Erythema multiforme‐like lesions in children and COVID‐19

Torrelo, Antonio; Andina, David; Santonja, Carlos; Noguera‐Morel, Lucero; Bascuas-Arribas, Marta; Gaitero-Tristán, Jara; Alonso‐Cadenas, José Antonio; Pellitero, Silvia Escalada; Hernández‐Martín, Ángela; Torre-Espí, Mercedes de la; Colmenero, Isabel

doi:10.1111/pde.14246

Cited by 116 publications

(152 citation statements)

References 11 publications

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“…[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.…”

Section: Resultsmentioning

confidence: 99%

“…[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. However, the limbs, face, genitals, and mucous membranes were spared.…”

Section: Resultsmentioning

confidence: 99%

“…The fact that immune histochemical staining (IHC) with Ab against SARS-CoV/SARS-CoV-2 spike protein was positive in 2/2 cases, with negative RT PCR reports, advocates a de nite causal role of SARS-CoV-2. [17] Limitations of the study: The study sample is less looking at the pandemic nature of the disease to give any concrete comment on the path physiology and pattern of presentation of the disease process.…”

Section: Resultsmentioning

confidence: 99%

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

Shah

Akhade

Ganguly

et al. 2020

Preprint

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Background: Cutaneous manifestation of COVID 19 in children has not yet been reviewed systematically and hence this review gives a future direction to the clinicians to be vigilant for skin presentations during such pandemic.Methodology: The review was done as per the guidelines of PRISMA and literature search was done on PubMed database using keywords as COVID-19, children and skin in different combinations. Articles published in English with cases of age 1 month to 18 years were eligible. The outcome included varied aspects of cutaneous and COVID-19 infection. The review protocol was not registered.Results: Of 51 publications identified, 13 studies containing 149 children met the eligibility criteria. Acrally located erythematous maculopapular lesion was the most common finding in 138 children. Erythema multiforme, varicella like exanthem and Kawasaki disease like presentations were reported in the rest of the cases. The duration of the skin lesion was 1-2 weeks in 43%. Skin biopsy done in 18 cases revealed superficial & deep perivascular and peri-eccrine lymphocytic infiltrate & lymphocytic vasculitis. RT-PCR was positive in 13.8% cases. Serological markers for HSV, parvovirus B19 analyzed across various studies, were found negative, except for mycoplasma pneumoniae in 2 of 20 cases tested.Discussion: Clinicopathologic analysis established chilblains like lesion in 43% cases with no confirmed etiology like cold exposure, autoimmune dysfunction, drug reaction, or viral infection. The usual cephalo-caudal spread of a viral exanthem was also missing. However, a low number of discussed cases was a limitation of the study.Conclusion: In the absence of any confirmed etiology for such cutaneous manifestations, the possibility of COVID-19 should be explored and evaluated thoroughly during such pandemic.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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

Shah

Akhade

Ganguly

et al. 2020

Preprint

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“…Documented cutaneous findings reported in children with COVID-19 include non-specific maculopapular eruptions, followed by chilblain-like or pernio-like acral lesions, urticarial lesions, livedo reticularis, papulovesicular or varicella-like lesions, petechiae or dengue-like lesions, and erythema multiforme-like lesions. [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] …”

Section: Introductionmentioning

confidence: 99%

A dermatologic perspective on multisystem inflammatory syndrome in children

Naka

Melnick

Gorelik

et al. 2021

Clinics in Dermatology

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As of May 2020, an emerging immune-mediated syndrome primarily affecting children has been detected primarily in Europe and the United States. The incidence of this syndrome appears to mirror the initial infectious assault, with a delay of several weeks. This syndrome has been termed multisystem inflammatory syndrome in children (MIS-C), and is observed in association with the coronavirus disease 2019 (COVID-19). The phenotypes of presentation include several characteristic features, including prolonged fever, eruption, neck stiffness and gastrointestinal manifestations with pronounced abdominal pain. Shock and organ dysfunction on presentation are frequently but inconsistent, while respiratory distress is typically, and notably, absent. We have reviewed recently published data aiming to better understanding MIS-C, with a focus on its mucocutaneous manifestations. Mucocutaneous manifestations of MIS-C: conjunctivitis, oral mucosal changes, rash. The rash of MIS-C is typically diffuse and non-specific. Mucocutaneous manifestations of MIS-C are more common in younger children. KD and MIS-C differ in mean age of onset, race predilection, and associated symptoms.

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“…Histopathologic analysis of the erythema multiforme-like eruptions revealed a superficial and deep perivascular and perieccrine inflammatory infiltrate, with immunohistochemistry (IHC) demonstrating cytoplasmic granular positivity to the SARS-CoV/SARS-CoV-2 spike protein in endothelial and epithelial eccrine glands. 34 …”

Section: Cutaneous Manifestations In Childrenmentioning

confidence: 99%

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

Lavery

Thompson

2021

Clinics in Dermatology

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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.

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Erythema multiforme‐like lesions in children and COVID‐19

Cited by 116 publications

References 11 publications

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

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

A dermatologic perspective on multisystem inflammatory syndrome in children

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

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