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)