Leslie Castelo-Soccio1,2, Irene Lara-Corrales3, Amy S Paller4, Eric Bean2, Sneha Rangu1, Michelle Oboite1, Carsten Flohr5, Regina-Celeste Ahmad6, Valerie Calberg7, Amy Gilliam6, Elena Pope3, Sean Reynolds6, Cathryn Sibbald3, Helen T Shin8, Emily Berger8, Julie Schaffer8, Michael P Siegel9, Kelly M Cordoro6. 1. Department of Pediatrics, Section of Dermatology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. 2. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 3. Section of Dermatology, Division of Pediatric Medicine, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada. 4. Departments of Dermatology and Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 5. St. John's Institute of Dermatology, King's College London, London, UK. 6. Department of Dermatology, University of California San Francisco, San Francisco, CA, USA. 7. Department of Dermatology, Medical College of Wisconsin, Milwaukee, WI, USA. 8. Department of Dermatology, Pediatric Dermatology, The Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, NJ, USA. 9. Pediatric Dermatology Research Alliance, Indianapolis, IN, USA.
Abstract
BACKGROUND/ OBJECTIVE: In spring 2020, high numbers of children presented with acral pernio-like skin rashes, concurrent with the coronavirus disease 2019 (COVID-19) pandemic. Understanding their clinical characteristics/ infection status may provide prognostic information and facilitate decisions about management. METHODS: A pediatric-specific dermatology registry was created by the Pediatric Dermatology COVID-19 Response Task Force of the Society for Pediatric Dermatology (SPD) and Pediatric Dermatology Research Alliance (PeDRA) and was managed by Children's Hospital of Philadelphia using REDCap. RESULTS: Data from 378 children 0-18 years entered into the registry between April 13 and July 17, 2020 were analyzed. Data were drawn from a standardized questionnaire completed by clinicians which asked for demographics, description of acral lesions, symptoms before and after acral changes, COVID-19 positive contacts, treatment, duration of skin changes, laboratory testing including SARS-CoV-2 PCR and antibody testing, as well as histopathology. 229 (60.6%) were male with mean age of 13.0 years (± 3.6 years). Six (1.6%) tested positive for SARS-CoV-2. Pedal lesions (often with pruritus and/or pain) were present in 96%. 30% (114/378) had COVID-19 symptoms during the 30 days prior to presentation. Most (69%) had no other symptoms and an uneventful course with complete recovery. CONCLUSIONS AND RELEVANCE: Children with acral pernio-like changes were healthy and all recovered with no short-term sequelae. We believe these acral changes are not just a temporal epiphenomenon of shelter in place during the spring months of the first wave of the COVID-19 pandemic and may be a late phase reaction that needs further study.
BACKGROUND/ OBJECTIVE: In spring 2020, high numbers of children presented with acral pernio-like skin rashes, concurrent with the coronavirus disease 2019 (COVID-19) pandemic. Understanding their clinical characteristics/ infection status may provide prognostic information and facilitate decisions about management. METHODS: A pediatric-specific dermatology registry was created by the Pediatric Dermatology COVID-19 Response Task Force of the Society for Pediatric Dermatology (SPD) and Pediatric Dermatology Research Alliance (PeDRA) and was managed by Children's Hospital of Philadelphia using REDCap. RESULTS: Data from 378 children 0-18 years entered into the registry between April 13 and July 17, 2020 were analyzed. Data were drawn from a standardized questionnaire completed by clinicians which asked for demographics, description of acral lesions, symptoms before and after acral changes, COVID-19 positive contacts, treatment, duration of skin changes, laboratory testing including SARS-CoV-2 PCR and antibody testing, as well as histopathology. 229 (60.6%) were male with mean age of 13.0 years (± 3.6 years). Six (1.6%) tested positive for SARS-CoV-2. Pedal lesions (often with pruritus and/or pain) were present in 96%. 30% (114/378) had COVID-19 symptoms during the 30 days prior to presentation. Most (69%) had no other symptoms and an uneventful course with complete recovery. CONCLUSIONS AND RELEVANCE: Children with acral pernio-like changes were healthy and all recovered with no short-term sequelae. We believe these acral changes are not just a temporal epiphenomenon of shelter in place during the spring months of the first wave of the COVID-19 pandemic and may be a late phase reaction that needs further study.
Authors: Esther E Freeman; Grace C Chamberlin; Devon E McMahon; George J Hruza; Dmitri Wall; Nekma Meah; Rodney Sinclair; Esther A Balogh; Steven R Feldman; Michelle A Lowes; Angelo V Marzano; Haley B Naik; Leslie Castelo-Soccio; Irene Lara-Corrales; Kelly M Cordoro; Satveer K Mahil; Christopher E M Griffiths; Catherine H Smith; Alan D Irvine; Phyllis I Spuls; Carsten Flohr; Lars E French Journal: Dermatol Clin Date: 2021-05-31 Impact factor: 3.478
Authors: Marta Bascuas-Arribas; David Andina-Martinez; Juan Añon-Hidalgo; Jose Antonio Alonso-Cadenas; Angela Hernandez-Martin; Nuria Lamagrande-Casanova; Lucero Noguero-Morel; Ana Mateos-Mayo; Isabel Colmenero-Blanco; Antonio Torrelo Journal: Pediatr Dermatol Date: 2022-02-07 Impact factor: 1.997