Persistent Fever and Rising CRP in a Patient With Pustular Psoriasis Deceived the Medical Team to Consider Her as a Case of COVID-19 During the Pandemic

Zahra Saffarian; Shahin Hamzelou; Fateme Shirzad Moghadam

doi:10.18502/acta.v59i8.7259

Zahra Saffarian Department of Dermatology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Shahin Hamzelou Department of Dermatology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Fateme Shirzad Moghadam Department of Dermatology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/acta.v59i8.7259

Keywords: Psoriasis; Coronavirus disease 2019 (COVID-19); Biological treatment; Infliximab

Abstract

Generalized pustular psoriasis is a rare variant of pustular psoriasis. During the pandemic of COVID-19, every patient referred to medical centers with fever or other flu-like symptoms would be first evaluated for COVID-19. Here, we report a case of pustular psoriasis who were under biologic immunosuppressive treatment (Infliximab) and was admitted to take her every eight weeks injection of infliximab. During evaluations before the injection, persistent fever and high CRP was detected. Due to these findings, she was suspected of having COVID-19, and this suspicion delayed routine medical care and infliximab infusion for her main disease, pustular psoriasis. After two negative results of the COVID-19 PCR test, Infliximab infusion was done, and surprisingly the fever disappeared, and CRP level decreased.