Results
In our group of patients no significant difference in gender was detected (5 Females and 4 Males). The median age was 11,4 years (from 5 to 15 years). Two patients were siblings. All patients were from the South of Italy and live in the town of Messina and surroundings. Family history was negative for autoimmune disorders, Raynaud’s phenomenon, acrocyanosis, chilblains or photosensitivity. All children were negative for clinical history of autoimmune or auto-inflammatory disorders except one with an episode of Raynaud’s phenomenon a few years earlier. No family member of these patients presented symptoms attributable to SARS-CoV2 infection but their parents had contact with people for work reasons. Only two siblings had both parents with compatible symptoms and confirmed SARS-CoV2 infection: positive nasal swab. The cutaneous manifestations 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 and/or fingers or heels (Fig. 1,2,3). Feet alone were mostly affected (6 of 9), hands (3 of 9) (Fig.1). Six patients had respiratory and systemic symptoms (cough, nasal congestion, chills, fever, asthenia) that preceded cutaneous findings of approximately 2 weeks (Table1). At the time of the first visit in 3 out 9 patients the skin lesions were quite mild only erythema persisted. Concerning the results of blood test: three out of nine had coagulation alterations (D-dimer weakly increased), 4 had ANA positivity: two with a title of 1:160, one with 1:320 and one with 1:5120 and a speckled pattern. The latter patient had also ENA SS-A positivity and FR positivity, in all others it was negative. Four out of nine had aPL positivity (IgM). Reactants acute phase were negative in all patients. Serology for SARS-CoV2 was negative (borderline in one patient for IgM). (Table2)