Chilblains in children in the setting of COVID-19 pandemic
Chilblains in children in the setting of COVID-19 pandemic
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DOI：
10.1111/pde.14215
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发表时间：
2020-05-22
影响因子：
1.5
通讯作者：
Torrelo, Antonio
中科院分区：
文献类型：
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作者：
Andina, David;Noguera-Morel, Lucero;Torrelo, Antonio
背景：新冠肺炎的不同皮肤表现已有报道。材料与方法对西班牙马德里一家儿童医院急诊科22例儿童和青少年在新冠肺炎高发期间短期内发现的类似冻疮的肢端皮损进行了回顾性分析。结果所有患者的皮损均与脚趾或足部冻疮的临床表现一致，其中3例还伴有手指皮损。皮肤瘙痒和轻微疼痛是唯一引起的皮肤症状，只有10人有轻微的呼吸道和/或胃肠道症状。无一例发烧。所有受试者的凝血试验、血象、血清化学和狼疮抗凝剂均正常。16例受试者中有1例D-二聚体结果升高，但没有全身症状或其他实验室异常。19例检测SARS-CoV-2，仅1例阳性。6名患者的皮肤活检结果与冻疮相符。所有病例均自发明显好转或完全愈合。结论新冠肺炎流行期间儿童和青少年出现了急性冻疮。这是一种症状轻微的情况，预后良好，通常不需要治疗。发病机制尚不清楚。
Background Different skin manifestations of COVID-19 are being reported. Acral lesions on the hands and feet, closely resembling chilblains, have been recognized during the peak incidence of the COVID-19 pandemic.Material and methods A retrospective review of 22 children and adolescents with chilblain-like lesions seen over a short period of time in the Emergency Department of a children's hospital during the peak incidence of COVID-19 in Madrid, Spain.Results All patients had lesions clinically consistent with chilblains of the toes or feet, with three also having lesions of the fingers. Pruritus and mild pain were the only skin symptoms elicited, and only 10 had mild respiratory and/or GI symptoms. None had fever. Coagulation tests, hemogram, serum chemistry, and lupus anticoagulant were normal in all patients tested. One out of 16 tested cases had elevated D-dimer results, but without systemic symptoms or other laboratory anomalies. SARS-CoV-2 PCR tested in 19 cases was positive in just one case. Skin biopsies obtained in six patients were consistent with chilblains. On follow-up, all cases showed spontaneous marked improvement or complete healing.Conclusion Acute chilblains were observed during COVID-19 pandemic in children and teenagers. It is a mildly symptomatic condition with an excellent prognosis, usually requiring no therapy. Etiopathogenesis remains unknown.