The Impact of Covid-19 Pandemic on the Clinical Course of Pediatric Skin Disorders: A Cross-Sectional Study

Objectives: As Covid-19 infection continues to affect both the pediatric and adult populations, new-onset and pre-existing skin diseases in addition to the skin diseases with exacerbation, are frequently being reported as the cutaneous manifestations of the pandemic. In the present study, the aim was to investigate the impact of Covid-19 pandemic on the clinical course of the skin diseases observed in the pediatric population. Materials and Methods: A web-based survey related to the cutaneous disorders seen in the pediatric population (0-18 years) prior to the pandemic and during the pandemic, was formed. The survey was spread using snowball sampling method. The questionnaire was asked to be filled by the parents. Demographical data, Covid-19 related questions, the presence of the new-onset skin disorders and the clinical course of the pre-existing cutaneous diseases during the pandemic were questioned. Results: Two hundred ninety one children aged between 0-18 years, were included in the study. The mean age was 11.3 ± 4.6 years. One hundred sixty four respondents were female; whereas 127 were male. Ninety seven cases were tested for SARS-CoV-2, 41 had positive RT-PCR result. During the pandemic, 65 children had at least one new-onset cutaneous disease: the most common ones were pruritus (n=23, 35.4%), xerosis (n=17,26.2%), acne vulgaris (n=11, 16.9%) and seborrheic dermatitis (n=11, 16.9%). There was no statistically significant relationship between the presence of any new-onset skin disease during the pandemic and being diagnosed with Covid-19 (p=0.73). However, there was a statistically significant relationship between the number of new-onset acne vulgaris cases and median duration of mask wearing during the pandemic (p=0.025). Conclusion: The present study shows that the era of the Coronavirus disease, has led to the emergence of new-onset skin problems in the pediatric population due to the use of personal protective equipment. Psychosocial burden of the pandemic also seems to have an impact on the pediatric skin disorders.

PDF

___

[1] Genovese G, Moltrasio C, Berti E, Marzano AV. Skin Manifestations Associated with COVID-19: Current Knowledge and Future Perspectives. Dermatology 2021;237:1-12.
[2] Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr 2020;109:1088-95.
[3] Andina D, Belloni-Fortina A, Bodemer C, et al. Skin manifestations of COVID-19 in children: Part 2. Clin Exp Dermatol 2021;46:451-61.
[4] Andina D, Belloni-Fortina A, Bodemer C, et al. Skin manifestations of COVID-19 in children: Part 1. Clin Exp Dermatol 2021;46:444-50.
[5] Andina D, Belloni-Fortina A, Bodemer C, et al. Skin manifestations of COVID-19 in children: Part 3. Clin Exp Dermatol 2021;46:462-72.
[6] Borch L, Thorsteinsson K, Warner TC, et al. COVID-19 reopening causes high risk of irritant contact dermatitis in children. Dan Med J 2020;67:A05200357.
[7] Altun E. The most common pediatric and adult dermatology patient complaints in a month of the COVID-19 pandemic in Turkey. Dermatol Ther 2020;33:e13972.
[8] Cui X, Zhao Z, Zhang T, et al. A systematic review and meta-analysis of children with coronavirus disease 2019 (COVID-19). J Med Virol 2021;93:1057-69.
[9] Cui X, Zhang T, Zheng J, et al. Children with coronavirus disease 2019: A review of demographic, clinical, laboratory, and imaging features in pediatric patients. J Med Virol 2020;92:1501-10.
[10] Khalili M, Iranmanesh B, Mohammadi S, Aflatoonian M. Cutaneous and histopathological features of coronavirus disease 2019 in pediatrics: A review article. Dermatol Ther 2021;34:e14554.
[11] Shah S, Akhade K, Ganguly S, Nanda R, Mohapatra E, Goel AK. Cutaneous manifestations associated with COVID-19 in children: A systematic review. J Family Med Prim Care 2021;10:93-101.
[12] Magro C, Mulvey JJ, Berlin D, et al. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: A report of five cases. Transl Res 2020;220:1-13.
[13] Castelo-Soccio L, Lara-Corrales I, Paller AS, et al. Acral Changes in pediatric patients during COVID 19 pandemic: Registry report from the COVID 19 response task force of the society of pediatric dermatology (SPD) and pediatric dermatology research alliance (PeDRA). Pediatr Dermatol 2021;38:364-70.
[14] Panda PK, Sharawat IK. Fluctuating Palmar Erythema in a Toddler during COVID-19 Pandemic: Do You Know the Offender? J Trop Pediatr 2021;67:fmab011.
[15] Corazza M, Bencivelli D, Zedde P, Monti A, Zampino MR, Borghi A. Severe contact urticaria, mimicking allergic contact dermatitis, due to a surgical mask worn during the COVID-19 pandemic. Contact Dermatitis 2021;84:466-7.
[16] Tagarro A, Epalza C, Santos M, et al. Screening and Severity of Coronavirus Disease 2019 (COVID-19) in Children in Madrid, Spain. JAMA Pediatr. 2020:e201346. Erratum in: JAMA Pediatr. 2020;174:1009.
[17] Tezer H, Bedir Demirdag T. Novel coronavirus disease (COVID-19) in children. Turk J Med Sci 2020;50:592-603.
[18] Hayran Y, Yorulmaz A, Gur G, Aktas A. Different hair loss patterns in two pediatric patients with COVID-19- associated multisystem inflammatory syndrome in children. Dermatol Ther 2021;34:e14820.
[19] Oner U. Children with trichotillomania in COVID-19 outbreak. J Cosmet Dermatol 2021;20:1967-8.
[20] Veraldi S, Angileri L, Barbareschi M. Seborrheic dermatitis and anti-COVID-19 masks. J Cosmet Dermatol 2020;19:2464-5.
[21] Han C, Shi J, Chen Y, Zhang Z. Increased flare of acne caused by long-time mask wearing during COVID-19 pandemic among general population. Dermatol Ther 2020;33:e13704.
[22] Chernyshov PV, Vozianova SV, Chubar OV. Quality of Life of Infants, Toddlers and Preschoolers with Seborrhoeic, Allergic Contact and Atopic Dermatitis Before and During COVID-19 Pandemic. Dermatol Ther (Heidelb) 2021;11:2017-26.