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. 2020 Aug 19;100(15):5861. doi: 10.2340/00015555-3612

Fig. 2.

Fig. 2

Histopathological findings in erythema multiforme like and livedoid like patterns. (A, Haematoxylin & Eosin (H&E) 20x) COVID-19-positive patient, 65 years old. Erythema multiforme-like pattern. Presenting clinically with multiple targetoid lesions on the trunk. Lichenoid dermatitis composed of CD8+ lymphocytes showing marked epidermotropism around necrotic acrosyringeal ducts (arrows). (B, H&E 10x) Patient at high risk of COVID-19, PCR swab-negative, 33 years old. Under lockdown at home with COVID-19-positive wife. Presenting clinically with target-like lesions on elbows and hands. Patchy perivascular band-like infiltration, particularly around acrosyringeal ducts and sparse necrotic keratinocytes. (C, H&E 40x) Patient at high risk of COVID-19, PCR swab-negative, 25 years old. Under lockdown at home with COVID-19-positive partner. Target-like lesions on elbows and hands. Multiple small thrombi in vessels of the deep dermis (arrows). (D, H&E 4x) COVID-19-positive 64-year-old patient. Erythema multiforme-like pattern. Presenting clinically with multiple papulo-squamous lesions on the trunk. Band-like infiltration involving the epidermis (arrow). In the dermis, vertically arranged and swollen dermal ducts surrounded by lymphocytes (arrow). Inset: diffuse epidermotropic infiltration with necrotic keratinocytes. (E, H&E 20x) Patient at high risk of COVID-19, 51 years old. Fever cough, ageusia, PCR swab not performed. Presenting clinically with polymorphic rash (targetoid, livedoid and maculo-purpuric). Band-like diffuse epidermotropic lymphocytic infiltration. Necrotic keratinocytes in the epidermis (arrows), lymphocytic infiltration involving eccrine dermal ducts (arrow). Inset: Cuticular positivity of the eccrine gland using the SARS-CoV-2 (2019-nCoV) nucleocapsid antibody. (F, H&E 50x) COVID-19 PCR swab-positive intubated 49-year-old patient. Livedoid thrombotic-like pattern. Presenting clinically with diffuse livedo vasculitis on the trunk and legs. A medium-sized thrombosed vessel in the deep dermis. (G, H&E 10x and 40x) Patient at high risk of COVID-19, 8 years old, PCR swab-negative. Under lockdown at home with COVID-19-positive mother. Livedoid thrombotic-like pattern. Presenting clinically with diffuse target-like lesions. Extreme vascular proliferation of endothelial cells with small thrombi.