Acral Changes in pediatric patients during COVID 19 pandemic: Registry report from the COVID 19 response task force of the society of pediatric dermatology (SPD) and pediatric dermatology research alliance (PeDRA)
Background/Objective In spring 2020, high numbers of children presented with acral pernio‐like skin rashes, concurrent with the coronavirus disease 2019 (COVID‐19) pandemic. Understanding their clinical characteristics/ infection status may provide prognostic information and facilitate decisions abo...
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| Veröffentlicht in: | Pediatric dermatology 2021-03, Vol.38 (2), p.364-370 |
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| creator | Castelo‐Soccio, Leslie Lara‐Corrales, Irene Paller, Amy S. Bean, Eric Rangu, Sneha Oboite, Michelle Flohr, Carsten Ahmad, Regina‐Celeste Calberg, Valerie Gilliam, Amy Pope, Elena Reynolds, Sean Sibbald, Cathryn Shin, Helen T. Berger, Emily Schaffer, Julie Siegel, Michael P. Cordoro, Kelly M. |
| description | Background/Objective
In spring 2020, high numbers of children presented with acral pernio‐like skin rashes, concurrent with the coronavirus disease 2019 (COVID‐19) pandemic. Understanding their clinical characteristics/ infection status may provide prognostic information and facilitate decisions about management.
Methods
A pediatric‐specific dermatology registry was created by the Pediatric Dermatology COVID‐19 Response Task Force of the Society for Pediatric Dermatology (SPD) and Pediatric Dermatology Research Alliance (PeDRA) and was managed by Children's Hospital of Philadelphia using REDCap.
Results
Data from 378 children 0‐18 years entered into the registry between April 13 and July 17, 2020 were analyzed. Data were drawn from a standardized questionnaire completed by clinicians which asked for demographics, description of acral lesions, symptoms before and after acral changes, COVID‐19 positive contacts, treatment, duration of skin changes, laboratory testing including SARS‐CoV‐2 PCR and antibody testing, as well as histopathology. 229 (60.6%) were male with mean age of 13.0 years (± 3.6 years). Six (1.6%) tested positive for SARS‐CoV‐2. Pedal lesions (often with pruritus and/or pain) were present in 96%. 30% (114/378) had COVID‐19 symptoms during the 30 days prior to presentation. Most (69%) had no other symptoms and an uneventful course with complete recovery.
Conclusions and Relevance
Children with acral pernio‐like changes were healthy and all recovered with no short‐term sequelae. We believe these acral changes are not just a temporal epiphenomenon of shelter in place during the spring months of the first wave of the COVID‐19 pandemic and may be a late phase reaction that needs further study. |
| doi_str_mv | 10.1111/pde.14566 |
| format | Article |
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In spring 2020, high numbers of children presented with acral pernio‐like skin rashes, concurrent with the coronavirus disease 2019 (COVID‐19) pandemic. Understanding their clinical characteristics/ infection status may provide prognostic information and facilitate decisions about management.
Methods
A pediatric‐specific dermatology registry was created by the Pediatric Dermatology COVID‐19 Response Task Force of the Society for Pediatric Dermatology (SPD) and Pediatric Dermatology Research Alliance (PeDRA) and was managed by Children's Hospital of Philadelphia using REDCap.
Results
Data from 378 children 0‐18 years entered into the registry between April 13 and July 17, 2020 were analyzed. Data were drawn from a standardized questionnaire completed by clinicians which asked for demographics, description of acral lesions, symptoms before and after acral changes, COVID‐19 positive contacts, treatment, duration of skin changes, laboratory testing including SARS‐CoV‐2 PCR and antibody testing, as well as histopathology. 229 (60.6%) were male with mean age of 13.0 years (± 3.6 years). Six (1.6%) tested positive for SARS‐CoV‐2. Pedal lesions (often with pruritus and/or pain) were present in 96%. 30% (114/378) had COVID‐19 symptoms during the 30 days prior to presentation. Most (69%) had no other symptoms and an uneventful course with complete recovery.
