SHM Converge Scientific Abstract ePoster Gallery-Rime With a Reason: Covid-Induced Rime Disease

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Northwell Health is New York State’s largest health care provider and private employer, dedicated to improving community health through high-quality clinical care, medical education, biomedical research, health education, and care for all regardless of ability to pay. It operates 23 hospitals and more than 700 outpatient sites, with a large network of affiliated physicians.<br /><br />The document also presents a clinical case about COVID-induced RIME (Reactive Infectious Mucocutaneous Eruption). RIME is characterized by mucositis affecting two or more mucosal sites and is usually triggered by infection through molecular mimicry. In the case described, a 75-year-old woman with anal cancer, lupus, and recent chemotherapy developed weakness, sore throat, mouth sores, fever, lip swelling, and pustular lesions. Her exam showed hemorrhagic and crusted lips and buccal mucosal erosions. Testing revealed COVID-19 positivity and elevated inflammatory markers, and skin biopsy showed interface dermatitis with subepidermal separation and epidermal necrosis, suggesting RIME versus Stevens-Johnson syndrome (SJS).<br /><br />She was treated with prednisone, antibiotics, remdesivir, and later clobetasol ointment, with improvement over several days and discharge after a five-day steroid course. The case emphasizes that RIME should be considered in COVID patients with mucosal lesions, and that distinguishing it from SJS depends on the extent of skin involvement, pain, systemic toxicity, and likely trigger. RIME generally has limited skin involvement, is often painless, infection-related, and has a better prognosis than SJS, which is usually drug-induced and more severe.

Asset Subtitle

Leanna R. Smith

Meta Tag

Author List Farhana Begum, Jared S. Honigman Do, Leanna R. Smith

Category Clinical Vignettes

Concept Reactive Infectious Mucocutaneous Eruption

Concept Mucositis

Concept Stevens-Johnson Syndrome

Concept Mucosal Site

Concept Infectious Trigger

Distinguished Non-Finalist

Presenter Organization Northwell Health

Presenting Author Leanna R. Smith

Track Adult

Keywords

Northwell Health

New York healthcare provider

COVID-induced RIME

Reactive Infectious Mucocutaneous Eruption

mucositis

Stevens-Johnson syndrome

COVID-19 infection

mucosal lesions

prednisone treatment

remdesivir therapy

Reactive Infectious Mucocutaneous Eruption

Mucositis

Stevens-Johnson Syndrome

Mucosal Site

Infectious Trigger