Monday , November 29 2021

Skin lesions similar to those reported in adolescents and young adults during the pandemic


As the coronavirus disease (COVID-19) pandemic grows, more outbreaks of viral infection appear.

At the beginning of the pandemic, people with COVID-19 had difficulty with fever, coughing and breathing. Later, other symptoms were added, such as loss of taste, loss of odor, and oral injuries in children.

In Madrid, Spain and at the Association of Pediatric Dermatology (Bari, Italy), a team of researchers from the Department of Dermatology, Hospital Infantil Universitario Niño Jesús University, acute ischemic lesions have been found throughout the COVID-19 pandemic, similar to children.


The presentation, course, and overall outcome of severe acute acute respiratory syndrome (SARS-CoV-2) infection in children is different in adult children. While urticaria, maculopapular rash, or vesicular rash can occur in people of all ages, it is more associated with children with erythema multiforme (MS), and temporary SARS-CoV-2 (PIMS-TS) multisystem syndrome in pregnant children. it is often seen in young patients.

To reach the results of the study Journal of Clinical and Experimental Dermatology, the group summarized current knowledge about the cutaneous occurrences of COVID-19 in children after reviewing articles published in the literature on the personal experience of European dermatologists.

Study: COVID - 19 skin expressions in children.  Image Credit: Zay Nyi Nyi

Chilblain-shaped lesions

Chilblain lesions cause painful and itchy swelling on the skin, usually seen on the hands and feet, due to poor circulation to the skin due to the cold.

Chilblain-like lesions associated with COVID-19 are erythematous-edematous or bruising skin lesions that affect the toes and soles. They appear less frequently on the fingers and hands.

Injuries are more common in children, adolescents, and young adults. Most patients have excellent health and mild symptoms. In all cases the recovery is between four and eight weeks. The group said that although the link between COVID-19 and children has not yet been proven, it seems likely.

Since March 2020, reports of acute injuries or pimples like children have been spreading on social media and Google Trends. Many people searched for words like “children”, “toes”, “toes” and “coronavirus” lesions in France.

However, the first published study and the case of similar injuries in children related to SARS-CoV-2 occurred in Italy, and later similar cases were reported in Spain and the Middle East.

Patients who complained of COVID-19-related injuries were mostly young people who were ordered to remain closed and were locked in their homes and had no previous history.

In Spain, doctors have reported cases of pseudo-children in 19% of the 375 patients with COVID-19 skin. Of these, only one had a history of previous pernice.

In addition, the 277 cases reported with injuries to children in France were mostly confirmed or suspected cases of COVID-19.

It is commonly seen among children and adolescents

Injuries are often seen among children and adolescents in good health. However, they are rarely seen in children under 10 years of age.

Between 74 and 100 percent of cases showed injuries to the foot. Multiple, round lesions affect the entire toe with a clear border. In some cases, the lesions may turn dark purple with black crusts.

Children and adolescents who develop injuries are usually asymptomatic, but local pain and itching can occur.

In addition, all children and adolescents had a positive outcome in health and had no complications. The reported recovery ranged from 12 days to more than eight weeks.

COVID-19 and child injuries

The researchers explained some pathogenic mechanisms in how children relate to COVID-19.

First, patients with severe COVID-19 have an interferon (IFN) type I response and increase tumor necrosis factor and interleukin production. The group explained that patients with children show a high IFN-I response and therefore decrease lung replication.

However, an early IFN-I response can cause microangiopathic changes, resulting in similar lesions in children.

Another theory involves the hypothesis of coagulopathy. Patients with COVID-19 are at increased risk for thromboembolism, which may lead to the development of acute ischemia.

In addition, patients with neurological signs had perfusion abnormalities. Anomalies in the microbial tubes have been found in lung biopsies, suggesting that the packaging has a direct effect on the virus. In addition, viral proteins were also seen in endothelial skin cells between two patients with children.

Finally, the researchers pointed out that changing pandemics and changing habits in confinement can be linked to young children. This can be due to walking barefoot at home, lack of physical activity and stress.

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