Skin, mucosa and nail findings in hospitalized pediatric patients with Coronavirus disease-2019 (COVID-19)


Özen T., Kahraman F. C., Öcal S., Ovalı H. F.

Anais Brasileiros de Dermatologia, vol.98, no.2, pp.208-215, 2023 (SCI-Expanded, Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 98 Issue: 2
  • Publication Date: 2023
  • Doi Number: 10.1016/j.abd.2022.03.006
  • Journal Name: Anais Brasileiros de Dermatologia
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, EMBASE, Veterinary Science Database, Directory of Open Access Journals
  • Page Numbers: pp.208-215
  • Keywords: Child, COVID-19, Mucous membrane, Skin manifestations
  • Marmara University Affiliated: No

Abstract

Background: Cutaneous manifestations of Coronavirus Disease-2019 (COVID-19) disease have not yet been fully described in hospitalized pediatric patients. Objectives: This prospective study aims to demonstrate the skin, mucosal, and nail findings of hospitalized children with COVID-19. Methods: The authors included hospitalized pediatric patients. Two dermatologists examined skin, hair, nails, and mucosa. Patients with drug eruptions were excluded with an anamnesis, clinical and laboratory test results. Results: Out of 46 enlisted patients, 19 (41,3%) patients displayed skin, mucosal or nail findings. Skin findings were seen on 14 (30.4%) patients. Ten (22%) patients presented skin findings matching described patterns. Half of the patients with patterned rashes had confluent erythematous/maculopapular/morbilliform rashes. Eleven out of 46 (23.9%) patients developed periorbital erythema and edema. Ten (22%) patients had at least one oral mucosal finding. One telogen effluvium, one blue nail, and one flag sign on nails were noticed. Nine (19.5%) patients out of 46 had developed MIS-C. MIS-C patients had mucocutaneous manifestations except one (88.8%). Study limitations: The authors have detected a higher rate of mucocutaneous manifestations compared to out-patients with mild COVID-19 because the study is based on hospitalized patients only. Conclusions: Pediatric COVID-19 patients are more susceptible to developing mucocutaneous manifestations compared to adults. The authors propose COVID-19 should be acknowledged as one of the viral exanthem rashes of childhood. The authors noticed that the most common findings were periorbital erythema and edema. The confluent erythematous/maculopapular/morbilliform rashes appear to be the most common patterns associated with severe COVID-19.