Conclusions and Relevance
Children with acral pernio‐like changes were healthy and all recovered with no short‐term sequelae. We believe these acral changes are not just a temporal epiphenomenon of shelter in place during the spring months of the first wave of the COVID‐19 pandemic and may be a late phase reaction that needs further study.</description><identifier>ISSN: 0736-8046</identifier><identifier>EISSN: 1525-1470</identifier><identifier>DOI: 10.1111/pde.14566</identifier><identifier>PMID: 33742457</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Child ; Children ; Complications ; Coronaviruses ; COVID-19 ; Demography ; Dermatology ; Dermatology - trends ; exanthems ; Humans ; infection‐viral ; Late phase reaction ; Male ; Original ; Pandemics ; Pediatrics ; Pediatrics - trends ; Pedra Original ; Philadelphia ; Pruritus ; Registries ; Severe acute respiratory syndrome coronavirus 2 ; Skin Diseases - epidemiology ; skin signs of systemic disease ; Skin tests ; Systemic diseases ; Task forces</subject><ispartof>Pediatric dermatology, 2021-03, Vol.38 (2), p.364-370</ispartof><rights>2021 The Authors. published by Wiley Periodicals LLC.</rights><rights>2021 The Authors. Pediatric Dermatology published by Wiley Periodicals LLC.</rights><rights>2021. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4716-aecddb7512643920fc3fb593b60a2a7f583b3e5e52437e927a66425553511b1f3</citedby><cites>FETCH-LOGICAL-c4716-aecddb7512643920fc3fb593b60a2a7f583b3e5e52437e927a66425553511b1f3</cites><orcidid>0000-0001-9288-1121 ; 0000-0003-3289-446X ; 0000-0002-2136-5661</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpde.14566$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpde.14566$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33742457$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Castelo‐Soccio, Leslie</creatorcontrib><creatorcontrib>Lara‐Corrales, Irene</creatorcontrib><creatorcontrib>Paller, Amy S.</creatorcontrib><creatorcontrib>Bean, Eric</creatorcontrib><creatorcontrib>Rangu, Sneha</creatorcontrib><creatorcontrib>Oboite, Michelle</creatorcontrib><creatorcontrib>Flohr, Carsten</creatorcontrib><creatorcontrib>Ahmad, Regina‐Celeste</creatorcontrib><creatorcontrib>Calberg, Valerie</creatorcontrib><creatorcontrib>Gilliam, Amy</creatorcontrib><creatorcontrib>Pope, Elena</creatorcontrib><creatorcontrib>Reynolds, Sean</creatorcontrib><creatorcontrib>Sibbald, Cathryn</creatorcontrib><creatorcontrib>Shin, Helen T.</creatorcontrib><creatorcontrib>Berger, Emily</creatorcontrib><creatorcontrib>Schaffer, Julie</creatorcontrib><creatorcontrib>Siegel, Michael P.</creatorcontrib><creatorcontrib>Cordoro, Kelly M.</creatorcontrib><title>Acral Changes in pediatric patients during COVID 19 pandemic: Registry report from the COVID 19 response task force of the society of pediatric dermatology (SPD) and pediatric dermatology research alliance (PeDRA)</title><title>Pediatric dermatology</title><addtitle>Pediatr Dermatol</addtitle><description>Background/Objective
In spring 2020, high numbers of children presented with acral pernio‐like skin rashes, concurrent with the coronavirus disease 2019 (COVID‐19) pandemic. Understanding their clinical characteristics/ infection status may provide prognostic information and facilitate decisions about management.
Methods
A pediatric‐specific dermatology registry was created by the Pediatric Dermatology COVID‐19 Response Task Force of the Society for Pediatric Dermatology (SPD) and Pediatric Dermatology Research Alliance (PeDRA) and was managed by Children's Hospital of Philadelphia using REDCap.
Results
Data from 378 children 0‐18 years entered into the registry between April 13 and July 17, 2020 were analyzed. Data were drawn from a standardized questionnaire completed by clinicians which asked for demographics, description of acral lesions, symptoms before and after acral changes, COVID‐19 positive contacts, treatment, duration of skin changes, laboratory testing including SARS‐CoV‐2 PCR and antibody testing, as well as histopathology. 229 (60.6%) were male with mean age of 13.0 years (± 3.6 years). Six (1.6%) tested positive for SARS‐CoV‐2. Pedal lesions (often with pruritus and/or pain) were present in 96%. 30% (114/378) had COVID‐19 symptoms during the 30 days prior to presentation. Most (69%) had no other symptoms and an uneventful course with complete recovery.
