Shah Seema, Akhade Kiran, Ganguly Satyaki, Nanda Rachita, Mohapatra Eli, Goel Anil Kumar
Assistant Professor, Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Project Coordinator, SCoE-SAM, State Centre of Excellence, Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
J Family Med Prim Care. 2021 Jan;10(1):93-101. doi: 10.4103/jfmpc.jfmpc_1389_20. Epub 2021 Jan 30.
Cutaneous manifestation of COVID 19 in children has not yet been reviewed systematically. Hence, this review gives the clinicians a future direction to be vigilant for skin presentations during pandemics. The Pubmed database used for literature search with keywords COVID 19, children, and skin in different combinations. Articles published in English with cases of age one month to 18 years were eligible. The outcome included varied aspects of cutaneous and COVID 19 infection. The authors did not register review protocol. Of 51 publications identified, 13 studies containing 149 children met the eligibility criteria. Acrally located erythematous maculopapular lesion was the most common finding in 138 children. The researcher reported Erythema multiforme, varicella like exanthem, and Kawasaki disease like presentations in the rest of the cases. The duration of the skin lesion was 1 2 weeks in 43%. Skin biopsy done in 18 patients revealed superficial and deep perivascular and peri eccrine lymphocytic infiltrate and lymphocytic vasculitis. RT PCR was positive13.8% cases. Serological markers for HSV, parvovirus B19 analyzed across various studies, were negative, except positive mycoplasma pneumonia in 2 of 20 cases tested. Clinicopathologic analysis established chilblains like lesion in 43% cases with no confirmed etiology like cold exposure, autoimmune dysfunction, drug reaction, or viral infection. The usual cephalo caudal spread of a viral exanthem was also missing. However, a low number of discussed cases was a limitation of the study. The absence of any confirmed etiology for such cutaneous manifestations, the possibility of COVID 19, should be explored and thoroughly evaluated and isolated during such a pandemic.
儿童新冠病毒感染的皮肤表现尚未得到系统综述。因此，本综述为临床医生在疫情期间对皮肤表现保持警惕提供了未来方向。使用Pubmed数据库，以不同组合的关键词“新冠病毒”“儿童”和“皮肤”进行文献检索。发表于英文且病例年龄在1个月至18岁之间的文章符合要求。结果包括皮肤和新冠病毒感染的各个方面。作者未登记综述方案。在确定的51篇出版物中，13项研究（包含149名儿童）符合纳入标准。138名儿童中最常见的表现是肢端红斑性斑丘疹。其余病例中，研究人员报告有多形红斑、水痘样皮疹和川崎病样表现。43%的病例皮肤病变持续时间为1至2周。18例患者进行了皮肤活检，显示浅表和深部血管周围及汗腺周围淋巴细胞浸润以及淋巴细胞性血管炎。13.8%的病例逆转录聚合酶链反应呈阳性。在各项研究中分析的单纯疱疹病毒、细小病毒B19的血清学标志物均为阴性，但20例检测中有2例肺炎支原体呈阳性。临床病理分析显示43%的病例有冻疮样病变，未证实有诸如寒冷暴露、自身免疫功能障碍、药物反应或病毒感染等病因。病毒疹通常的头向尾端蔓延也未出现。然而，所讨论病例数量较少是本研究的一个局限。对于此类皮肤表现，应探索并彻底评估新冠病毒感染这一未得到证实的病因，并在疫情期间进行隔离。
