Skin manifestations of COVID‐19 in children: Part 2

Abstract

Summary The current COVID‐19 pandemic is caused by the SARS‐CoV‐2 coronavirus. The initial recognized symptoms were respiratory, sometimes culminating in severe respiratory distress requiring ventilation, and causing death in a percentage of those infected. As time has passed, other symptoms have been recognized. The initial reports of cutaneous manifestations were from Italian dermatologists, probably because Italy was the first European country to be heavily affected by the pandemic. The overall clinical presentation, course and outcome of SARS‐CoV‐2 infection in children differ from those in adults, as do the cutaneous manifestations of childhood. In this review, we summarize the current knowledge on the cutaneous manifestations of COVID‐19 in children after thorough and critical review of articles published in the literature and from the personal experience of a large panel of paediatric dermatologists in Europe. In Part 1, we discussed one of the first and most widespread cutaneous manifestations of COVID‐19, chilblain‐like lesions. In this part of the review, we describe other manifestations, including erythema multiforme, urticaria and Kawasaki disease‐like inflammatory multisystemic syndrome. In Part 3, we discuss the histological findings of COVID‐19 manifestations, and the testing and management of infected children for both COVID‐19 and any other pre‐existing conditions.

Mucocutaneous manifestations in children hospitalized with COVID-19

“…8,9 The other cutaneous manifestations of COVID-19 in children have been the subject of case reports or small case series. 10 The mucocutaneous manifestations in hospitalized children infected with SARS-CoV-2 and the implications on the clinical course have not yet been extensively described. The objective of this study was to describe mucocutaneous manifestations in children hospitalized for COVID-19.…”

Urticaria multiforme in a child with SARS-CoV-2 infection

“…[1][2][3] Of note, pediatric patients with skin lesions related to SARS-CoV-2 may be otherwise asymptomatic or experience only mild respiratory and gastrointestinal symptoms. [5][6][7] Skin involvement might be an element of multisystem inflammatory syndrome in children, which should be taken into consideration, especially in the setting of fever. 6 This presentation shares common features with mucocutaneous lesions found in Kawasaki disease, which is characterized by polymorphic, nonvesicular eruptions, erythema and edema of hands and feet along with nonsuppurative conjunctivitis and strawberry tongue.…”

Dermatological manifestations associated with COVID-19 infection

“…[ 78 79 80 ] Dengue-like lesions, pityriasis rosea-like, vasculitic lesions, acro-ischemia, and livedoid lesions are some rare nonspecific lesions that have also been described in children. [ 81 ]…”