Erythema multiforme-like lesions in children and COVID-19
Erythema multiforme-like lesions in children and COVID-19
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DOI：
10.1111/pde.14246
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发表时间：
2020-05-01
影响因子：
1.5
通讯作者：
Colmenero, Isabel
中科院分区：
文献类型：
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作者：
Torrelo, Antonio;Andina, David;Colmenero, Isabel
在儿童和青少年冻疮病例的检查中，我们发现了四名患者也表现出类似于多形性红斑（EM）的皮肤病变。他们没有其他已知的EM触发器。其中1例SARS-CoV-2 PCR阳性，其余3例均为阴性。两名患者的皮肤活检显示出不典型的EM特征，如深血管周围和外分泌浸润和角质形成细胞坏死的情况下。免疫组化SARS-CoV/SARS-CoV-2刺突蛋白在两种活检中均显示外泌腺的内皮细胞和上皮细胞呈颗粒状阳性。所有患者的结局都很好，全身症状很小或没有。EM（一种通常与病毒相关的疾病）与COVID-19背景下的冻疮的一致性，以及SARS-CoV/SARS-CoV-2刺突蛋白的免疫组织化学阳性，强烈表明EM样病变与SARS-CoV-2之间的联系。
During examination of cases of chilblains in children and adolescents, we identified four patients who also showed skin lesions similar to erythema multiforme (EM). They had no other known triggers for EM. One of them had a positive PCR for SARS-CoV-2, while the other three were negative. Skin biopsies from two patients showed features not typical of EM, such as deep perivascular and perieccrine infiltrate and absence of necrosis of keratinocytes. Immunohistochemistry for SARS-CoV/SARS-CoV-2 spike protein showed granular positivity in endothelial cells and epithelial cells of eccrine glands in both biopsies. All patients had an excellent outcome, and had minimal or no systemic symptoms. The coincidence of EM, a condition commonly related to viruses, and chilblains in the setting of COVID-19, and the positivity for SARS-CoV/SARS-CoV-2 spike protein by immunohistochemistry strongly suggest a link between EM-like lesions and SARS-CoV-2.