OBJECTIVES: To describe the cutaneous manifestations presented by a patient with pediatric multisystemic inflammatory syndrome (MIS-C) temporarily associated with SARS-CoV-2. METHODS: Female patient, 10 years old, presenting arthralgia in the wrists and ankles, edema in hands and feet, persistent fever, appearance of diffuse, and itchy maculopapular rash associated with odynophagia and productive cough. Evolution of the rash to violaceous lesions on the face, trunk and limbs (upper and lower), in addition to the appearance of vesicles on the face, within 48 hours. CBC suggestive of an infectious condition, with CRP 307mg/L (insert reference value) and ESR 61mm. RT-PCR for SARS-CoV-2 positive. RESULTS: Diagnosis of pediatric multisystemic inflammatory syndrome temporarily associated with SARS-CoV2. Transferred to ICU for monitoring and intravenous human immunoglobulin initiated. Good evolution, with the disappearance of injuries and discharge with outpatient follow-up. CONCLUSION: MIS-C has several dermatological manifestations and pediatricians must be attentive to the diagnosis, not limited to a specific presentation. In this case report, the importance of referral to tertiary referral centers for better case management and timely recognition of the syndrome in these patients is emphasized.

The pandemic caused by COVID-19 triggers a disease that manifests itself through flu-like symptoms from mild to severe, up to varied clinical presentations, involving different organs and systems. In pediatric patients, COVID-19 has shown milder manifestations compared to adult patients. The authors report in this article a case that suggest diabetic ketoacidosis (CAD) as the initial manifestation of COVID-19, in a 13-year-old female patient, previously diagnosed with type I diabetes mellitus, admitted to a pediatric emergency room with symptoms CAD compatible, later tested positive for COVID-19. This article discusses the importance of considering COVID-19 infection as a cause of diabetic decompensation in the pediatric population and the possibility of this relationship helping to discover new mechanisms of the disease.