Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;181(10):3577-3593.
doi: 10.1007/s00431-022-04585-7. Epub 2022 Aug 10.

Epidemiology and clinical evolution of non-multisystem inflammatory syndrome (MIS-C) dermatological lesions in pediatric patients affected by SARS-CoV-2 infection: A systematic review of the literature

Arianna Dondi  1 , Giacomo Sperti  2 , Davide Gori  3 , Federica Guaraldi  4 , Marco Montalti  5 , Lorenza Parini  2 , Bianca Maria Piraccini  5 , Marcello Lanari #  1 , Iria Neri #  6
Affiliations

Epidemiology and clinical evolution of non-multisystem inflammatory syndrome (MIS-C) dermatological lesions in pediatric patients affected by SARS-CoV-2 infection: A systematic review of the literature

Arianna Dondi et al. Eur J Pediatr. 2022 Oct.

Abstract

COVID-19 can present with a range of skin manifestations, some of which specific of the pediatric age. The aim of this systematic literature review was to determine the type, prevalence, time of onset, and evolution of cutaneous manifestations associated with COVID-19 in newborns, children, and adolescents, after excluding multisystem inflammatory syndrome in children (MIS-C). PubMed, Tripdatabase, ClinicalTrials, and Cochrane Library databases were searched using an ad hoc string for case reports/series and observational studies, published between December 2019 and February 2022. Study quality was assessed using the STROBE and CARE tools. Seventy-three (49 case reports/series and 24 studies) out of 26,545 identified articles were included in the analysis. Dermatological lesions were highly heterogeneous for clinical presentation, time of onset, and association with other COVID-19 manifestations. Overall, they mainly affected the acral portions, and typically presented a favorable outcome. Pseudo-chilblains were the most common.

Conclusions: Mucocutaneous manifestations could be the only/predominant and early manifestation of COVID-19 that could precede other more severe manifestations by days or weeks. Therefore, physicians of all disciplines should be familiar with them.

What is known: • A variety of cutaneous manifestations have been reported in association with COVID-19. • Urticaria, maculopapular, or vesicular rashes can occur at any age, while chilblains and erythema multiforme are more common in children and young patients.

What is new: • Skin lesions related to SARS-CoV-2 infection often show a peculiar acral distribution. • Mucocutaneous lesions of various type may be the only/predominant manifestation of COVID-19; they could present in paucisymptomatic and severely ill patients and occur at different stages of the disease.

Keywords: COVID-19; Cutaneous acral lesions; Erythema multiforme; Pediatric dermatology; Pseudo-chilblains.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) 2020 flow diagram showing the process for articles selection [5]
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–733. - PMC - PubMed
    1. Abrams JY, Oster ME, Godfred-Cato SE, Bryant B, Datta SD, Campbell AP et al (2021) Factors linked to severe outcomes in multisystem inflammatory syndrome in children (MIS-C) in the USA: A retrospective surveillance study. Lancet Child Adolesc Heal [Internet] 5(5):323–31. Available from: 10.1016/S2352-4642(21)00050-X - PMC - PubMed
    1. Buonsenso D, Munblit D, De Rose C, Sinatti D, Ricchiuto A, Carfi A, et al. Preliminary evidence on long COVID in children. Acta Paediatr Int J Paediatr. 2021;110(7):2208–2211. - PMC - PubMed
    1. Andina D, Belloni-Fortina A, Bodemer C, Bonifazi E, Chiriac A, Colmenero I, et al. Skin manifestations of COVID-19 in children: Part 1. Clin Exp Dermatol. 2021;46(3):444–450. - PMC - PubMed
    1. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: 10.1136/bmj.n71. - DOI - PMC - PubMed

Publication types

Supplementary concepts