LAUSR

DEAR EDITOR, A 23-year-old woman presented with vesiculobullous lesions in the lips with an erythematous halo (a, b). She also presented with fever and dry cough starting 3 days before. Polymerase chain reaction for SARS-CoV-2 was positive. Treatment with systemic dexamethasone resulted in complete remission of the lesions by the eighth day. Lip biopsy showed moderate lymphocytic infiltrate and microvascular thrombosis. Immunohistochemistry for the SARS-CoV-2 spike protein was positive in inflammatory endothelial cells and keratinocytes, and acinar and ductal cells of the minor salivary glands (c, d). Herpes simplex virus (HSV)-1, HSV-2, human herpesvirus-3 and cytomegalovirus were negative. Previous studies reported oral lesions in patients with COVID-19, but our group demonstrated microvascular thrombi by histology. To our knowledge, this is the first report showing the SARS-CoV-2 spike protein in oral lesions of patients with COVID-19.