Conclusions and Relevance
Children with acral pernio‐like changes were healthy and all recovered with no short‐term sequelae. We believe these acral changes are not just a temporal epiphenomenon of shelter in place during the spring months of the first wave of the COVID‐19 pandemic and may be a late phase reaction that needs further study.</description><subject>Adolescent</subject><subject>Child</subject><subject>Children</subject><subject>Complications</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Demography</subject><subject>Dermatology</subject><subject>Dermatology - trends</subject><subject>exanthems</subject><subject>Humans</subject><subject>infection‐viral</subject><subject>Late phase reaction</subject><subject>Male</subject><subject>Original</subject><subject>Pandemics</subject><subject>Pediatrics</subject><subject>Pediatrics - trends</subject><subject>Pedra Original</subject><subject>Philadelphia</subject><subject>Pruritus</subject><subject>Registries</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Skin Diseases - epidemiology</subject><subject>skin signs of systemic disease</subject><subject>Skin tests</subject><subject>Systemic diseases</subject><subject>Task forces</subject><issn>0736-8046</issn><issn>1525-1470</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp1kl1v0zAUhiMEYmVwwR9AlrhpL7L52ykXk6p2wKRJq8bHreU4J61HEgc7BeWH8n9w17EB0nxjWefRc46P3ix7TfAJSee0r-CEcCHlk2xCBBU54Qo_zSZYMZkXmMuj7EWMNxjjQkryPDtiTHHKhZpkvxY2mAYtt6bbQESuQz1UzgzBWdSbwUE3RFTtgus2aHn19WKFyDwVugpaZ9-ha9i4OIQRBeh9GFAdfIuGLTywAWLvuwhoMPEbqn2wgHx9y0RvHQzj_vnQtILQmsE3fjOi6af1aoZSs0fqyQ0m2C0yTeNMl8zTNayuF7OX2bPaNBFe3d3H2Zf355-XH_PLqw8Xy8VlbrkiMjdgq6pUglDJ2Zzi2rK6FHNWSmyoUbUoWMlAgKCcKZhTZaTkVAjBBCElqdlxdnbw9ruyhcqmbaVt6j641oRRe-P0v5XObfXG_9AFFZhinATTO0Hw33cQB926aKFpTAd-F3XCGOdEFCqhb_9Db_wudOl7iSKcKqzme-HsQNngYwxQ3w9DsN6HRaew6NuwJPbN39Pfk3_SkYDTA_DTNTA-btLr1flB-RtB7cpQ</recordid><startdate>202103</startdate><enddate>202103</enddate><creator>Castelo‐Soccio, Leslie</creator><creator>Lara‐Corrales, Irene</creator><creator>Paller, Amy S.</creator><creator>Bean, Eric</creator><creator>Rangu, Sneha</creator><creator>Oboite, Michelle</creator><creator>Flohr, Carsten</creator><creator>Ahmad, Regina‐Celeste</creator><creator>Calberg, Valerie</creator><creator>Gilliam, Amy</creator><creator>Pope, Elena</creator><creator>Reynolds, Sean</creator><creator>Sibbald, Cathryn</creator><creator>Shin, Helen T.</creator><creator>Berger, Emily</creator><creator>Schaffer, Julie</creator><creator>Siegel, Michael P.</creator><creator>Cordoro, Kelly M.</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9288-1121</orcidid><orcidid>https://orcid.org/0000-0003-3289-446X</orcidid><orcidid>https://orcid.org/0000-0002-2136-5661</orcidid></search><sort><creationdate>202103</creationdate><title>Acral Changes in pediatric patients during COVID 19 pandemic: Registry report from the COVID 19 response task force of the society of pediatric dermatology (SPD) and pediatric dermatology research alliance (PeDRA)</title><author>Castelo‐Soccio, Leslie ; Lara‐Corrales, Irene ; Paller, Amy S. ; Bean, Eric ; Rangu, Sneha ; Oboite, Michelle ; Flohr, Carsten ; Ahmad, Regina‐Celeste ; Calberg, Valerie ; Gilliam, Amy ; Pope, Elena ; Reynolds, Sean ; Sibbald, Cathryn ; Shin, Helen T. ; Berger, Emily ; Schaffer, Julie ; Siegel, Michael P. ; Cordoro, Kelly M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4716-aecddb7512643920fc3fb593b60a2a7f583b3e5e52437e927a66425553511b1f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Child</topic><topic>Children</topic><topic>Complications</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Demography</topic><topic>Dermatology</topic><topic>Dermatology - trends</topic><topic>exanthems</topic><topic>Humans</topic><topic>infection‐viral</topic><topic>Late phase reaction</topic><topic>Male</topic><topic>Original</topic><topic>Pandemics</topic><topic>Pediatrics</topic><topic>Pediatrics - trends</topic><topic>Pedra Original</topic><topic>Philadelphia</topic><topic>Pruritus</topic><topic>Registries</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Skin Diseases - epidemiology</topic><topic>skin signs of systemic disease</topic><topic>Skin tests</topic><topic>Systemic diseases</topic><topic>Task forces</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Castelo‐Soccio, Leslie</creatorcontrib><creatorcontrib>Lara‐Corrales, Irene</creatorcontrib><creatorcontrib>Paller, Amy S.