Doctors have revealed the most common sites and types of rashes found in children with a rare coronavirus-related hyperinflammation.
Called MIS-C, patients were first diagnosed in 2020 after doctors noted that some children developed inflammation in a range of organs after exposure to SARS-CoV-2, with the Center for Disease Control saying it could be fatal, but most children survive.
Experts at Children’s Hospital in Philadelphia say diagnosing MIS-C has proven difficult because many of the symptoms, including rashes, fever, and gastrointestinal upset, are similar to other childhood conditions.
The team found that while there was no single location for rashes, they often occurred on the lower extremities, inner thigh, chest, and upper extremities.
In more than half of the seven patients studied, they usually presented as small to medium-sized circles the size of a 5 pence coin with small red spots in the center.
Authors hope that by highlighting common coronavirus rashes in children, their findings can help doctors and parents know when a rash needs further investigation.
Small 5p-sized plaques appear on the back of a child with MIS-C with small red spots on the inside
There was no single place where the rash appeared, and no single style for the rash – but researchers found they were common on arms and legs
In April 2020, doctors began to recognize a syndrome in children with hyperinflammation that results in a range of symptoms.
These symptoms include the usual Covid-19 problems, including fever, as well as gastrointestinal upset and rashes.
The syndrome, thought to be a post-infectious complication of Covid-19, was dubbed Multisystem Inflammatory Syndrome Children or MIS-C.
However, diagnosing the condition posed challenges as many of the symptoms, including a rash, are common with many other childhood infections.
Philadelphia researchers say there was also no single type of rash or rash placement that was common in all the cases of MISH-C in the children they studied.
In a study published in Open Forum Infectious Diseases, researchers at Children’s Hospital of Philadelphia (CHOP) describe the range of rashes seen in MIS-C patients.
They say these are all seen in children with the condition and can hope that the photos they share in the newspaper can help doctors diagnose future cases.
“We hope that the information in this research letter will help general pediatricians and emergency physicians who may be wondering if a patient with a fever needs a more comprehensive examination,” said author Audrey Odom John.
“ Given that some rashes related to MIS-C are distinctive, we can also imagine that these images could help many parents looking for signs that their child needs a quick evaluation, ” explains CHOP’s infectious disease expert. from.
According to the team, all patients showed some degree of a rash on their lower extremities
One patient had a rash along the hairline – this was unusual, with the lower and upper limbs the most common sites for a rash
One patient saw a rash on the neck (left) and another saw a much larger rash on the shoulder (right), but both were uncommon and not found in all children
Regarding the site of the rash, all patients in the study developed a rash on their lower body and five of the seven patients had a rash on the inner thighs.
Rashes on the chest and upper extremities were also common, according to doctors, and occurred in four of seven patients.
More than half of the patients had small to medium sized ring-shaped plaques – circles the size of a UK 5p or US dime on the chest and back.
More than half of the patients in the study also developed purpura – small red spots, often in the center of the aforementioned small circular ring-shaped plaques.
Researchers have found a number of locations for the rash, including the stomach and legs
No two rashes were the same, some showing as several small dots and others as a few larger dots scattered across the abdomen, pouch, legs and arms
Although some patients developed a cherry red rash on the bottoms of their feet and palms, this type of rash was seen in less than half of the patients.
A rash on the face was unusual and the rash was rarely itchy.
“Depending on the age of the child, parents may not regularly look at the child’s chest, back, or thighs, but this is where the rash associated with MIS-C usually occurs,” said John.
“Since MIS-C is still largely a diagnosis of exclusion, parents and caregivers should look for a rash in these locations if the child has a fever that appears suspicious.”
The findings are published in the journal Open Forum Infectious Diseases