{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:53:14Z","timestamp":1747187594180,"version":"3.40.5"},"reference-count":10,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T00:00:00Z","timestamp":1626393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The role of SARS\u2010CoV\u20102 as the cause of chilblains in children remains a matter of debate but it is important to elucidate it for patient isolation and contact tracing. We sought to define the etiology, clinical presentation, time course, and outcomes of children presenting to the emergency department (ED) with cutaneous manifestations shortly after the first pandemic peak of COVID\u201019 in Spain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective, observational study in children &lt;15\u00a0years of age evaluated for skin lesions in the EDs of three pediatric hospitals. Children underwent a comprehensive work\u2010up including tests for SARS\u2010CoV\u20102 antibodies and polymerase chain reaction (PCR), and serology and PCR tests for other viruses and bacteria. A 1 month follow\u2010up visit was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From April 14 through May 8, 2020, we enrolled 62 children. Of those, 34 had acro\u2010ischemic skin lesions and 28 had a variety of skin rashes. Overall, 40% of children had mild systemic symptoms. Children with chilblains were older, had pain more frequently and a more prolonged duration of skin lesions, while those with non\u2010specific rashes had fever more frequently. Lesions were resolved in 75% of children at follow up. Five patients demonstrated SARS\u2010CoV\u20102 antibodies, and none tested positive with PCR. Three additional patients tested positive with PCR for rhinovirus, <jats:italic>Mycoplasma pneumoniae<\/jats:italic> and <jats:italic>Chlamydia pneumoniae<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The number of ED visits for chilblains, which are rare in pediatrics, was high soon after the first peak of COVID\u201019 in Spain. The disease course was self\u2010limited, outcomes were favorable, and the possibility of viral transmission was negligible as all patients tested negative for SARS\u2010CoV\u20102 by PCR.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.14568","type":"journal-article","created":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T16:44:09Z","timestamp":1607186649000},"page":"1033-1037","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Skin manifestations during the COVID\u201019 pandemic in the pediatric emergency department"],"prefix":"10.1111","volume":"63","author":[{"given":"Silvia","family":"Oliva Rodr\u00edguez\u2010Pastor","sequence":"first","affiliation":[{"name":"Division of Pediatric Emergency Medicine and Critical Care Hospital Regional Universitario Materno\u2010Infantil de M\u00e1laga M\u00e1laga Spain"},{"name":"Departamento de Farmacologia y Pediatria Facultad de Medicina Universidad de M\u00e1laga M\u00e1laga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Mart\u00edn Pedraz","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases Hospital Regional Universitario Materno\u2010Infantil de M\u00e1laga M\u00e1laga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bego\u00f1a","family":"Carazo Gallego","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases Hospital Regional Universitario Materno\u2010Infantil de M\u00e1laga M\u00e1laga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roc\u00edo","family":"Galindo Zavala","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases Hospital Regional Universitario Materno\u2010Infantil de M\u00e1laga M\u00e1laga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gema","family":"Lozano S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Hospital de la Axarqu\u00eda V\u00e9lez\u2010M\u00e1laga, M\u00e1laga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inmaculada","family":"de Toro Peinado","sequence":"additional","affiliation":[{"name":"Department of Microbiology Hospital Regional Universitario de M\u00e1laga M\u00e1laga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margarita","family":"Rodriguez Benjumea","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Hospital Virgen de las Nieves Granada Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5983-8006","authenticated-orcid":false,"given":"Asuncion","family":"Mejias","sequence":"additional","affiliation":[{"name":"Departamento de Farmacologia y Pediatria Facultad de Medicina Universidad de M\u00e1laga M\u00e1laga Spain"},{"name":"Center for Vaccines and Immunity and Division of Pediatric Infectious Diseases Nationwide Children's Hospital and The Ohio State University College of Medicine Columbus OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1938-1678","authenticated-orcid":false,"given":"Esmeralda","family":"N\u00fa\u00f1ez Cuadros","sequence":"additional","affiliation":[{"name":"Division of Pediatric Rheumatology Hospital Regional Universitario Materno\u2010Infantil de M\u00e1laga M\u00e1laga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,7,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.16387"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19163"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ced.14294"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2020.04.093"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2020.2340"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.16544"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19264"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19327"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.14215"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2020.2368"}],"container-title":["Pediatrics 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