Cutaneous manifestations of COVID-19 in children (and adults): A virus that does not discriminate

Abstract

COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a beta coronavirus with a characteristic S-glycoprotein ‘spike’ on the cell surface. 1 Initial reports did not include cutaneous manifestations as a feature of COVID-19; however, there is a growing repertoire of reports demonstrating an array of dermatologic manifestations on the skin in children and adults. Dermatologic afflictions have been summarized into different categories several times, with the most recent analysis identifying six clinical patterns: urticaria, maculopapular-morbilliform eruption, papulovesicular exanthem, chilblain-like acral pattern, livedo reticularis-livedo racemose pattern, and purpuric ‘vasculitic’ pattern. 2 In children, the dermatologic features appear to occur before or concomitantly with other COVID-19 manifestations. Dermatologists play a key role in diagnosing patients with COVID-19 who may present for the first time unwittingly exhibiting early signs of COVID-19. We have reviewed the current evidence on the dermatologic impact of COVID-19 in both the adult and pediatric population.

Dermatological manifestations associated with COVID‐19: A comprehensive review of the current knowledge

“… 28 May involves about 6% of the patients, 25 these lesions are first symmetrical and lace‐like, resulting from cutaneous vasoconstriction or vascular flow disturbances and disappearing by themselves. 29 On the other hand, the latter usually consisted of more oversized, more irregular, and asymmetrical lesions related to focal blood flow disturbances and may be associated with severe coagulopathies. These eruptions are more common in the elderly and patients with severe COVID‐19 infection.…”

“…This skin involvement appears as a cross‐linked pattern accompanied by bluish discoloration of the skin and can occur either as a typical livedo reticularis or livedo racemosa 28 . May involves about 6% of the patients, 25 these lesions are first symmetrical and lace‐like, resulting from cutaneous vasoconstriction or vascular flow disturbances and disappearing by themselves 29 . On the other hand, the latter usually consisted of more oversized, more irregular, and asymmetrical lesions related to focal blood flow disturbances and may be associated with severe coagulopathies.…”

“…These eruptions are more common in the elderly and patients with severe COVID‐19 infection. Both types are usually self‐limited 29 …”

Las mil caras de la piel en enfermos con enfermedad COVID-19

“…La morfología del exantema está compuesto por máculas, pápulas eritematosas a menudo confluentes, y ocasionalmente placas eccematoides. 11,[43][44][45] La afección de las mucosas es rara.…”

A Unique Set of Symptoms in the Background of SARS-CoV-2 Infection

“…COVID-19 has been linked to a variety of different dermatological conditions. Some of the documented manifestations in children include maculopapular rash, erythema multiforme, vesicular rash, chilblain-like lesions, multisystem inflammatory syndrome, and urticaria [ 2 ]. The combination of both urticaria and angioedema in a COVID-19 patient has rarely been reported in the literature.…”