Kawasaki disease with persistent severe psoriatic-like skin manifestations and sudden cardiac death

This case report describes a 1.3-year-old infant with an atypical presentation of Kawasaki Disease (KD) following exposure to COVID-19 within the family and positive SARS-CoV-2 IgG antibodies. The clinical course was marked by significant left ventricular (LV) dysfunction, progressive coronary artery involvement, and complicated by severe dermatologic manifestations including Steven-Johnson-like lesions and psoriatic-like eruptions. Despite initial improvement in cardiac function, the infant developed multiple coronary aneurysms and succumbed to sudden cardiac death. This case highlights the diagnostic and therapeutic challenges in managing atypical KD in the context of COVID-19. We describe the case and review the literature related to the associated severe skin lesions.