Management of a Child vs an Adult Presenting With Acral Lesions During the COVID-19 Pandemic: A Practical Review

Abstract

testing should be obtained in adults if there is diagnostic uncertainty or if there are worsening symptoms.

Transient Anti PM-Scl75 Antibody Positive Acral Ischemia Syndrome in a 15 Years-Old Girl

“…A mild acral ischemia could be interpreted as incomplete Raynaud phenomenon [10,11,12,13,14,20]. Acral ischemia was found in COVID-19 [15,16,9], chronic gangrenous ergotism [17], t-cell lymphoma [18], essential thrombocythemia [3], thrombotic microangiopathy [12], Hodgkin lymphoma [7], application of immune checkpoint inhibitors [19], nivolumab [2] and epinephrine [20] and closed injury [6]. It remains a rare acral vascular event in children and teenagers like in our case.…”

Top 10 acral skin manifestations associated with COVID‐19: A scoping review

“…Moreover, several acral cutaneous manifestations could be associated with poor prognosis or additional medical conditions. 5 …”

“…Moreover, several acral cutaneous manifestations could be associated with poor prognosis or additional medical conditions. 5 Thus, recognition of covid-19 related acral signs and symptoms can help clinicians to consider COVID-19 in the differential diagnoses of acral skin lesions. Some of the most common acral skin presentations of COVID-19 include: acral papulo-vesicular eruption, acral urticarial lesion, acral non-inflammatory purpura and necrosis, acro-ischemia associated COVID-19, acral vasculitis, chilblain-like lesion (COVID Toe), acral erythema multiform (EM) like lesion, hand and foot skin lesions associated with multisystem inflammatory syndrome in children (MISC), acral peeling conditions and red half-moon nail sign.…”

“…Occasionally, acral skin lesions may represent the initial presentation of SARS‐CoV‐2 infection prior to fever or respiratory manifestations. Moreover, several acral cutaneous manifestations could be associated with poor prognosis or additional medical conditions 5 …”