Erythema multiforme-like lesions in children and COVID-19 |
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| Authors: | Antonio Torrelo MD David Andina MD Carlos Santonja MD Lucero Noguera-Morel MD Marta Bascuas-Arribas MD Jara Gaitero-Tristán MD José Antonio Alonso-Cadenas MD Silvia Escalada-Pellitero MD Ángela Hernández-Martín MD Mercedes de la Torre-Espi MD Isabel Colmenero MD |
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| Affiliation: | 1. Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain;2. Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain;3. Department of Pathology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain;4. Department of Pathology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain |
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| Abstract: | 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. |
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| Keywords: | chilblains COVID-19 erythema multiforme exanthem pernio SARS-CoV-2 skin viral diseases |
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