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Erythema multiforme‐like lesions in children and COVID‐19
Author(s) -
Torrelo Antonio,
Andina David,
Santonja Carlos,
NogueraMorel Lucero,
BascuasArribas Marta,
GaiteroTristán Jara,
AlonsoCadenas José Antonio,
EscaladaPellitero Silvia,
HernándezMartín Ángela,
TorreEspi Mercedes,
Colmenero Isabel
Publication year - 2020
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.14246
Subject(s) - erythema multiforme , medicine , immunohistochemistry , pathology , erythema , covid-19 , coronavirus , skin biopsy , spike protein , biopsy , dermatology , disease , infectious disease (medical specialty)
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.