Case Report Is It Stevens–Johnson Syndrome or MIS-C with Mucocutaneous Involvement? AbdollahKarimi, 1 ElhamPourbakhtiaran , 1 MazdakFallahi , 2 Fereshtehkarbasian , 3 Shahnaz Armin , 1 and Delara Babaie 2 1 Pediatric Infections Research Center, Research Institute for Children’s Health, ShahidBeheshti University of Medical Sciences, Tehran, Iran 2 Department of Allergy and Clinical Immunology, Mofid Children’s Hospital, ShahidBeheshti University of Medical Sciences, Tehran, IR, Iran 3 DepartmentofPediatricGastroenterologyandHepatology,NamaziHospital,ShirazUniversityofMedicalSciences,Shiraz,Iran Correspondence should be addressed to Delara Babaie; delara77@yahoo.com Received 4 August 2021; Revised 30 October 2021; Accepted 3 December 2021; Published 24 December 2021 Academic Editor: Ozgur Kasapcopur Copyright © 2021 Abdollah Karimi et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) can be present in the form of multisystem in- flammatory disease in children. Case Presentation. A 25-month-old boy presented with fever, malaise, diffuse maculopapular rashes, and mucosal involvement during the COVID-19 pandemic. He was first diagnosed with Stevens–Johnson syndrome (SJS). Further evaluation revealed lymphopenia, thrombocytopenia, and elevated levels of C-reactive protein (CRP), ferritin, and fibrinogen. is was followed by a positive polymerase chain reaction (PCR) test for COVID-19. In addition to receiving initial care for SJS, he was treated for MIS-C, which led to his recovery after four days. Conclusion. COVID-19 infection should be considered in children with fever and dermatological features during the pandemic because it may cause different features of the multisystem inflammatory syndrome in children (MIS-C), suggestive of delayed hyperimmune response. 1.Introduction A novel coronavirus, i.e., severe acute respiratory syndrome coronavirus-2, emerged in December 2019, which led to a pandemic in March 2020 [1]. According to the primary reports, the pediatric population was at a low risk [1, 2]. In April 2020, however, the Pediatric Intensive Care Society of the United Kingdom released an alert regarding an increased number of children tested positive for COVID-19 [1]. Several case reports and small series also emphasized the presentation of an acute illness with multiorgan failure and shock [1, 3, 4]. For instance, Riphagen et al. [5] conducted a research on eight children presented as the first report of hyperinflammatory conditions in the pediatric population due to COVID-19. All eight children presented with similar symptoms such as fever, conjunctivitis, peripheral edema, extremity pain, diarrhea, vomiting, and abdominal pain. ey also experienced refractory shock, but none of them experienced significant respiratory involvement. e most recent case reports described pediatric patients presenting with refractory shock symptoms resembling toxic shock syndrome (TSS) rather than Kawasaki disease (KD) [6, 7]. Moreover, patients with COVID-19 and a hyper- inflammatory state shared similar cytokine profiles, lymphocyte counts, and levels of inflammatory markers, which made hemophagocytic lymphohistiocytosis (SHLH)/macrophage activation syndrome (MAS) important in differential diagnosis [8, 9]. Although mucocutaneous manifestations are not among the top clinical manifestations of COVID-19 infection in the pediatric population, they are an important clinical mani- festation of multisystem inflammatory syndrome in children (MIS-C) [10]. ere is a wide range of skin manifestations including Stevens–Johnson syndrome (SJS)/toxic epidermal Hindawi Case Reports in Pediatrics Volume 2021, Article ID 1812545, 4 pages https://doi.org/10.1155/2021/1812545