Background: A variety of skin manifestations have been associated with COVID-19 infection Acral lesions on hands and feet, closely resembling chilblains, have been reported in association with COVID-19, which are nonspecific These acro-ischemic painful lesions have been described mainly in asymptomatic and mildly symptomatic pediatric COVID-19 positive patients, without a precise patho-genetic mechanism COVID-19-induced chilblains may portend an indolent course and a good outcome In young patients, the IFN-1 response induces microangiopathic changes and produces a chilblain lupus erythematosus-like eruption with vasculitic neuro-pathic pain features Objectives: This paper presented a case series of pediatric patients with COVID-19-related skin lesions and neuropathic-like pain Methods: Clinical outcomes were collected from 11 patients diagnosed with painful erythematous skin lesions with neuropathic-like pain and positive IgG for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Results: It is a mildly symptomatic condition not related to severe pain rates, and it is treated with paracetamol due to the transitory nature of the problem, which provides good results Conclusions: A particular point of interest is skin lesion manifestation as a further indirect sign of SARS-CoV-2 infection Due to the initial manifestation of chilblains in pauci-symptomatic pediatric patients, they need to be immediately tested and isolated Chilblains can be considered a clinical clue to suspect SARS-CoV-2 infection and help in early diagnosis, patient triage, and infection control
COVID-19 related acro-ischemic neuropathic-like painful lesions in pediatric patients: A case seriese