Stevens-Johnson syndrome as a primary skin manifestation of COVID-19.

A 75-year-old lady presented to us with a 2-day history of fever, runny nose and cough. She was tested positive for COVID-19. The patient had mild symptoms and was admitted for observation due to her advanced age. No medication was given as she had been symptom-free after admission. On day 9 of illness, she developed extensive oral ulcers with generalised purpuric macules which were predominantly axial in distribution (figure 1). The illness was also associated with malaise, poor appetite, conjunctivitis and genital ulcers. She had negative cultures and serology for all other infections screened. Skin biopsy showed focal subepidermal separation, epidermal necrosis, basal cell vacuolation, dyskeratosis …