Dermatologic manifestations of COVID-19-associated multisystem inflammatory syndrome in children

Multisystem inflammatory syndrome in children (MIS-C) affects a small percentage of pedi-atric patients infected with COVID-19 and is characterized by fever, laboratory evidence of inflamma-tion, multisystem involvement, and severe illness necessitating hospitalization. Skin findings are often present in these patients, and when initially compared with Kawasaki disease, they likely represent dis-tinct phenomena and overall remain poorly characterized. In this retrospective review of 34 case reports and series, we identified cutaneous manifestations documented in 417 of 736 patients (57%) with MIS-C associated with COVID-19. "Rash" was the sole descriptor of skin findings in nearly half of patients. Case reports and smaller case series provided more detail, outlining a broad range of lesion morpholo-gies (polymorphic, maculopapular, morbilliform, erythrodermic, urticarial, reticular, petechial, purpuric) in variable anatomic distribution. More thorough descriptions of dermatologic manifestations in patients with MIS-C are warranted to better characterize this syndrome, as they may lend important insight into pathogenic mechanisms of disease. (c) 2020 Elsevier Inc. All rights reserved.