Chilblain-like lesions in children following suspected COVID-19 infection

Abstract

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.

Keywords: infection-viral; skin signs of systemic disease; vasculitis.

FIGURE 1

Patient 1, chilblains‐like lesions on the toes in an 11‐y‐old girl

FIGURE 2

Patient 2, moderately painful chilblains‐like lesions localized on the plantar surface of the first metatarsus in a 6‐y‐old girl

FIGURE 3

Patient 3, diffuse chilblains‐like lesions on the plantar surface of the left foot in a 5‐y‐old boy

FIGURE 4

Patient 4, chilblains‐like lesion on the lateral surface of the left foot in an 11‐y‐old girl

FIGURE 5

Patient 4, punch biopsy from the lateral surface of the left foot of Patient 4. Dense lymphocytic perivascular and periadnexal infiltrates extending to the subcutis. Inset: higher magnification of a small thrombus in a capillary vessel in the upper part of the dermis (arrow)