Two adult cases of multisystem inflammatory syndrome associated with SARS-CoV-2

Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults

“…A total of 221 patients with MIS-A were identified: 102 were from the CDC’s MIS-C surveillance system, of whom 55 were described in a recent publication 3 ; 20 were from voluntary reports to the CDC, of whom 9 were included in a recent publication 2 ; and 99 were from case reports published in the literature. 2 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , …”

“…In total, 449 relevant articles were identified, and 86 were selected for in-depth review; of these, 60 had data for patients with MIS-A. 2 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 Figure 1 summarizes...…”

Histopathologic correlation of skin manifestations of multisystem inflammatory syndrome in adults associated with SARS-CoV-2 infection

“…We suggest that skin biopsy should only be considered in suspected MIS-A cases in contexts where it may be helpful in excluding a likely alternative diagnosis. We hope this builds upon Mieczkowska et al's 1…”

“…As noted here and in prior reports, dermatologic findings in MIS-A are varied, including a polymorphous rash with urticarial or targetoid erythematous papules and plaques with variable mucosal involvement; an erythematous, morbilliform eruption; palmar desquamation; and conjunctivitis. [1][2][3] To date, there has been little histopathologic characterization of MIS-Aerelated skin manifestations described in the literature. Based on the 2 cases of our patients, skin biopsies demonstrate nonspecific histologic findings of perivascular dermatitis with negative in situ hybridization for SARS-CoV-2 spike protein as well as negative lesional direct immunofluorescence, consistent with patterns seen in viral exanthems.…”

“…To the Editor: We read with interest the case report by Mieczkowska et al 1 describing skin findings in multisystem inflammatory syndrome in adults (MIS-A). We hope to contribute to this discussion by presenting corresponding histopathologic features in 2 patients with MIS-A with similar dermatologic manifestations.…”