During the COVID‐19 pandemic, chilblain‐like lesions have been reported in mildly symptomatic children and adolescents. We present four children investigated for suspected COVID‐19 infection who presented with acral skin findings and mild systemic symptoms. Histology from one case showed signs of vasculitis with evident fibrin thrombus.

It has been reported that the novel coronavirus disease (COVID-19) may be associated with a papulovesicular skin eruption predominantly involving the trunk. We hereby present a case of COVID-19-associated varicella-like exanthem in an 8-year-old girl with mild systemic symptoms. Et al. including myalgia and diarrhea. 1 Loss of smell and taste has also been reported. 2 Cutaneous manifestations associated with COVID-19 have been recently reported in adults by Joob and coworkers, 3 who described a patient from Thailand with a petechial rash initially misdiagnosed as dengue, and by Recalcati 4 who reported on hospitalized patients in Italy with erythematous rash (n = 14), widespread urticaria (n = 3), and varicella-like vesicles (n = 1). Two of the authors of the present paper (GG and AVM) have reported a series of 21 adult patients and one child (who is the case described here in detail) with COVID-19 who developed a varicella-like rash predominantly involving the trunk, including 7 cases in which histology was obtained and findings were compatible with viral infection. 5 Pediatric Dermatology GENOVESEHerein, we describe this varicella-like exanthem as a possible COVID-19-associated skin manifestation in children. In our patient, the latency time of the development of rash after cough's onset was three days and the exanthem duration was seven days. Other skin manifestations and mucosal involvement as well as symptoms such as pruritus, pain, or burning were absent. Alternative diagnoses for such an eruption include varicella infection, which is unlikely based on prior infection, and insect bites, which are unlikely in the absence of pruritus.Even though our data do not prove that this rash is caused by or definitively associated with COVID-19, we suggest that papulovesicular eruptions be included in the spectrum of exanthems possibly associated with COVID-19. Based on the features and early appearance, this varicella-like exanthem could be a useful clue to suspect the diagnosis of COVID-19 in asymptomatic and paucisymptomatic children, prompting microbiological investigation in these patients.Since COVID-19 usually manifests without severe respiratory symptoms in children, the recognition of potential associated skin manifestations could avoid spreading of the infection in the population. K E Y WO R DScoronavirus, COVID-19, infection, pediatric, SARS-CoV-2, viral exanthem

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The clinical scoring systems of atopic dermatitis were analysed and compared. Some biological parameters that can correlate with the clinical score were also reviewed. After the definition of the disease based on validated clinical criteria, the second necessity was the availability of reliable severity scores to allow clinicians to verify the course of the disease and the efficacy of treatments. After many proposals, the SCORAD (SCORing Atopic Dermatitis), that required more than three years of work, was the first one that was validated. SCORAD is freely available from an internet site and can be easily calculated using dedicated software. EASI (Eczema Area and Severity Index) score has also been validated but it has been modified twice. Simpler systems include SASSAD (Six Area, Six Sign Atopic Dermatitis) and TIS score (Three-Item Severity score). In parallel, biological parameters were investigated. Eosinophil cationic protein, circulating basophils, major basic protein, soluble E-selectin, antistaphylococcal enterotoxin B, immunoglobulin E titres and macrophage-derived chemokine, can correlate significantly with the clinical score. The clinicians will not benefit directly from laboratory techniques and will employ clinical scores.