Pediatric Reports (Apr 2021)

Inflammatory Skin Lesions in Three SARS-CoV-2 Swab-Negative Adolescents: A Possible COVID-19 Sneaky Manifestation?

  • Giuseppe Ingravallo,
  • Francesco Mazzotta,
  • Leonardo Resta,
  • Sara Sablone,
  • Gerardo Cazzato,
  • Antonietta Cimmino,
  • Roberta Rossi,
  • Anna Colagrande,
  • Beniamino Ferrante,
  • Teresa Troccoli,
  • Ernesto Bonifazi

DOI
https://doi.org/10.3390/pediatric13020025
Journal volume & issue
Vol. 13, no. 2
pp. 181 – 188

Abstract

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Coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with various clinical manifestations, including skin lesions. In particular, during the COVID-19 pandemic lock-down period numerous chilblain-like lesions, mainly located on the feet, were observed in adolescents. The latter were often asymptomatic or associated with very mild respiratory symptoms. Here, we report three cases of acral nodular lesions in SARS-CoV-2 swab-negative adolescents with histological findings of chronic immune-mediated inflammation and immunohistochemical evidence of SARS-CoV-2 spike glycoproteins in endothelial cells and eccrine sweat glands. In one of these cases, the virus presence was confirmed by electron microscopy.

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