Morbilliform Rash: An Uncommon Herald of SARS-CoV-2.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus first detected in Wuhan, China in 2019 after an outbreak of flu-like illness. The disease came to be known as the coronavirus disease of 2019 (COVID-19). It has spread quickly, spanning many countries, and has become a global pandemic. As this is a novel virus, its varied manifestations and symptomatology are coming to light daily. Although most threatening to the respiratory system, this virus has the propensity to affect multiple organ systems quickly leading to multi-organ dysfunction. Many dermatologic manifestations have been reported with no clear pattern. Most data have been anecdotal.  Here we present a 78-year-old male who tested positive for SARS-CoV-2 with no usual symptoms that would alert one of the possibilities of COVID-19. He did, however, have a diffuse morbilliform rash most notable on the trunk and back. He went on to develop fever thereafter but did not develop any respiratory complications. The rash was short-lived and was treated with topical steroids and oral antihistamines. It is important to know and report new findings of novel diseases not only for diagnosis and treatment but also to place appropriate isolation precautions and containment. Rash may be the initial and sometimes the only manifestation of COVID-19.

Elevated C-reactive Protein and Role of Steroids in Cocaine-associated Levamisole-induced Vasculitis.

Levamisole is a common contaminant in cocaine and has led to the emergence of an entity known as levamisole-induced vasculitis (LIV). There is no consensus on the management of this condition. We describe a patient who presented with acute on chronic LIV who was treated with pulse dose steroids. We aim to discuss the diagnosis and current management options for LIV. We have compared seven case reports that have measured C-reactive protein (CRP) and compared the CRP levels, site involved, dose, and mode of steroid administration. We postulate that elevated CRP may warrant steroid therapy over conservative management and could lead to a possible decreased hospital stay.

Keratoacanthoma clinical behavior: a systematic review.

As of 2013, keratoacanthomas (KAs) have not been decided on as either a benign or a malignant entity. Originally considered benign epidermal growths, the assertion by Hodak, Jones, and Ackerman that these lesions are truly "an expression of squamous cell carcinoma" (SCC) fueled the controversy and placed some of the biggest names in the field on opposite sides of the issue. Without a clear understanding of the etiology of KAs and without stringent diagnostic criteria, the literature in regard to KA contains scant reports of their "metastatic potential." Four hundred forty-five cases of KA with reported follow-up and outcomes were reviewed from 113 published articles. In our data set, none of these cases resulted in death or distant metastases. When compared with 429 cases of SCC of the skin, with 61 cases of metastases and 24 deaths as a direct result of SCC, the biologic behavior of the 2 entities is distinct and evident. KAs are benign epidermal growths and not a malignant variant of SCC.