</creatorcontrib><creatorcontrib>Bean, Eric</creatorcontrib><creatorcontrib>Rangu, Sneha</creatorcontrib><creatorcontrib>Oboite, Michelle</creatorcontrib><creatorcontrib>Flohr, Carsten</creatorcontrib><creatorcontrib>Ahmad, Regina‐Celeste</creatorcontrib><creatorcontrib>Calberg, Valerie</creatorcontrib><creatorcontrib>Gilliam, Amy</creatorcontrib><creatorcontrib>Pope, Elena</creatorcontrib><creatorcontrib>Reynolds, Sean</creatorcontrib><creatorcontrib>Sibbald, Cathryn</creatorcontrib><creatorcontrib>Shin, Helen T.</creatorcontrib><creatorcontrib>Berger, Emily</creatorcontrib><creatorcontrib>Schaffer, Julie</creatorcontrib><creatorcontrib>Siegel, Michael P.</creatorcontrib><creatorcontrib>Cordoro, Kelly M.</creatorcontrib><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Castelo‐Soccio, Leslie</au><au>Lara‐Corrales, Irene</au><au>Paller, Amy S.</au><au>Bean, Eric</au><au>Rangu, Sneha</au><au>Oboite, Michelle</au><au>Flohr, Carsten</au><au>Ahmad, Regina‐Celeste</au><au>Calberg, Valerie</au><au>Gilliam, Amy</au><au>Pope, Elena</au><au>Reynolds, Sean</au><au>Sibbald, Cathryn</au><au>Shin, Helen T.</au><au>Berger, Emily</au><au>Schaffer, Julie</au><au>Siegel, Michael P.</au><au>Cordoro, Kelly M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acral Changes in pediatric patients during COVID 19 pandemic: Registry report from the COVID 19 response task force of the society of pediatric dermatology (SPD) and pediatric dermatology research alliance (PeDRA)</atitle><jtitle>Pediatric dermatology</jtitle><addtitle>Pediatr Dermatol</addtitle><date>2021-03</date><risdate>2021</risdate><volume>38</volume><issue>2</issue><spage>364</spage><epage>370</epage><pages>364-370</pages><issn>0736-8046</issn><eissn>1525-1470</eissn><abstract>Background/Objective
In spring 2020, high numbers of children presented with acral pernio‐like skin rashes, concurrent with the coronavirus disease 2019 (COVID‐19) pandemic. Understanding their clinical characteristics/ infection status may provide prognostic information and facilitate decisions about management.
Methods
A pediatric‐specific dermatology registry was created by the Pediatric Dermatology COVID‐19 Response Task Force of the Society for Pediatric Dermatology (SPD) and Pediatric Dermatology Research Alliance (PeDRA) and was managed by Children's Hospital of Philadelphia using REDCap.
Results
Data from 378 children 0‐18 years entered into the registry between April 13 and July 17, 2020 were analyzed. Data were drawn from a standardized questionnaire completed by clinicians which asked for demographics, description of acral lesions, symptoms before and after acral changes, COVID‐19 positive contacts, treatment, duration of skin changes, laboratory testing including SARS‐CoV‐2 PCR and antibody testing, as well as histopathology. 229 (60.6%) were male with mean age of 13.0 years (± 3.6 years). Six (1.6%) tested positive for SARS‐CoV‐2. Pedal lesions (often with pruritus and/or pain) were present in 96%. 30% (114/378) had COVID‐19 symptoms during the 30 days prior to presentation. Most (69%) had no other symptoms and an uneventful course with complete recovery.
Conclusions and Relevance
Children with acral pernio‐like changes were healthy and all recovered with no short‐term sequelae. We believe these acral changes are not just a temporal epiphenomenon of shelter in place during the spring months of the first wave of the COVID‐19 pandemic and may be a late phase reaction that needs further study.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33742457</pmid><doi>10.1111/pde.14566</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-9288-1121</orcidid><orcidid>https://orcid.org/0000-0003-3289-446X</orcidid><orcidid>https://orcid.org/0000-0002-2136-5661</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Pediatric dermatology, 2021-03, Vol.38 (2), p.364-370 |
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| language | eng |
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| source | MEDLINE; Wiley Journals |
| subjects | Adolescent Child Children Complications Coronaviruses COVID-19 Demography Dermatology Dermatology - trends exanthems Humans infection‐viral Late phase reaction Male Original Pandemics Pediatrics Pediatrics - trends Pedra Original Philadelphia Pruritus Registries Severe acute respiratory syndrome coronavirus 2 Skin Diseases - epidemiology skin signs of systemic disease Skin tests Systemic diseases Task forces |
| title | Acral Changes in pediatric patients during COVID 19 pandemic: Registry report from the COVID 19 response task force of the society of pediatric dermatology (SPD) and pediatric dermatology research alliance (PeDRA) |
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