Chilblain‐like lesions in children following suspected COVID‐19 infection

Abstract

During the COVID‐19 pandemic, chilblain‐like lesions have been reported in mildly symptomatic children and adolescents. We present four children investigated for suspected COVID‐19 infection who presented with acral skin findings and mild systemic symptoms. Histology from one case showed signs of vasculitis with evident fibrin thrombus.

Cutaneous manifestations associated with COVID-19 in children: A Systematic Review

“…Acrally located erythematous to violaceous maculopapular lesion having blurred edges, occasionally with super cial bullae and focal hemorrhagic crust was the most common nding in 127 children. [16], [20], [24], [25], [26] A similar but larger lesion as erythematous to purpuric plaques with occasional macules was reported in 11 cases. [16], [19] [21], [27] Erythema multiforme like lesion observed in 6 cases, consisted of target and targetoid, con uent macules, papules and plaques of different sizes, few with bleeding and crust at the center with the involvement of conjunctiva in one and mucous membrane in one patient each.…”

“…[16], [20], [24], [25], [26] A similar but larger lesion as erythematous to purpuric plaques with occasional macules was reported in 11 cases. [16], [19] [21], [27] Erythema multiforme like lesion observed in 6 cases, consisted of target and targetoid, con uent macules, papules and plaques of different sizes, few with bleeding and crust at the center with the involvement of conjunctiva in one and mucous membrane in one patient each. [17] [18], [23] Bilaterally symmetrical varicella like exanthem presented as erythematous papules & vesicles with super cial vesiculation & crust formation, on the trunk, in an 8-year female child.…”

“…URI and GI symptoms together were present in 10 cases. Radiologic evidence of pneumonia was present in 2 patients; both were under 5 years of age and negative for RT PCR (16,18). The incubation period varied from less than 10 days (n=10) to 30 days (n=32) with more than 60 days in a 5-year-old boy having pneumonia but negative RT PCR.…”

“…[11], [12] [13], [14] [15] Thus, a total of 13 articles met the inclusion criteria and were systematically reviewed. Out of that 5 were case series, [16], [17] [18], [19] [20] 4 were case reports, [21], [22] [23], [24] and 4 were original studies. [25], [26] [27], [28] Maximum number of articles were reported from Italy, [16], [19] [20], [21] [22], [24] [26] followed by Spain, [17] [23], [25] France, [8] Turkey, [28] and USA.…”

“…The incubation period varied from less than 10 days (n=10) to 30 days (n=32) with more than 60 days in a 5-year-old boy having pneumonia but negative RT PCR. [16] Symptomatic treatment with antihistaminic, topical steroid or antibiotic was given in 41, Oral short course steroid in 2 and IV immunoglobulins in one patient with Kawasaki Disease like presentation. No cutaneous sequelae were reported in any study.…”