Discussion
Since the start of the COVID-19 pandemic, numerous cases of psoriasis flares have been reported2-4. Both viral infection and medications used for treatment, like hydroxychloroquine, were incriminated3. In our case, the two possible causes are the viral infection and the emotional stress due to self-isolation. So far one case of guttate psoriasis secondary to COVID-19 has been reported in a patient with a past medical history of plaque psoriasis1. The delay of onset of psoriasis in this case was 6 days, similar to our case. A longer delay was observed in a patient who presented a new-onset pustular psoriasis 4 weeks after the beginning of COVID-19 symptoms. That was the first and the only case of new-onset psoriasis induced by COVID-19 described in the literature. The delay was explained by the fact that SARS-CoV-2 related inflammation has not yet resolved even though the patient was asymptomatic5. A dysregulation of innate immune response due to stimulation of toll-like receptor 3 by viral RNA leading to production of pathogenic cytokines (IL17, IL23) might be a possible mechanism for COVID 19 infection leading to psoriasis2.