1/24/2024 0 Comments Covid rash![]() The diagnosis of COVID-19-associated mucocutaneous manifestation in all above cases was based on morphology and distribution of the mucocutaneous lesions, temporal relationship with COVID-19 infection, clinical status of the child and laboratory confirmation by the SARS-CoV-2 PCR test. He had urticated plaques, some with targetoid appearance over the elbows, hands, wrists, ankles and feet. (D) Urticaria multiforme secondary to COVID-19 infection. He had scattered papules urticarial rashes over the extremities, thighs, trunk and back, with slightly swollen hands and feet. ![]() (C) Acute urticaria of hands and feet related to COVID-19 infection. There were no other rashes or eye and genital involvement. Erosions and crusting were noted over upper and lower lips, with 1 blister over the right lower lip. (B) Reactive infectious mucocutaneous eruption in children diagnosed with COVID-19. There was no lesion on his mucosal surfaces, toes or other parts of the body. Multiple shallow ulcers and erosions with erythematous base and violaceous plaques were noted on finger pulps of the right second, third, fourth fingers and left thumb. He was given regular antihistamines, and topical corticosteroid twice a day with improvement.įig. He was diagnosed with urticaria multiforme secondary to COVID-19 infection. On examination, there were multiple urticated plaques, some with targetoid appearance, over the limbs and extremities (Fig. His symptoms improved on regular fexofenadine and he was discharged well on the second day of admission.Ĭase 4 was a 9-year-old Korean boy who presented with 3 days of sore throat and 5 days of itchy rash over the limbs and extremities. He was diagnosed with acute urticaria related to COVID-19 infection. No other clinical features of Kawasaki disease were seen. Both hands and feet were also slightly swollen (Fig. On examination, there were generalised scattered urticated papules and wheals. He was discharged well after 1 week of inpatient hospital stay.Ĭase 3 was a previously well 3-year-old Chinese boy who presented acutely with fever, sore throat, hives and swelling of hands and feet. He completed an empirical 5-day course of oral acyclovir, and a course of oral prednisolone (initial dose 1mg/kg/day) tapered over 12 days. He was started on intravenous fluid and analgaesia, lip treatment with mometasone cream and paraffin ointment, normal saline soaks and chlorhexidine mouthwash. He was diagnosed with RIME associated with COVID-19. Microbiology investigations were negative for herpes simplex virus, mycoplasma and human herpesvirus 6. Inflammatory markers were mildly elevated (C-reactive protein 65.6mg/L, lactate dehydrogenase 326 U/L, ferritin 89.8µg/L and D-dimer 0.67mg/L). Results of SARS-CoV-2 polymerase chain reaction (PCR) and SARS-CoV-2 serology tests were positive. ![]() Examination by the ophthalmologist showed no keratoconjunctivitis. Coalescing ulcers were noted over the buccal mucosa, posterior pharynx and tongue. Clinically, there were extensive erosions with crusting over the upper and lower lips, with blister formation (Fig. There was almost full recovery of his digital lesions after another 2 weeks.Ĭase 2 was a previously well 10-year-old Indian boy who presented with 3 days of lower lip swelling and lip ulcers associated with mild cough and sore throat, which were complicated by poor feeding. He was diagnosed to have COVID-19-related chilblains, and discharged after 4 days. Blisters on his digital lesions were treated and topical cream (fusidic acid and betamethasone) was applied. However, there was no clinical improvement so referral to the dermatology team was made. He was commenced on intravenous cefazolin. ![]() He was reviewed by the orthopaedic surgeon for initial concerns of felon progressing to septic arthritis or osteomyelitis. There were multiple shallow ulcers and erosions with violaceous plaques on his finger pulps (Fig. The main objective is to describe the clinical characteristics of these patients, focusing on chilblains-like acute acral eruptions (AAE), and reactive infectious mucocutaneous eruption (RIME), with relevance to COVID-19 infection.Ĭase 1 was a 6-year-old Malay boy who presented acutely with painful skin lesions on his fingers with respiratory symptoms and fever. 1,2,3 We report 4 cases of paediatric patients who had COVID-19 with mucocutaneous involvement, admitted to a tertiary children’s hospital in Singapore. Children with COVID-19 infection can present with a variable spectrum of clinical manifestations, and sometimes mucocutaneous manifestations can be the only manifestation of COVID-19 infection in children.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |