{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T05:44:02Z","timestamp":1781761442780,"version":"3.54.5"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T00:00:00Z","timestamp":1631491200000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Dermatology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Coronavirus disease (COVID\u201019) is related to several extrapulmonary disorders; however, little is known about the clinical, laboratory, and histopathological characteristics of pernio\u2010like skin lesions associated with COVID\u201019 infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate and summarize the clinical, laboratory, and histopathological characteristics of pernio\u2010like lesions reported in the literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a search of the PubMed, SciELO, and ScienceDirect databases for articles published between January 1, 2020 and November 30, 2020, following the PRISMA recommendations (PROSPERO registration ID: CRD42020225055). The target population was individuals with suspected or laboratory\u2010confirmed COVID\u201019 with pernio\u2010like lesions. Observational studies, research letters, and case\/series reports were all eligible for inclusion. Observational studies were evaluated using a random\u2010effects model to calculate the weighted mean prevalence, overall mean, and 95% confidence interval. We evaluated case studies using the chi\u2010square test for dichotomous variables and the Mann\u2010Whitney test for continuous variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 187 patients from case reports and 715 patients from 18 observational studies were included. The mean age of patients was 16.6 years (range 14.5\u201018.8). Feet were affected in 91.4% (87.0\u201094.4%) of patients in observational studies. The proportion of patients with a positive RT\u2010PCR test was less than 15%. Lesion topography and morphology were associated with age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Lesions mostly occurred in pediatric patients, and the morphological characteristics tended to differ between pediatric and non\u2010pediatric populations. There is a possible multifactorial component in lesion pathophysiology. The non\u2010positivity of laboratory tests does not exclude an association with COVID\u201019. Pernio\u2010like lesions may be a late manifestation of COVID\u201019.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pde.14805","type":"journal-article","created":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T10:10:51Z","timestamp":1631527851000},"page":"1143-1149","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["\u201cCOVID toes\u201d: A meta\u2010analysis of case and observational studies on clinical, histopathological, and laboratory findings"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8031-1196","authenticated-orcid":false,"given":"Kelvin Oliveira","family":"Rocha","sequence":"first","affiliation":[{"name":"Department of Medicine and Nursing Federal University of Vi\u00e7osa Vi\u00e7osa Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4442-3606","authenticated-orcid":false,"given":"Virg\u00ednia Vinha","family":"Zanuncio","sequence":"additional","affiliation":[{"name":"Department of Medicine and Nursing Federal University of Vi\u00e7osa Vi\u00e7osa Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7863-0681","authenticated-orcid":false,"given":"Brunnella Alc\u00e2ntara Chagas de","family":"Freitas","sequence":"additional","affiliation":[{"name":"Department of Medicine and Nursing Federal University of Vi\u00e7osa Vi\u00e7osa Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5349-1577","authenticated-orcid":false,"given":"Luciana Moreira","family":"Lima","sequence":"additional","affiliation":[{"name":"Department of Medicine and Nursing Federal University of Vi\u00e7osa Vi\u00e7osa Brazil"},{"name":"Post\u2010graduate program of the Department of Medicine and Nursing Federal University of Vi\u00e7osa Vi\u00e7osa 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