Published time: 18 May 2020
Authors: Claudio Guarneri, Emmanuele Venanzi Rullo, Piero Pavone, Massimiliano Berretta, Manuela Ceccarelli, Alfonso Natale, Giuseppe Nunnari
Keywords: Covid-19, Global Health, Public Health
Clinical manifestations of coronavirus disease 2019 (COVID-19) are rare or absent in children and adolescents;1, 2 hence, early clinical detection is fundamental to prevent further spreading. We report three young patients presenting with chilblain-like lesions who were diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Two of them were asymptomatic and potentially contagious. Skin lesions, such as erythematous rashes, urticaria, and chicken pox-like vesicles, were reported in 18 (20·4%) of 88 patients with COVID-19 in a previous study.3 These symptoms developed at the onset of SARS-CoV-2 infection or during hospital stay and did not correlate with disease severity.3 In our cases, lesions involved the acral sites, especially the dorsum of the digits of the feet, beginning as erythematous-violaceous patches that slowly evolved to purpuric lesions and then to blisters and ulceronecrotic lesions, with final complete return to normal. Burning and itching were also present with some of the lesions. Informed consent was obtained from the parents of patients 1 and 2 and from patient 3 himself.
Silent COVID-19; what your skin can reveal