Cutaneous hyperalgesia in the setting of COVID-19 infection: reporting 2 cases from North India


  • Ipshita Bhattacharya Department of Dermatology, Venereology and Leprosy, ESI-PGIMSR Hospital, New Delhi, India
  • Ananta Kanwar Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India
  • Keshav Sachdeva Department of Cardiology, Batra Hospital and Medical Research Centre, New Delhi, India
  • Vishnu Choudhary Department Of Dermatology, Venereology and Leprosy, Brijesh Banger Hospital, Bhilwara, Rajasthan, India



COVID-19, COVID infection, Cutaneous hyperalgesia


COVID-19 (Coronavirus disease) infection can manifest with a variety of dermatological and neurological symptoms which might have similar underlying patho-mechanisms. Here we report 2 cases of rt-PCR (Real time PCR) positive COVID infection who developed cutaneous hyperalgesia during the illness and review the case reports, case series, and other literature available on this symptom. We found that out of the total 13 reported cases (including the two cases reported here), most common onset of this symptom was within the first 3 days of illness (median duration ten days). Common sites of involvement included abdomen and back, but chest, arms and legs could also be involved. Warm baths, gabapentin and pregabalin showed good efficacy in relieving the symptom. The exact pathogenesis remains unclear but is hypothesised to be due to the neurotrophic properties of the virus and/or the inflammatory cytokines released during the illness. Further studies are necessary to expand the scope of knowledge in this regard.


Krajewski PK, Maj J, Szepietowski JC. Cutaneous Hyperaesthesia in SARS-CoV-2 Infection: Rare but not Unique Clinical Manifestation. Acta derm venereol. 2020.

Harsch IA, Atudorei I, Frank K. Is there a link between COVID-19 and cutaneous hyperesthesia? Confirmation of a recent observation. GMS Hygiene and Infection Control. 2021;16.

Aksan F, Nelson EA, Swedish KA. A COVID-19 patient with intense burning pain. J neurovirol. 2020;26(5):800-1.

Jindal R, Chauhan P. Cutaneous manifestations of coronavirus disease 2019 in 458 confirmed cases: A systematic review. J family med pri care. 2020;9(9):4563.

Krajewski PK, Szepietowski JC, Maj J. Cutaneous hyperesthesia: A novel manifestation of COVID-19. Brain, Behavior Immunity. 2020;1.

Shrestha M, Chen A. Modalities in managing postherpetic neuralgia. Korean j pain. 2018;31(4):235.

Singh S, Gupta R, Kaur S, Kaur J. Post-herpetic neuralgia: A review of current management strategies. Indian J Pain. 2013;27(1):12.

Das M, Penn C, Martinez T, Mayilsamy K, McGill A, Wiling A et al. COVID-19 neurotropism and implications for therapy. Neuroimmunol Neuroinflammation. 2020;7(2):141-9.

Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. ACS Chem Neurosci. 2020;10.

Song Z, Xu Y, Bao L, Zhang L, Yu P. From SARS to MERS, thrusting coronaviruses into the spotlight. Viruses. 2019;11.






Case Reports