Mucocutaneous Manifestations due to Covid-19 in Paediatric Age Group in a Tertiary Care Centre in Southern India: A Retrospective Study

This study throws light on the diversity in cutaneous manifestations due to COVID-19 in paediatric age group. Mucocutaneous lesions associated with SARS-CoV-2 infection are still under investigation, due to their polymorphic clinical aspect and incompletely understood pathogenic mechanism. Dermatological lesions described during COVID-19 infection can be brought on by a variety of inflammatory cytokines that enter the skin and reach different cells of the cutaneous immune system.

The study was an observational study done on paeadiatric COVID cases aged less than 12 years who were admitted in COVID isolation ward of Institute of Child Health, Rajiv Gandhi Government General Hospital conducted for 3 months from August 2020 to October 2020.

A total of 191 swab-confirmed cases of COVID-19 aged less than 12 years were recruited in the study. Out of 191 cases, 19 had dermatological manifestations (10%). The most common type of dermatological manifestation noted in our study was maculopapular rash (n=8), followed by purpura (n=4), urticaria (n=3), angular cheilitis (n=2), palmar erythema (n=1), purpura with palmar erythema occurring together (n=1). Time latency between onset of first COVID symptom and occurrence of cutaneous lesion was 1 to 7 days. Mucocutaneous manifestations in MIS-C can be diverse with scarlatiniform rashes, morbilliform rashes, urticarial, reticulated eruptions, periorbital erythema and edema, palmoplantar erythema, lip erythema,lip cracking, conjuctival injection.

Children hospitalized with COVID-19 had various mucocutaneous manifestations which dermatologists and paediatricians should be aware of. Kawasaki disease like features during this pandemic should provoke the minds of treating doctors to consider diagnosis of Multisystem Inflammatory Syndrome in Children, thereby enabling timely intervention.