Acral lesions in a pediatric population during the COVID-19 pandemic: a case series of 36 patients from a single hospital in Spain

Rosés-Gibert, Pau; Castillo, Javier Gimeno; Aguirre, Amaia Saenz; Gomar, F.; González, Lucía Carnero; Arcaya, Zuriñe Martínez de Lagrán Álvarez de; González‐Pérez, R.

doi:10.1007/s12519-020-00390-0

Cited by 12 publications

(19 citation statements)

References 21 publications

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“…In three cases, general symptoms appeared after cutaneous manifestations and in two cases they appeared simultaneously. 2,8,14,27,39 Skin lesions improved between 3 and 88 days without any sequelae.…”

Section: Methodsmentioning

confidence: 91%

Cutaneous and histopathological features of coronavirus disease 2019 in pediatrics: A review article

Khalili

Iranmanesh

Mohammadi

et al. 2020

Dermatologic Therapy

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Prevalence of dermatological manifestations of coronavirus disease 2019 (COVID‐19) is estimated between 0.25% and 3% in children and adolescents. In this review article, we decided to describe the cutaneous and histopathological manifestations of COVID‐19 infection in pediatrics. We searched published articles in PubMed database for key words of “children” or “pediatric” and “cutaneous” or “dermatology” or “skin” and “COVID‐19” or “SARS‐CoV‐2” or “Coronavirus disease 2019” in abstract or title from December of 2019 until September 2020. Finally, 38 articles were selected. The majority of patients were between 11 and 17 years old with predominantly male gender. Most of the patients were either asymptomatic or had a few general symptoms. The latency time from appearance of general symptoms to cutaneous ones was between 1 day and weeks. Skin lesions faded between 3 and 88 days without any sequelae, spontaneously or with either topical or systemic corticosteroids. Skin manifestations were chilblain‐like (pseudochilblain), erythema multiforme‐like, dactylitis, acral erythema, acute urticaria, livedo reticularis, mottling, acro‐ischemia, generalized maculopapular lesions, eyelid dermatitis, miliaria‐like, varicelliform lesions, and petechiae and/or purpura. Kawa‐COVID‐19 patients were presented more frequently with cardiogenic shock, neurological symptoms, lymphocytopenia, and thrombocytopenia as compared to classic Kawasaki's disease. Furthermore, more number of cases were resistant to the first‐line treatments.

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Section: Methodsmentioning

confidence: 91%

Cutaneous and histopathological features of coronavirus disease 2019 in pediatrics: A review article

Khalili

Iranmanesh

Mohammadi

et al. 2020

Dermatologic Therapy

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“…Chilblain-like lesions, also known as COVID toes, are a well-described dermatosis characterized by erythema and swelling localized to acral areas, occurring most commonly on the toes and fingers. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] The second most common cutaneous manifestation related to COVID-19 was erythema multiforme-like lesions. Erythema multiforme is an acute, self-limited, manifestation that is considered to be a type IV hypersensitivity reaction.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 cutaneous manifestations in children and adolescents: a systematic review

Neto

Mazzo

Vieira

et al. 2022

Rev. paul. pediatr.

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Objective: The aim of this study was to evaluate the coronavirus disease 2019 (COVID-19) cutaneous manifestations described in pediatric patients and discuss their relevance for early diagnosis. Data source: The study consisted of a systematic review of original articles indexed in PubMed and Embase databases, as well as gray literature articles found through Google Scholar. A search strategy, based on PICO (Patient, Intervention, Comparison, Outcome) Tool, with the terms “child,” “infant,” “childhood,” “adolescents,” “teenagers,” “COVID-19,” “SARS-CoV-2,” and “skin manifestations,” was performed to optimize the findings. The study did not restrict any article regarding language. Data synthesis: Out of the 310 articles that initially met the inclusion criteria, 35 were selected for review, totalizing 369 patients. The most common COVID-19 cutaneous manifestations in children and adolescents were Chilblain-like lesions, presented in 67.5% of the cases, followed by erythema multiforme-like (31.7%) and varicella-like lesions (0.8%). The Chilblain-like lesions appeared 7.6 days (95%CI 7.4–7.8) after the viral infection and lasted for 17.5 days (95%CI 16.5–18.5), erythema multiforme-like lesions appeared in 9.5 days (95%CI 9–10) and lasted for 10.3 days (95%CI 9.1–11.5), and varicella-like lesions appeared in 12.3 days (95%CI 4–20.6) and lasted for 7 days. Conclusions: Knowledge of the different skin manifestations in children and adolescents with COVID-19 is essential for an early diagnosis and, consequently, the possibility of promptly care adoption as well as to interrupt the new coronavirus transmission chains in the current pandemic context.

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“…mometasone furoate cream in one case, hydroxychloroquine in 1 case, azithromycin in 1 case, and instructions to avoid cold and/or damp environments in six cases (29,30,35,42,44). Warming measures were recommended in 74 cases (11).…”

Section: Characteristics Of Patientsmentioning

confidence: 99%

Chilblains-Like Lesions in Pediatric Patients: A Review of Their Epidemiology, Etiology, Outcomes, and Treatment

Fennell

Onel

2022

Front. Pediatr.

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Vascular pathologies associated with SARS-CoV-2 infection are poorly understood. Color and sensory changes to the extremities, often referred to as “COVID toes” or chilblains-like lesions, have been widely reported in children and adolescents since the onset of the pandemic, raising the concern that they could be a vasculitis secondary to the infection. However, it is unclear if the lesions are a result of the infection or an epiphenomenon. Most literature focuses on adults, and while there are reports on children and adolescents, many of them are small. This review will help medical care providers better understand the epidemiology, etiology, outcomes, and potential treatments for chilblains-like lesions seen in children and adolescents during the pandemic.

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Acral lesions in a pediatric population during the COVID-19 pandemic: a case series of 36 patients from a single hospital in Spain

Cited by 12 publications

References 21 publications

Cutaneous and histopathological features of coronavirus disease 2019 in pediatrics: A review article

Cutaneous and histopathological features of coronavirus disease 2019 in pediatrics: A review article

COVID-19 cutaneous manifestations in children and adolescents: a systematic review

Chilblains-Like Lesions in Pediatric Patients: A Review of Their Epidemiology, Etiology, Outcomes, and Treatment

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