About: A clinical, histopathological and laboratory study of 19 consecutive Italian paediatric patients with chilblain‐like lesions: lights and shadows on the relationship with COVID‐19 infection

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About: A clinical, histopathological and laboratory study of 19 consecutive Italian paediatric patients with chilblain‐like lesions: lights and shadows on the relationship with COVID‐19 infection Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	A clinical, histopathological and laboratory study of 19 consecutive Italian paediatric patients with chilblain‐like lesions: lights and shadows on the relationship with COVID‐19 infection
Creator	Diociaiuti, Andrea Carsetti, R Concato, C Atti, Degli Alaggio, R Carnevale, C Ciofi, M Diociaiuti, A Giovannelli, L Hachem, M Latella, E Muda, A Porzio, O Rossi, S Stracuzzi, A Zaffina, S Zambruno, G
Source	Medline; PMC
abstract	BACKGROUND: Acral chilblain‐like lesions are being increasingly reported during COVID‐19 pandemic. However, only few patients proved positivity for SARS‐CoV‐2 infection. The relationship between this skin manifestation and COVID‐19 infection has not been clarified yet. OBJECTIVE: To thoroughly characterize a prospective group of patients with chilblain‐like lesions, and to investigate the possible relationship with SARS‐CoV‐2 infection. METHODS: Following informed consent, patients underwent: (i) clinical evaluation, (ii) RT‐PCR and serology testing for SARS‐CoV‐2, (iii) digital videocapillaroscopy of finger‐ and toe‐nailfolds, (iv) blood testing to screen for autoimmune diseases and coagulation anomalies, and (v) skin biopsy for histopathology, direct immunofluorescence, and, in selected cases, electron microscopy. RESULTS: Nineteen patients, all adolescents (mean age: 14 years), were recruited. 11/19 (58%) of them and/or their cohabitants reported flu‐like symptoms one to two months prior to skin manifestation onset. Lesions were localized to toes and also heels and soles. Videocapillarcosopy showed pericapillary oedema, dilated and abnormal capillaries, and microhemorrhages both in finger and toe in the majority of patients. Major pathological findings included: epidermal basal layer vacuolation, papillary dermis oedema and erythrocyte extravasation, perivascular and perieccrine dermal lymphocytic infiltrate, and mucin deposition in the dermis and hypodermis; dermal vessel thrombi were observed in 2 cases. Blood exams were normal. Nasopharyngeal swab for SARS‐CoV‐2 and IgG serology for SARS‐CoV‐2 nucleocapsid protein were negative. Importantly, IgA serology for S1 domain of SARS‐CoV‐2 spike protein was positive in 6 patients and borderline in 3. CONCLUSIONS: Chilblain‐like lesions during COVID‐19 pandemic have specific epidemiologic, clinical, capillaroscopic and histopathological characteristics, which distinguish them from idiopathic perniosis. Though we could not formally prove SARS‐CoV‐2 infection in our patients, history data and the detection of anti‐SARS‐COV‐2 IgA strongly suggest a relationship between skin lesions and COVID‐19. Further investigations on the mechanisms of SARS‐CoV‐2 infection in children and pathogenesis of chilblain‐like lesions are warranted.
has issue date	2020-05-31(xsd:dateTime)
bibo:doi	10.1111/jdv.16682
bibo:pmid	32474947
has license	no-cc
sha1sum (hex)	f53bf76e47cd1523b799d65f4e7d23f2c029abee
schema:url	https://doi.org/10.1111/jdv.16682
resource representing a document's title	A clinical, histopathological and laboratory study of 19 consecutive Italian paediatric patients with chilblain‐like lesions: lights and shadows on the relationship with COVID‐19 infection
has PubMed Central identifier	PMC7301001
has PubMed identifier	32474947
schema:publication	J Eur Acad Dermatol Venereol
resource representing a document's body	covid:f53bf76e47cd1523b799d65f4e7d23f2c029abee#body_text
is schema:about of	named entity 'laboratory' named entity 'COVID' named entity 'histopathological' named entity 'infection' named entity '1, 2' named entity 'IgA' named entity 'paediatric' named entity 'conjugated' named entity 'oedema' named entity 'intraluminal' named entity 'papules' named entity 'infection' named entity 'COVID-19 pandemic' named entity 'erythematous' named entity 'IgA' named entity 'COVID-19 disease' named entity 'infection' named entity '3, 4' named entity 'epidemiological' named entity 'pustules' named entity 'case series' named entity 'chilblain' named entity 'Chilblain' named entity 'Clinical features' named entity 'antibodies' named entity 'formalin-fixed' named entity 'histological' named entity 'prothrombin time' named entity 'asymptomatic' named entity 'IgG antibodies' named entity 'SARS-CoV-2' named entity 'dehydrated' named entity 'perniosis' named entity 'IgG' named entity 'C1q' named entity 'papillary dermis' named entity 'capillaries' named entity 'necrotic lesions' named entity 'clinical features' named entity 'paediatric' named entity 'Chilblains' named entity 'coronavirus' named entity 'IgG' named entity 'infection' named entity 'urticaria' named entity 'immunoassay' named entity 'infection' named entity 'skin biopsies' named entity 'chilblains' named entity 'Red cell' named entity 'IgA' named entity 'TEM' named entity 'case series' named entity 'morphology' named entity 'respiratory infections' named entity 'mucosal' named entity 'Alcian blue stain' named entity 'papules' named entity 'respiratory airways' named entity 'histopathological' named entity 'colloid' named entity 'basal membrane' named entity 'asymptomatic' named entity 'serology' named entity 'case series'

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