1.2 Virus induced vesicular eruptions
Virus induced vesicular eruptions are quite common for herpes simplex
virus or varicella zoster virus induced skin lesions in which the
vesicles are caused by intraepidermal blister and epithelial necrosis.
Either reticular degeneration of the epidermis or ballooning of
keratinocytes might cause intraepidermal vesicle formation (53,
54 ) (Table 2). Another example for virus induced vesicular eruptions
are caused by Coxsackie A16 virus, an enterovirus, which is responsible
for Hand-foot-and mouth diseases. Intraepidermal vesicles with reticular
degeneration and ballooned cells are characteristic features. Papillary
edema and mild perivascular infiltrates might be detectable as well. In
all of those virus induced skin eruptions, viral antigens are detectable
in various cutaneous structures using different methods such as antibody
staining, electron-microscopy or others (53, 54 ).
Whether vesicular eruptions observed in part of the COVID-19 patients
are caused by SARS-CoV-2, needs to be evaluated in further studies.
Some reports of erythemato-violaceous papules and patches with a
pseudo-vesicle in the center, resembling erythema-multiforme and an
enanthem of the oral cavity in some of those patients during or after
improvement of COVID-19 symptoms exist (55-58 ). If those
lesions are related to SARS-CoV-2 infection or drugs applied in this
context or both remains to be elucidated in further studies.