J Oral Med Oral Surg
Volume 26, Number 2, 2020
|Number of page(s)||1|
|Section||Lettre à la rédaction / Letter to the editor|
|Published online||30 April 2020|
Letter to the Editor
Oral manifestation of Covid-19 as an inaugural symptom?
Département de Chirurgie Orale, Faculté d'Odontologie, Université Claude Bernard Lyon I, Lyon, France
2 Unité de chirurgie cervico-faciale, Centre Régional de Lutte contre le Cancer Léon Bérard, Lyon, France
* Correspondence: email@example.com
Accepted: 12 April 2020
Covid-19 has a huge range of clinical manifestations and, due to the high number of patients involved, the diagnosis is mostly based on clinical findings or suspicions .
A 45-years-old female patient presented with an irregular ulcer on the dorsal side of the tongue (Fig. 1a). History of the lesion revealed 24 h painful inflammation of a tongue papilla, followed by 24 h of erythematous macula, which evolved into irregular and asymptomatic ulcer. After 10 days, the ulcer completely healed without scar.
At Day 3, after occurrence of the oral lesion, an erythematous plane lesion appeared on the big toe (Fig. 1b). It was also painful during 48 h and then became asymptomatic. General symptoms were mild asthenia. Considering the general aspects of the lesions, and despite a lack of general status alterations and symptoms, a nasopharyngeal Covid-19 test was performed at Day 8. The test was positive.
Cutaneous lesions related to Covid-19 have been described  and reported by dermatologists, but to our knowledge, oral lesions have not been yet described with a proven Covid-19 infection. The irregular ulcer observed occurred after a short time of macular erythematous lesion, which could be explained by vasculitis. Coronavirus disease 2019 is associated with a variable inflammatory reaction that can induce vascular inflammation . Erythematous rash has been described  and could also be explained by an inflammatory reaction.
Thus, this irregular oral ulcer could be an inaugural symptom of Covid-19 which needs to be proven in larger cohorts of patients.
The authors have no conflict of interest to declare.
Patient's consent has been obtained for publication.
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© The authors, 2020
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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