28.05.2020

Are chilblain-like acral skin lesions really indicative of COVID-19? A prospective study and literature review

Epidemiological Dermatology
Docampo-Simon A et al
J Eur Acad Dermatol Venerol

Main result

Main results [en]:

<p><u>Cross-sectional observational study : </u></p>

<p>- 58 patients (median age 14 years, 29 males and 29 females) with acral lesions were included, 72.4% (42) had lesions similar to frostbite. 12 out of 55 of them had been in contact with a proven case, 7 with a suspected case; only 11 out of 52 of them had symptoms suggestive of COVID-19.</p>

<p>- 15 patients had previously been tested for CoV-2-SARS: only one of them was positive, an 85-year-old patient with severe lung disease and whose lesion was an ulceration of a toe of vascular etiology.</p>

<p>- Tests performed on 24 other patients: all negative.</p>

<p><u>Literature review :</u></p>

<p>- Identification of 99 articles (including 97 by querying databases); only 9 articles specifically describing acral lesions.</p>

<p>- Total number of patients from the 9 articles: 232 patients, only 42 of them tested, 12/42 were positive.</p>

 

Takeaways

There is currently no evidence suggesting an association between chilblain-like acral skin lesions and SARS-CoV-2 infection

Strength of evidence Weak

- Letter to the editor
- Cross-sectional observational study coupled with a seemingly systematic literature review lacking methodological details.

Objectives

- To establish the prevalence of COVID-19 infection among patients with chilblain-like acral skin lesions.

Method

<p>- Cross-sectional observational study [presented as "prospective" without&nbsp;follow-up] in 2 steps :</p>

<p>1- Pool of patients from a specific region in the east of Spain who consulted for acral dermatological lesions in dermatology, paediatric services or private general practitioners over a period of 3 weeks.</p>

<p>2- Performed RT-PCR for SARS-CoV-2 on nasopharyngeal aspirate in all previously identified and available patients [median time not specified].</p>

<p>- Performed literature review [seemingly systematic but lacking methodology details] of papers published before May 2020 on the topic of dermatological lesions in COVID-19 patients.</p>

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