Dear Editor, A 23‐year‐old woman presented with vesiculobullous lesions in the lips with an erythematous halo (a, b). She also presented with fever and dry cough starting 3 days before. Polymerase chain reaction for SARS‐CoV‐2 was positive. Treatment with systemic dexamethasone resulted in complete remission of the lesions by the eighth day. Lip biopsy showed moderate lymphocytic infiltrate and microvascular thrombosis. Immunohistochemistry for the SARS‐CoV‐2 spike protein was positive in inflammatory endothelial cells and keratinocytes, and acinar and ductal cells of the minor salivary glands (c, d). Herpes simplex virus (HSV)‐1, HSV‐2, human herpesvirus‐3 and cytomegalovirus were negative. Previous studies reported oral lesions in patients with COVID‐19, but our group demonstrated microvascular thrombi by histology.1, 2 To our knowledge, this is the first report showing the SARS‐CoV‐2 spike protein in oral lesions of patients with COVID‐19.
Author Contribution
Ciro Dantas Soares: Conceptualization (equal); Data curation (equal); Formal analysis (equal); Project administration (equal). Adalberto Mosqueda‐Taylor: Supervision (equal); Validation (equal); Writing‐review & editing (equal). Maria Goretti Freire Carvalho: Conceptualization (equal); Data curation (equal). Oslei Paes de Almeida: Supervision (equal); Writing‐review & editing (equal).
Contributor Information
C.D. Soares, University of Campinas Piracicaba São Paulo Brazil Laboratório de Citopatologia Private Service Natal RN Brazil.
A. Mosqueda‐Taylor, Health Care Department Universidad Autónoma Metropolitana Xochimilco Mexico
de M.G.F. Carvalho, Laboratório de Citopatologia Private Service Natal RN Brazil.
de O.P. Almeida, University of Campinas Piracicaba São Paulo Brazil.
References
- Martín Carreras‐Presas C, Amaro Sánchez J, López‐Sánchez AF, et al. Oral vesiculobullous lesions associated with SARS‐CoV‐2 infection. Oral Dis 2020; 10.1111/odi.13382. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Soares CD, Carvalho RA, Carvalho KA et al. Letter to Editor: Oral lesions in a patient with Covid‐19. Med Oral Patol Oral Cir Bucal 2020; 25:e563–4. [DOI] [PMC free article] [PubMed] [Google Scholar]