Skin Rashes After Using Hydroxychloroquine in a COVID-19 Patient

Hydroxychloroquine is an antimalarial drug which is also used in various chronic diseases such as systemic lupus erythematosus and rheumatoid arthritis because of its anti-inflammatory and antiviral effects. Recently, it's frequently preferred as a treatment alternative in the COVID-19 pandemic. Skin side effects of hydroxychloroquine range from side effects such as pruritus, urticaria, alopecia, dry skin, pigment changes, redness to serious Stevens-Johnson-like life-threatening rashes. Herein, we report a patient who was infected with COVID-19 and started hydroxychloroquine and had a rash on her hands after a short time. Contact dermatitis is one of the first diagnoses to be considered in the differential diagnosis, since lesions are only seen on the hand. Our patient did not respond despite the use of topical corticosteroids, which are used as the first step in the treatment of contact dermatitis. Another disease that should be considered in the differential diagnosis of our patient is phototoxic and photoallergic contact dermatitis, which is well-known to be caused by hydroxychloroquine. Although it is clinically difficult to distinguish contact dermatitis from photo-induced dermatitis, the fact that our patient was exposed to intense sunlight during drug use is a clue to the diagnosis of photo-induced skin reaction.