Chilblains in a child with confirmed SARS‐CoV‐2 infection: a red flag for late‐onset skin manifestation in previously infected individuals

Neri, Iria; Conti, Francesca; Virdi, Annalucia; Guglielmo, Alba; Leonardi, Lucia; Corsini, Ilaria; Ghizzi, Chiara; Gabrielli, Liliana; Lazzarotto, Tiziana; Lanari, Marcello; Patrizi, Annalisa; Misciali, Cosimo

doi:10.1111/jdv.17194

Cited by 6 publications

(21 citation statements)

References 10 publications

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“…In 470 cases, they were macules, papules or a combination of the two; plaques or patches were also reported in 27 cases ( 12 , 16 , 17 , 26 , 28 , 29 , 31 , 38 , 40 – 43 , 46 – 48 , 51 , 54 , 55 ). Eight lesions were macules or patches, 6 were reported as nodules, 1 was papulopustular, and 1 was reported as palpable ( 23 , 30 , 33 , 35 , 38 ). One hundred and fifty-six lesions were reported as chilblain or chilblain-like ( 14 , 18 , 25 , 33 , 48 – 50 , 56 , 57 ).…”

Section: Resultsmentioning

confidence: 99%

“…Eight lesions were macules or patches, 6 were reported as nodules, 1 was papulopustular, and 1 was reported as palpable ( 23 , 30 , 33 , 35 , 38 ). One hundred and fifty-six lesions were reported as chilblain or chilblain-like ( 14 , 18 , 25 , 33 , 48 – 50 , 56 , 57 ). Six were described as dusky ( 6 , 19 , 20 , 55 ).…”

Section: Resultsmentioning

confidence: 99%

“…There were 24 cases with lesion blanching, and 23 cases with ulcers ( 10 , 11 , 13 , 22 , 38 ). Desquamation was reported in seven cases, and in 20 cases, desquamation, peeling, scabs, and scale were reported together ( 11 , 22 – 24 , 26 , 33 , 34 ). Less common findings included crusts (14), acrocyanosis (13), hyperhidrosis (10), livedo or livedo-like (8), acrorhigosis (7), pulpitis (7), eccrine hidradenitis-like (6), telangiectasia (4), acrocholosis (3), urticaria (3), pustules (3), erythema nodosa (2), targetoid (2), cheilitis (1), cyanotic lesions (1), scale (1), and petechiae ( 1 , 10 , 17 , 19 – 21 , 26 , 28 , 40 , 43 , 47 , 48 , 51 , 54 ).…”

Section: Resultsmentioning

confidence: 99%

“…There was a predilection for the toes and heels: 154 and 40 cases respectively ( 6 , 10 – 13 , 16 – 18 , 20 – 23 , 26 , 27 , 29 – 33 , 35 – 38 , 40 – 42 , 46 , 51 , 53 – 55 ). Additionally, 34 lesions were reported on the soles, 26 on the dorsum of the feet, 12 on the fingers, nine on the palms, and seven on the dorsum of the toes ( 6 , 12 , 16 , 19 – 22 , 26 , 28 – 31 , 33 – 38 , 40 , 42 – 44 , 51 , 53 , 55 ). Other locations included the dorsum of the hands in three cases, the ankles in three cases, the face in two cases, and the lateral aspects of the feet in one case ( 6 , 12 , 16 , 18 – 21 , 23 , 26 , 33 , 37 , 38 , 42 , 44 , 54 , 55 ).…”

Section: Resultsmentioning

confidence: 99%

“…Lymphocytes were commonly reported as the dominant tissue infiltrate and were present in 129 instances; CD3+ T lymphocytes were reported in 14 samples ( 6 , 10 – 12 , 17 – 20 , 22 , 29 , 31 , 33 , 35 , 41 , 45 , 51 , 52 ). The infiltrate was perivascular in 75 cases, perieccrine in 42 cases, and periadenexal in 3 cases ( 6 , 10 – 12 , 18 – 20 , 22 , 31 , 33 , 35 , 41 , 45 , 51 , 52 ). CD20+ B cells were also reported in 12 instances ( 18 ).…”

Section: Resultsmentioning

confidence: 99%

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Chilblains-Like Lesions in Pediatric Patients: A Review of Their Epidemiology, Etiology, Outcomes, and Treatment

Fennell

Onel

2022

Front. Pediatr.

