Cutaneous manifestations of covid-19 in pediatric population: A web based comparative study between the perspectives of dermatologists and pediatricians
Akash Agarwala, Anupam Dasb✉, Maitreyee Pandaa, Jhalak Goyalc, Mrutunjay Dashd
- aDepartment of Dermatology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
- bDepartment of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
- cDepartment of Pediatrics, SCB Medical College and Sardar Vallabhbhai Patel Post Graduate Institute of Pediatrics, Cuttack, Odisha, India
- dDepartment of Pediatrics, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
- ✉Corresponding author
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Abstract
Objectives: To compare the perspectives of dermatologists and pediatricians regarding cutaneous manifestations of covid-19 in the pediatric age group. Material and methods: An online semi-structured English questionnaire was circulated among the doctors (snowball sampling). Items of the questionnaire with a content validity ratio ≥0.49 were retained. Content validity index (CVI) was estimated, and those with a CVI score of >0.79, were accepted. Appropriate statistical tests were carried out for data analysis. Results: Among 305 responders, majority were dermatologists (n = 139; 45.57%) followed by pediatricians (n = 106; 34.75%) and other specialties (n = 60; 19.6%). Nearly 46.55% of all responders (n = 142) observed cutaneous manifestations among pediatric covid patients (40/139 dermatologists, 28.77%, and 94/106 pediatricians, 88.67%). Nearly 54.22% of pediatricians and 10% of dermatologists reported the infection to be moderate to severe. About 15% of dermatologists and 5.3% of pediatricians came across cutaneous manifestations as the sole manifestation. The commonest manifestation was urticarial (61.26%) followed by a morbilliform rash (52.81%). Multisystem inflammatory syndrome in covid (MISC) was observed almost exclusively by 63.82% of pediatricians. Vascular manifestations were seen by 11.97% responders (n = 17). Chilblains were reported by 4.5% of pediatricians. Nearly 78.04% of pediatricians and 35% of dermatologists observed mucosal manifestations. Conclusion: Pediatricians are more commonly observing cutaneous manifestations. MISC is exclusively reported by pediatricians, highlighting the fact that severe disease is usually not seen by dermatologists. Vascular manifestations are uncommon in the skin of color. Dermatologists encounter asymptomatic covid patients with cutaneous manifestation more often, reiterating the fact that children presenting with urticarial and morbilliform rashes should be tested for covid-19, considering the present scenario.