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PUTATIVE CUTANEOUS MANIFESTATIONS PERNIO LIKE AND COVID 19 INFECTION IN CHILDREN
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  • Romina Gallizzi,
  • Diana Sutera ,
  • Alessandra Spagnolo,
  • Serafinella Patrizia Cannavò,
  • Loredana Grasso,
  • Claudio Guarneri,
  • Giuseppe Nunnari,
  • Francesca Mazza,
  • Giovanni Pajno
Romina Gallizzi
University of Messina, Italy
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Diana Sutera
Department of Human Pathology of Adulthood and Childhood Gaetano Barresi, Unit of Pediatric, University of Messina, Italy
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Alessandra Spagnolo
Department of Human Pathology of Adulthood and Childhood Gaetano Barresi, Unit of Pediatric, University of Messina, Italy
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Serafinella Patrizia Cannavò
Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Italy
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Loredana Grasso
Department of Services, Unit of Immunometry and Laboratory Diagnostic, University of Messina, Italy
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Claudio Guarneri
Department of Biomedical and Dental Sciences and Morphofunctional imaging, Institute of Dermatology, University of Messina, Italy
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Giuseppe Nunnari
Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Italy
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Francesca Mazza
Department of Human Pathology of Adulthood and Childhood Gaetano Barresi, Unit of Pediatric, University of Messina, Italy
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Giovanni Pajno
University of Messina
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Abstract

ABSTRACT Background During the outbreak of COVID-19 many chilblain-like lesions are being increasingly reported. The aim of the study is to evaluate a possible correlation between pernio like skin lesions and SARS CoV2 infection. Methods All patients underwent not only clinical and laboratory tests to evaluate a possible underlying connective disease, but also specific SARS CoV2 investigations such as oropharyngeal swab and IgG-IgM serology. Results Nine patients, all children, were recruited. 6/9 had respiratory and systemic symptoms that preceded cutaneous findings of approximately 2 weeks. The injuries observed were purplish, erythematous and edematous; four children reported subjective symptoms, painful and pruritus localized to the sole of the feet or to the toes, fingers or heels. Concerning blood exams: 3/9 had D-dimer weakly increased, 4 had ANA positivity: two with a title 1:160, one with 1:320 and one with 1:5120 and a speckled pattern. The latter patient had also ENA SS-A positive and FR positivity, confirmed at a second check, so as to allow us to make a diagnosis of connectivity. 4/9 had aPL positivity (IgM). Reactants acute phase were all negative. Oropharyngeal swabs and serology tests for SARS-CoV2 was negative (borderline in one patient for IgM). Conclusions Even if we do not have enough data to prove it, we hypothesize a correlation between chilblain and SARS-CoV2 infection for an increased number of these lesions described and also because such lesions appeared when temperatures were mild and patients were at home in isolation for the lockdown. Many questions remain open about interaction host-virus.