ABSTRACT

A variety of dermatological lesions have been described in COVID-19, although the prevalence and pathogenic relationship remain unclear particularly for chilblain-like lesions. Dermatological examination was performed in a prospective cohort of consecutive patients seen at the service for SARS-CoV-2 infection. Out of 417 patients with confirmed SARS-CoV-2 infection [median age 29.5 years (range 15–65); 62.5% males], dermatological lesions were detected in 7 (1.7%). Three patients had acral lesions; their age (range) was 15–29 years; all had a negative nasopharyngeal swab and developed IgG and/or IgM-specific antibodies; all presented none or mild symptoms. A fourth patient remained negative at repeated testing; mother, father and sister had a documented mild COVID-19. Non-acral lesions were observed in four older patients, with severe COVID-19. Chilblain-like lesions may be the sole manifestation of SARS-CoV-2 infection; their presence in asymptomatic school children and adolescents should be considered a potential signal of familial or community spread of the virus.

摘要

COVID-19 中描述了多种皮肤病学病变，但其患病率和致病关系仍不清楚，尤其是冻疮样病变。在一个前瞻性队列中进行了皮肤病学检查，该队列由在服务部门就诊的 SARS-CoV-2 感染的连续患者组成。在 417 名确诊的 SARS-CoV-2 感染患者中[中位年龄 29.5 岁（范围 15-65）；62.5% 男性]，在 7 人 (1.7%) 中检测到皮肤病灶。3名患者有肢端病变；他们的年龄（范围）为 15-29 岁；所有人的鼻咽拭子均为阴性，并产生 IgG 和/或 IgM 特异性抗体；所有人都没有或轻微症状。第 4 名患者在重复检测中仍呈阴性；母亲、父亲和姐妹有记录在案的轻度 COVID-19。在四名患有严重 COVID-19 的老年患者中观察到非肢端病变。冻疮样病变可能是 SARS-CoV-2 感染的唯一表现；它们在无症状学童和青少年中的存在应被视为病毒在家庭或社区传播的潜在信号。