Médica Sur Fundación Clínica y Hospital, Mexico City, Mexico.
Hospital Médica Sur, Torre 2, cons. Puente de piedra 150, T2-602 Toriello-Guerra; delegación Tlalpan, Mexico City, Mexico.
Curr Allergy Asthma Rep. 2021 Feb 25;21(2):13. doi: 10.1007/s11882-020-00986-6.
At the juncture of the COVID-19 pandemic, the world is currently in an early phase of collecting clinical data and reports of its skin manifestations, and its pathophysiology is still highly conjectural. We reviewed cutaneous manifestations associated with COVID-19 in the pediatric age group.
Children infected by SARS-CoV-2 usually develop milder respiratory symptoms, but cutaneous manifestations seem a little more prevalent than in adults. These skin features of infection by the coronavirus can be similar to those produced by other common viruses, but there are also reports of cases with more heterogeneous clinical pictures, which have made their classification difficult. To date, the more frequently reported skin variants featured in pediatric cases are purpuric (pseudo-chilblain, necrotic-acral ischemia, hemorrhagic macules, and/or cutaneous necrosis), morbilliform/maculopapular, erythema multiforme, urticarial, vesicular, Kawasaki-like, and miscellaneous (highly variable in both frequency and severity). Their pathophysiological mechanism is still elusive and is likely to be the result of the complex involvement of one or more mechanisms, like direct virus-induced skin damage, vasculitis-like reactions, and/or indirect injury as a consequence of a systemic inflammatory reaction. In this review, we presented and discussed clinical cases as examples of different cutaneous responses reported in some children with SARS-CoV-2 infection, differential diagnosis considerations, and a preliminary conceptual approach to some of their probable associated pathologic mechanisms.
在 COVID-19 大流行之际，目前全世界正处于收集其皮肤表现临床数据和报告的早期阶段，其病理生理学仍高度推测。我们回顾了与 COVID-19 相关的儿科皮肤表现。
感染 SARS-CoV-2 的儿童通常表现出较轻的呼吸道症状，但皮肤表现似乎比成人更为普遍。这些由冠状病毒引起的感染的皮肤特征可能与其他常见病毒产生的特征相似，但也有报道称存在更具异质性临床表现的病例，这使得它们的分类变得困难。迄今为止，在儿科病例中更常报告的皮肤变异特征是紫癜性（假性冻疮样、坏死性肢端缺血、出血性斑疹和/或皮肤坏死）、麻疹样/斑丘疹、多形红斑、荨麻疹、水疱、川崎病样和其他（在频率和严重程度上均高度多变）。其病理生理学机制仍难以捉摸，可能是一个或多个机制的复杂参与的结果，如直接病毒引起的皮肤损伤、血管炎样反应和/或全身性炎症反应引起的间接损伤。在这篇综述中，我们以一些感染 SARS-CoV-2 的儿童中报告的不同皮肤反应的临床病例为例，介绍并讨论了这些病例，讨论了鉴别诊断的考虑因素，并对其一些可能相关的病理机制进行了初步的概念性探讨。
