5 Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Italy
Pernio like in children during Covid 19 era
*Corresponding Author Romina Gallizzi
Department of Human Pathology of Adulthood and Childhood Gaetano Barresi, University of Messina, Messina, Italy
Gaetano Martino University Hospital, UOC Pediatria
Via Consolare Valeria
Messina, 98125, Italy
Tel: 090 221 3154
Fax: 090 221 3170
E-mail: rgallizzi@unime.it
Romina Gallizzi : Conceptualization (Lead) Data curation (Lead) Investigation (Lead) Methodology (Lead) Project administration (Lead) Resources (Lead) Software (Lead) Supervision (Lead) Validation (Lead) Visualization (Lead) Writing-original draft (Lead) Writing-review & editing (Lead)
Diana Sutera : Writing-original draft (Lead)
Alessandra Spagnolo : Writing-original draft (Lead)
Serafinella Patrizia Cannavò : Visualization (Equal)
Loredana Grasso : Methodology (Equal)
Claudio Guarneri : Visualization (Equal)
Giuseppe Nunnari : Visualization (Equal)
Francesca Mazza : Writing-original draft (Equal)
Giovanni Battista Pajno : Supervision (Equal) Validation (Equal) Visualization (Equal)
There aren’t conflict of interests related to the manuscript content
We have not received financial support for the execution of the work
ABSTRACT
Background
During the outbreak of COVID-19 many chilblain-like lesions are being increasingly reported. The aim of the study is to evaluate a possible correlation between pernio like skin lesions and SARS CoV2 infection.
Methods
All patients underwent not only clinical and laboratory tests to evaluate a possible underlying connective disease, but also specific SARS CoV2 investigations such as oropharyngeal swab and IgG-IgM serology.
Results
Nine patients, all children, were recruited. 6/9 had respiratory and systemic symptoms that preceded cutaneous findings of approximately 2 weeks. The injuries observed were purplish, erythematous and edematous; four children reported subjective symptoms, painful and pruritus localized to the sole of the feet or to the toes, fingers or heels. Concerning blood exams: 3/9 had D-dimer weakly increased, 4 had ANA positivity: two with a title 1:160, one with 1:320 and one with 1:5120 and a speckled pattern. The latter patient had also ENA SS-A positive and FR positivity, confirmed at a second check, so as to allow us to make a diagnosis of connectivity. 4/9 had aPL positivity (IgM). Reactants acute phase were all negative. Oropharyngeal swabs and serology tests for SARS-CoV2 was negative (borderline in one patient for IgM).
Conclusions
Even if we do not have enough data to prove it, we hypothesize a correlation between chilblain and SARS-CoV2 infection for an increased number of these lesions described and also because such manifestations appeared when temperatures were mild and patients were at home in isolation for the lockdown. Many questions remain open about interaction host-virus.
KEYWORDS: chilblain, pernio, Covid19, children, skin lesions
The study was approved by our Institutional Ethical Committee and conducted in accordance with the Declaration of Helsinki.