Brett Sloan1. 1. Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut. Electronic address: brettsloanjaad@gmail.com.
Coronavirus disease 19 (COVID-19) has rarely been associated with immune thrombocytopenic purpura (ITP). Of the few cases reported, >90% had at least 1 symptom of COVID-19. In the November edition of JAAD Case Reports, Lobos et al reported a 22 year old healthy active male who presented via a tele-dermatology consultation with an asymptomatic petechial eruption on his lower extremities after vigorous exercise. His review of symptoms was negative for COVID-19 symptoms yet he had reported gingival bleeding and a buccal hematoma after a dental procedure 1 day prior. A full laboratory workup revealed a platelet count of 1000/μL and an oropharyngeal swab positive for SARS-Cov-2. Fortunately, he remained asymptomatic of COVID-19 symptoms and his platelet count and petechial eruption improved after receiving intravenous immunoglobulin and eltrombopag.Numerous cutaneous eruptions have been associated with COVID-19. Given the well-known association of viruses with ITP, it is not surprising that SARS-Cov-2 is added to this list. The case presented by Lobos et al is a great example of the utility of tele-dermatology during this pandemic and a stark reminder to have a low threshold on thoroughly investigating any petechial eruption regardless of symptomology.