Background: Cutaneous manifestations in hospitalized children with SARS-CoV-2 have not been studied systematically.Objective: To describe the mucocutaneous involvement in pediatric patients with COVID-19 admitted to a pediatric institution in Madrid (Spain), located in a zone reporting among the highest prevalence of COVID-19 in Europe.

Skin manifestations in patients with COVID-19 have been extensively reported, mostly in adults. 1,2 Skin lesions in children with proven COVID-19 are much less frequent 3 and may show specific features not seen in adults, such as those associated with the multisystem inflammatory syndrome in children (MIS-C). 4 Once the microbiologic test for SARS-CoV-2 became widely available for all suspected cases in our institution (not only for admitted patients), we were able to diagnose the first case of acral pulpitis as an isolated sign of COVID-19 in children. 5 Due to the mild nature of this presentation, in December 2020, we recruited similar cases through an advertisement on the "Spanish Primary Care Pediatric Association" website.We present a series of six children infected with SARS-CoV-2 who presented with mild erythema and desquamation of the fingertips and/or toes as the only skin manifestation of COVID-19.Otherwise, all children had asymptomatic to mildly symptomatic disease. | C A S E REP ORTSData were collected anonymously. We recorded age, sex, personal history of previous diseases, previous treatments, epidemiologic background, skin symptoms, type and location of lesions, systemic symptoms, microbiological test performed, and therapies administered.Approval from the institutional Ethics Committee and Board was obtained. Informed consent was obtained for recording images in all patients.Six patients (four male and two female), age range 5-13 years, were included. Five had a positive microbiologic test for SARS-CoV-2 (three positive real-time polymerase chain reaction for SARS-CoV-2 and two positive rapid antigenic test). One patient had a negative

Introduction: Endemic coronaviruses have been found in acute bronchiolitis, mainly as a coinfecting virus. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been responsible for respiratory illness in hospitalized children. The characteristics of patients with bronchiolitis have not been extensively described.Methods: Cross-sectional study of patients with bronchiolitis and SARS-CoV-2 infection enrolled in a prospective multicenter cohort of children hospitalized with

A previously healthy breastfed 7-month-old infant presented with several papulovesicular lesions, a hyperemic pharynx and a petechial enanthema. His mother had confirmed monkeypox infection with similar skin lesions on the chest wall. Skin-to-skin contact is the most likely mode of transmission of monkeypox.Precautions to limit skin contact during activities such as breastfeeding are recommended if suspected skin lesions are present.

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Background The COVID‐19 pandemic has brought innumerable reports of chilblains. The relation between pernio‐like acral eruptions and COVID‐19 has not been fully elucidated because most reported cases have occurred in patients with negative microbiological tests for SARS‐CoV‐2. Methods A retrospective study of 49 cases of chilblains seen during the first year of the pandemic in a children's hospital in Madrid, Spain. The incidence of these skin lesions was correlated with the number of COVID‐19 admissions and environmental temperatures. Patients were separated into two groups depending on the day of onset (strict lockdown period vs. outside the lockdown period). Results Most chilblains cases presented during the first and third waves of the pandemic, paralleling the number of COVID‐19 admissions. The first wave coincided with a strict lockdown, and the third wave coincided with the lowest ambient seasonal temperatures of the year. Systemic symptoms preceding chilblains were more frequent in the first wave (45.8% vs. 8.0%, p = .002), as was the co‐occurrence with erythema multiforme‐like lesions (16.7% vs. 0%, p = .033). Laboratory test and skin biopsies were performed more frequently in the first wave (75.0% vs. 12.0%, p < .001; and 25.0% vs. 0%, p = .007; respectively). Five patients developed recurrent cutaneous symptoms. Conclusions An increased incidence of chilblains coincided not only with the two major waves of the pandemic, but also with the strict lockdown period in the first wave and low seasonal temperatures during the third wave. Both increased sedentary behaviors and cold environmental temperatures may have played an additive role in the development of COVID‐19‐related chilblains.

Streptococcus dysgalactiae subspecies equisimilis infection is an emerging pathogen. Cutaneous and systemic manifestations resemble those of other pyogenic streptococci. However, the rapid group A antigen detection test used to diagnose Streptococcus pyogenes infection is usually negative, making the diagnosis difficult. If clinical suspicion of streptococcal infection is high, a tonsillar culture should be performed to confirm the diagnosis.

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