Giant Urticaria and Acral Peeling in a Child with Coronavirus Disease 2019

Rotulo, Gioacchino Andrea; Signa, Sara; Rosina, Silvia; Pastorino, Carlotta; Bondi, Elisabetta; Maghnie, Mohamad

doi:10.1016/j.jpeds.2020.10.039

Cited by 11 publications

(14 citation statements)

References 3 publications

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“…Moreover, acral peeling was reported in 7 patients by 2 studies [ 34 , 40 ]. Acral edema, erythematous papules and purpura, and nail Beau lines were rarely detected (Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

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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“…Moreover, acral peeling was reported in 7 patients by 2 studies [ 34 , 40 ]. Acral edema, erythematous papules and purpura, and nail Beau lines were rarely detected (Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

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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“…These lesions may be present before fever onset or with pyrexia and cough. For example, Rotulo et al presented a healthy 6-year-old female with fever and pharyngodynia and was positive for SARS-CoV-2 by molecular and antigen tests; she had fleeting urticarial lesions that lasted < 24 h and desquamation of the distal phalanges of the hands and feet [ 24 ]. Pagali and Parikh reported a 54-year-old female infected with SARS-CoV-2 who first presented urticarial rash on the trunk for 3 days before developing other SARS-CoV-2 related symptoms [ 25 ].…”

Section: Urticarial Lesionsmentioning

confidence: 99%

Cutaneous Manifestations of SARS-CoV-2 Infection

et al. 2022

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the coronavirus disease 2019 (COVID-19) pandemic, affecting people worldwide. SARS-CoV-2 infection is a multisystem disease with potential for detrimental effects on various systemic organs. It affects people of all ages with varying degrees of disease severity. Patients with SARS-CoV-2 infection commonly present with dry cough, fever, and fatigue. A clinical spectrum of skin findings secondary to SARS-CoV-2 has also been reported. The most common cutaneous patterns associated with COVID-19 are chilblain-like lesions (CBLL), maculopapular lesions, urticarial lesions, vesicular lesions, and livedoid lesions. Other skin findings secondary to SARS-COV-2 infection are erythema multiforme (EM)-like lesions and skin findings associated with multisystem inflammatory syndrome in children (MIS-C) and rarely multisystem inflammatory syndrome in adults (MIS-A). Physician awareness of skin manifestations of SARS-CoV-2 infection can help with early identification and treatment. This narrative review provides an update of various skin manifestations reported with SARS-CoV-2 infection, including clinical presentation, proposed pathogenesis, histopathology, prognosis, and treatment options.

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“…Including our case, 22 paediatric cases of APD have been reported so far during COVID‐19 pandemic. They can be classified into three groups based on the association with SARS‐CoV‐2 infection and the severity of the COVID‐19 symptoms: APD during asymptomatic (two cases) or mild COVID‐19 infection (five cases, including our) 2 ; APD during severe COVID‐19 (one case) 3 or multisystem inflammatory syndrome (nine cases) 4 ; and APD with no evidence of SARS‐CoV‐2 infection (five cases). 5 In patients with symptomatic COVID‐19, the APD occurred 3 days up to 4 weeks after systemic symptoms in 14 cases, 2 , 4 while only in one case, it preceded the onset of fever.…”

Section: Figurementioning

confidence: 99%