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Vascular pathologies associated with SARS-CoV-2 infection are poorly understood. Color and sensory changes to the extremities, often referred to as “COVID toes” or chilblains-like lesions, have been widely reported in children and adolescents since the onset of the pandemic, raising the concern that they could be a vasculitis secondary to the infection. However, it is unclear if the lesions are a result of the infection or an epiphenomenon. Most literature focuses on adults, and while there are reports on children and adolescents, many of them are small. This review will help medical care providers better understand the epidemiology, etiology, outcomes, and potential treatments for chilblains-like lesions seen in children and adolescents during the pandemic.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Chilblains-Like Lesions in Pediatric Patients: A Review of Their Epidemiology, Etiology, Outcomes, and Treatment

Fennell

Onel

2022

Front. Pediatr.

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Epidemiology and clinical evolution of non-multisystem inflammatory syndrome (MIS-C) dermatological lesions in pediatric patients affected by SARS-CoV-2 infection: A systematic review of the literature

et al. 2022

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COVID-19 can present with a range of skin manifestations, some of which specific of the pediatric age. The aim of this systematic literature review was to determine the type, prevalence, time of onset, and evolution of cutaneous manifestations associated with COVID-19 in newborns, children, and adolescents, after excluding multisystem inflammatory syndrome in children (MIS-C). PubMed, Tripdatabase, ClinicalTrials, and Cochrane Library databases were searched using an ad hoc string for case reports/series and observational studies, published between December 2019 and February 2022. Study quality was assessed using the STROBE and CARE tools. Seventy-three (49 case reports/series and 24 studies) out of 26,545 identified articles were included in the analysis. Dermatological lesions were highly heterogeneous for clinical presentation, time of onset, and association with other COVID-19 manifestations. Overall, they mainly affected the acral portions, and typically presented a favorable outcome. Pseudo-chilblains were the most common. Conclusions : Mucocutaneous manifestations could be the only/predominant and early manifestation of COVID-19 that could precede other more severe manifestations by days or weeks. Therefore, physicians of all disciplines should be familiar with them. What is Known: • A variety of cutaneous manifestations have been reported in association with COVID-19. • Urticaria, maculopapular, or vesicular rashes can occur at any age, while chilblains and erythema multiforme are more common in children and young patients. What is New: • Skin lesions related to SARS-CoV-2 infection often show a peculiar acral distribution. • Mucocutaneous lesions of various type may be the only/predominant manifestation of COVID-19; they could present in paucisymptomatic and severely ill patients and occur at different stages of the disease. Supplementary Information The online version contains supplementary material available at 10.1007/s00431-022-04585-7.

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Dermatological Manifestations of COVID-19 in Children

2022

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Context The clinical picture of pediatric severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection differs from adults as do the cutaneous manifestations. In this review, we summarize the varied morphological manifestations of SARS-CoV-2 infection in the pediatric population. Evidence acquisition A comprehensive literature search was conducted (23 September, 2021) across multiple databases (PubMed, EMBASE, MEDLINE and Cochrane) with the relevant keywords. An additional filter of age group between 0–18 years was kept in each of the searches. Results Chilblains constitute the most common cutaneous manifestation of pediatric coronavirus disease (COVID-19). Other commonly reported manifestations include maculopapular rash, urticaria, erythema multiforme, and papulovesicular eruptions. Majority of children with these manifestations are asymptomatic, highlighting the need to clinically suspect and appropriately manage such patients. A subset of pediatric patients develop severe multisystem involvement termed as multi-system inflammatory syndrome in children (MIS-C) that has varied mucocutaneous manifestations. Conclusion A wide variety of dermatological manifestation of SARS-CoV-2 infection is reported, and both the pediatrician and dermatologist need to be aware of the same to suspect and diagnose COVID-19 infection in children. Electronic Supplementary Material Supplementary material is available in the online version of this article at 10.1007/s13312-022-2521-6.

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Chilblains in a child with confirmed SARS‐CoV‐2 infection: a red flag for late‐onset skin manifestation in previously infected individuals

Cited by 6 publications

References 10 publications

Chilblains-Like Lesions in Pediatric Patients: A Review of Their Epidemiology, Etiology, Outcomes, and Treatment

Chilblains-Like Lesions in Pediatric Patients: A Review of Their Epidemiology, Etiology, Outcomes, and Treatment

Epidemiology and clinical evolution of non-multisystem inflammatory syndrome (MIS-C) dermatological lesions in pediatric patients affected by SARS-CoV-2 infection: A systematic review of the literature

Dermatological Manifestations of COVID-19 in Children

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