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

World J Pediatr. 2020 Dec;16(6):629-632. doi: 10.1007/s12519-020-00390-0. Epub 2020 Sep 8.

Abstract

Background: To describe the cutaneous acral findings in a pediatric population noticed during this pandemic.

Methods: A retrospective descriptive study was performed collecting data on 36 patients under 14 years old, presenting suspicious acral skin manifestations for coronavirus disease 2019 (COVID-19).

Results: Patients were mostly male (63.8%). The mean age was 11.11 years. 66.67% of patients showed erythematous papules, and 44.44% purpuric macules. Feet were affected in 97.22% of patients and hands in 5.55%. Lesions were asymptomatic in 50% of patients. 30.55% of patients showed extracutaneous findings, preceding skin lesions in 12.62 days. Seven patients underwent specific severe acute coronavirus 2 (SARS-CoV-2) testing; all of these patients tested negative.

Conclusions: The association between these symptoms and SARS-CoV-2 remains unclear. We recommend using these manifestations as a sign of SARS-CoV-2 infection in children. This could lead to the examination of asymptomatic and mildly symptomatic children so that contagions may be avoided.

Keywords: Acral lesions; Acute acro-ischemia; COVID-19; Chilblain-like.

MeSH terms

  • Adolescent
  • Age Distribution
  • COVID-19
  • Child
  • Child, Preschool
  • Cohort Studies
  • Comorbidity
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology*
  • Erythema / diagnosis
  • Erythema / epidemiology*
  • Female
  • Hospitals, Urban
  • Humans
  • Incidence
  • Male
  • Pandemics / statistics & numerical data*
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology*
  • Prognosis
  • Pruritus / diagnosis
  • Pruritus / epidemiology*
  • Retrospective Studies
  • Risk Assessment
  • Sex Distribution
  • Skin Diseases / diagnosis
  • Skin Diseases / epidemiology
  • Spain / epidemiology