Skin manifestations in patients with COVID-19 have been extensively reported, mostly in adults. 1,2 Skin lesions in children with proven COVID-19 are much less frequent 3 and may show specific features not seen in adults, such as those associated with the multisystem inflammatory syndrome in children (MIS-C). 4 Once the microbiologic test for SARS-CoV-2 became widely available for all suspected cases in our institution (not only for admitted patients), we were able to diagnose the first case of acral pulpitis as an isolated sign of COVID-19 in children. 5 Due to the mild nature of this presentation, in December 2020, we recruited similar cases through an advertisement on the "Spanish Primary Care Pediatric Association" website.We present a series of six children infected with SARS-CoV-2 who presented with mild erythema and desquamation of the fingertips and/or toes as the only skin manifestation of COVID-19.Otherwise, all children had asymptomatic to mildly symptomatic disease. | C A S E REP ORTSData were collected anonymously. We recorded age, sex, personal history of previous diseases, previous treatments, epidemiologic background, skin symptoms, type and location of lesions, systemic symptoms, microbiological test performed, and therapies administered.Approval from the institutional Ethics Committee and Board was obtained. Informed consent was obtained for recording images in all patients.Six patients (four male and two female), age range 5-13 years, were included. Five had a positive microbiologic test for SARS-CoV-2 (three positive real-time polymerase chain reaction for SARS-CoV-2 and two positive rapid antigenic test). One patient had a negative