{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:52:16Z","timestamp":1787061136028,"version":"build-2736575974"},"reference-count":17,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T00:00:00Z","timestamp":1654560000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a viral infection involving multi-organ manifestations. The main oral symptoms of COVID-19 associated are taste loss and xerostomia, but literature has reported other oral manifestation, such as oral blisters, ulcers, vesicles and other immunological lesions. This case report showed an Erythema Multiforme (EM) manifesting as oral mucosa lesions in a patient with a late diagnosis of COVID-19 infection. Case Presentation: A 30 years-old Caucasian woman was sent to an oral medicine office, in order to manage painful and oral mucosa lesions associated with target symmetrical skin lesions. Oral examination revealed extensive ulcers in the mouth and crusts on the lips. Based on clinical examinations, a diagnosis of Erythema Multiforme major was made and a drug therapy with steroids was administered. Five days after the specialist visit, the patient discovered that she was positive for COVID-19. The complete recovery occurred in 3 weeks. Conclusion: Confirming the literature studies, EM is an early disease associated with COVID-19 infection.<\/jats:p>","DOI":"10.3390\/pathogens11060654","type":"journal-article","created":{"date-parts":[[2022,6,12]],"date-time":"2022-06-12T23:55:24Z","timestamp":1655078124000},"page":"654","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Erythema Multiforme as Early Manifestation of COVID-19: A Case Report"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8509-2255","authenticated-orcid":false,"given":"Gaspare","family":"Palaia","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Pernice","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8885-0496","authenticated-orcid":false,"given":"Daniele","family":"Pergolini","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Impellizzeri","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Migliau","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Gambarini","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2439-2187","authenticated-orcid":false,"given":"Umberto","family":"Romeo","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2679-7607","authenticated-orcid":false,"given":"Antonella","family":"Polimeni","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"395","DOI":"10.14639\/0392-100X-N1584","article-title":"COVID-19 manifestation in the oral cavity\u2013a narrative literature review","volume":"41","author":"Kusiak","year":"2021","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"726753","DOI":"10.3389\/fmed.2021.726753","article-title":"Oral Manifestations of COVID-19: Updated Systematic Review With Meta-Analysis","volume":"8","author":"Aragoneses","year":"2021","journal-title":"Front. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1111\/ced.14281","article-title":"Erythema multiforme-like eruption in patients with COVID-19 infection: Clinical and histological findings","volume":"45","year":"2020","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2055","DOI":"10.3389\/fimmu.2020.02055","article-title":"COVID-19: Infection or Autoimmunity","volume":"11","author":"Icenogle","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1038\/s41584-021-00608-z","article-title":"Systemic and organ-specific immune-related manifestations of COVID-19","volume":"17","author":"Mariette","year":"2021","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"31","DOI":"10.20411\/pai.v6i1.417","article-title":"The intersection of COVID-19 and autoimmunity: What is our current understanding?","volume":"6","author":"Winchester","year":"2021","journal-title":"Pathog. Immun."},{"key":"ref_7","first-page":"S22","article-title":"Anosmia, hyposmia, and dysgeusia as indicators for positive SARS-CoV-2 infection","volume":"17","author":"Lao","year":"2020","journal-title":"World J. Otorhinolaryngol. Head Neck Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1002\/cre2.332","article-title":"How to deal with coronavirus disease 2019: A comprehensive narrative review about oral involvement of the disease","volume":"7","author":"Capocasale","year":"2021","journal-title":"Clin. Exp. Dent Res."},{"key":"ref_9","first-page":"e14717","article-title":"COVID-19 from the perspective of dentists: A case report and brief review of more than 170 cases","volume":"34","author":"Hosseinzadeh","year":"2021","journal-title":"Dermatol. Ther."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1016\/j.oooo.2020.07.014","article-title":"Oral lesions in patients with SARS-CoV-2 infection: Could the oral cavity be a target organ?","volume":"131","author":"Gueiros","year":"2021","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2217\/fvl-2020-0333","article-title":"Erythema multiform-like lesions in a patient infected with SARS-CoV-2: A case report","volume":"16","author":"Fathi","year":"2021","journal-title":"Future Virol."},{"key":"ref_12","first-page":"1148945","article-title":"Oral Manifestations of Exudative Erythema Multiforme in a Patient with COVID-19","volume":"8","author":"Dalipi","year":"2021","journal-title":"Case Rep. Dent."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"102591","DOI":"10.1016\/j.amsu.2021.102591","article-title":"Erythema multiforme eruption due to SARS-COV 2: Case report","volume":"68","author":"Bouabdella","year":"2021","journal-title":"Ann. Med. Surg."},{"key":"ref_14","first-page":"e20814","article-title":"Erythema Multiforme-Like Presentation in an Asymptomatic COVID-19 Patient","volume":"13","author":"Tahir","year":"2021","journal-title":"Cureus"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e139","DOI":"10.1016\/j.oooo.2021.06.019","article-title":"Stevens-Johnson syndrome post second dose of Pfizer COVID-19 vaccine: A case report","volume":"132","author":"Elboraey","year":"2021","journal-title":"Oral. Surg. Oral. Med. Oral. Pathol. Oral. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e15416","DOI":"10.1111\/dth.15416","article-title":"An extremely rare mucocutaneous adverse reaction following COVID-19 vaccination: Toxic epidermalnecrolysis","volume":"35","author":"Mardani","year":"2022","journal-title":"Dermatol. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Impellizzeri, A., Dilucca, M., Squillace, F., Guarnieri, R., Polimeni, A., and Galluccio, G. (2021). Psychological and Physical Distress in Italian People during COVID-19 Pandemic: One Year Later. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182312525"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/11\/6\/654\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:25:15Z","timestamp":1760138715000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/11\/6\/654"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,7]]},"references-count":17,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["pathogens11060654"],"URL":"https:\/\/doi.org\/10.3390\/pathogens11060654","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,7]]}}}