-19 symptoms, the list of possible ways in which the coronavirus might impact the body continues to grow. In recent months some patients have experienced a wide variety of skin issues, including rashes, hives, blisters, and reddish/purple discoloration of the toes (aka “COVID toes”).

Now Spanish researchers seem to have identified another related skin problem: oral lesions.

In a new research letter, published in the journal JAMA Dermatology, physicians from Madrid reported on a small group of patients with confirmed coronavirus who had “enanthem,” or lesions inside their mouth. They found that six of 21 COVID-19 patients who had external skin rashes also had oral lesions.

Other viral infections are associated with oral lesions. People who contract strep, for instance, often develop petechiae, which are tiny, pinprick-sized red, purple, or brown dots that may appear on the roof of the mouth, as well as on the chest and face. “However, owing to safety concerns, many patients with suspected or confirmed COVID-19 do not have their oral cavity examined,” the authors wrote.

Clearly this study was extremely small and is considered preliminary, but both health care providers and patients might consider adding oral lesions to the list of symptoms that could be associated with COVID-19 infection.

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Carrington AE, et al. COVID-19 Rashes: How Your Skin Can Be a Sign of the Virus. ABC News. July 23, 2020. https://abcnews.go.com/US/covid-19-rashes-skin-sign-virus/story?id=71931954.

Jimenez-Cauhe J, et al. Enanthem in Patients with COVID-19 and Skin Rash. JAMA Dermatology. July 15, 2020. doi: https://doi.org/10.1001/jamadermatol.2020.2550.

Walker M. COVID-19 May Manifest in the Mouth in Some Patients.
MedPage Today. July 15, 2020. https://www.medpagetoday.com/infectiousdisease/covid19/87584.