tetano
Editor, Senior Moderator
JAMA Dermatol
. 2020 Jun 25.
doi: 10.1001/jamadermatol.2020.2340. Online ahead of print.
Assessment of Acute Acral Lesions in a Case Series of Children and Adolescents During the COVID-19 Pandemic
Juncal Roca-Gin?s[SUP] 1 [/SUP], Ignacio Torres-Navarro[SUP] 1 [/SUP], Javier S?nchez-Arr?ez[SUP] 1 [/SUP], Carlos Abril-P?rez[SUP] 1 [/SUP], Oihana Sabalza-Bazt?n[SUP] 2 [/SUP], Sergio Pardo-Granell[SUP] 2 [/SUP], Vicent Mart?nez I C?zar[SUP] 3 [/SUP], Rafael Botella-Estrada[SUP] 1 4 [/SUP], Montserrat ?vole-Buselli[SUP] 1 [/SUP]
Affiliations
Abstract
Importance: A novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has recently been identified as the cause of a pandemic called coronavirus disease 2019 (COVID-19). In this context, some associated skin diseases have been described. Cutaneous lesions referred to as acute acro-ischemia have been reported as a possible sign of COVID-19 in adolescents and children.
Objective: To evaluate the pathogenesis of these newly described acute acral lesions.
Design, setting, and participants: This prospective case series was conducted at La Fe University Hospital, a tertiary referral hospital in Valencia, Spain, between April 9 and April 15, 2020. Among 32 referred patients, 20 children and adolescents with new-onset inflammatory lesions did not have a diagnosis.
Exposures: Patients were not exposed to any drug or other intervention.
Main outcomes and measures: We performed reverse transcriptase-polymerase chain reaction for SARS-CoV-2 and a range of blood tests for possible origins of the lesions. Skin biopsies were performed in 6 patients.
Results: Of the 20 patients enrolled, 7 were female and 13 were male, with an age range of 1 to 18 years. Clinical findings fit into the following patterns: acral erythema (6 patients), dactylitis (4 patients), purpuric maculopapules (7 patients), and a mixed pattern (3 patients). None of the patients had remarkable hematologic or serologic abnormalities, including negative antibodies to SARS-CoV-2. Biopsies performed in 6 patients showed histologic findings characteristic of perniosis.
Conclusions and relevance: The clinical, histologic, and laboratory test results were compatible with a diagnosis of perniosis, and no evidence was found to support the implication of SARS-CoV-2 infection.
. 2020 Jun 25.
doi: 10.1001/jamadermatol.2020.2340. Online ahead of print.
Assessment of Acute Acral Lesions in a Case Series of Children and Adolescents During the COVID-19 Pandemic
Juncal Roca-Gin?s[SUP] 1 [/SUP], Ignacio Torres-Navarro[SUP] 1 [/SUP], Javier S?nchez-Arr?ez[SUP] 1 [/SUP], Carlos Abril-P?rez[SUP] 1 [/SUP], Oihana Sabalza-Bazt?n[SUP] 2 [/SUP], Sergio Pardo-Granell[SUP] 2 [/SUP], Vicent Mart?nez I C?zar[SUP] 3 [/SUP], Rafael Botella-Estrada[SUP] 1 4 [/SUP], Montserrat ?vole-Buselli[SUP] 1 [/SUP]
Affiliations
- PMID: 32584397
- DOI: 10.1001/jamadermatol.2020.2340
Abstract
Importance: A novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has recently been identified as the cause of a pandemic called coronavirus disease 2019 (COVID-19). In this context, some associated skin diseases have been described. Cutaneous lesions referred to as acute acro-ischemia have been reported as a possible sign of COVID-19 in adolescents and children.
Objective: To evaluate the pathogenesis of these newly described acute acral lesions.
Design, setting, and participants: This prospective case series was conducted at La Fe University Hospital, a tertiary referral hospital in Valencia, Spain, between April 9 and April 15, 2020. Among 32 referred patients, 20 children and adolescents with new-onset inflammatory lesions did not have a diagnosis.
Exposures: Patients were not exposed to any drug or other intervention.
Main outcomes and measures: We performed reverse transcriptase-polymerase chain reaction for SARS-CoV-2 and a range of blood tests for possible origins of the lesions. Skin biopsies were performed in 6 patients.
Results: Of the 20 patients enrolled, 7 were female and 13 were male, with an age range of 1 to 18 years. Clinical findings fit into the following patterns: acral erythema (6 patients), dactylitis (4 patients), purpuric maculopapules (7 patients), and a mixed pattern (3 patients). None of the patients had remarkable hematologic or serologic abnormalities, including negative antibodies to SARS-CoV-2. Biopsies performed in 6 patients showed histologic findings characteristic of perniosis.
Conclusions and relevance: The clinical, histologic, and laboratory test results were compatible with a diagnosis of perniosis, and no evidence was found to support the implication of SARS-CoV-2 infection.