en Infectious Disease Infectious Disease case report case report COVID-19 was first discovered in Wuhan, China, and has spread rapidly around the world. The most important manifestation of COVID-19 was ARDS-like lung injury at first, but the involvement of other organs, such as kidney, heart, liver, and skin, was gradually reported. It is important to report and share all atypical manifestations of this disease to help other physicians to gain more knowledge about this new viral disease. As mentioned, there are also studies that show different types of cutaneous involvement in these patients, but due to the lack of more detailed studies in this field, and on the other hand, the possible usefulness of skin lesions as a diagnostic or alarming sign in the COVID-19 era, in this study we report a COVID-19 patient with a large hemorrhagic blister similar to sepsis-induced skin lesion. Despite the lack of common symptoms of the disease, the lung scan of the patient was positive for COVID-19. COVID-19, Skin lesion, Extra pulmonary complication, Cutaneous manifestation, Coagulopathy, Hemorrhagic bullae, Vascular injury, Vasculitis, Vasculopathy 110 113 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-6204-1&slc_lang=en&sid=1 Mohammad Karimi Alavije med_vir@yahoo.com 200319475328460063487 200319475328460063487 No Department of Infectious Diseases, Imam Reza Hospital, Amol, Iran Mohammad Hadi Karbalaie Niya mohamad.karbalai@yahoo.com 200319475328460063488 200319475328460063488 No Gastrointestinal and Liver Diseases Research Center, & Department of Virology, Iran University of Medical Sciences, Tehran, Iran Afsaneh Sadeghzadeh-Bazargan DR.MHKN@YAHOO.COM 200319475328460063489 200319475328460063489 No Department of Dermatology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Mehdi Nikkhah nikkhahmd@yahoo.com 200319475328460063490 200319475328460063490 No Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran Amirhossein Faraji amir.hfaraji@yahoo.com 200319475328460063491 200319475328460063491 No Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran Nima Motamed nima.motamed@gmail.com 200319475328460063492 200319475328460063492 No Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, Iran Fahimeh Safarnezhad Tameshkel fahime.1615@yahoo.com 200319475328460063493 200319475328460063493 No Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran Farhad Zamani zamani.f@iums.ac.ir 200319475328460063494 200319475328460063494 Yes Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran