Histopathological and Clinical Analysis of Skin Rashes in Children with Multisystem Inflammatory Syndrome Associated with COVID-19

YÜKSEL S., Demirkan N. C., Comut E., Yilmaz M., Gurses D.

American Journal of Dermatopathology, vol.44, no.3, pp.183-189, 2022 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 44 Issue: 3
  • Publication Date: 2022
  • Doi Number: 10.1097/dad.0000000000002091
  • Journal Name: American Journal of Dermatopathology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Page Numbers: pp.183-189
  • Keywords: COVID-19, histopathology, microscopy, MIS-C, skin rash
  • Çanakkale Onsekiz Mart University Affiliated: No


Introduction:A new entity, which occurs a few weeks after SARS-CoV-2 infection and resembling incomplete Kawasaki disease or toxic shock syndrome, has been defined and named multisystem inflammatory syndrome (MIS-C) associated with COVID-19 in children. The aim of our study was to describe histopathological characteristics of skin lesions of MIS-C patients to reveal whether there is a relationship between histopathological features and clinical manifestations.Materials and Methods:Seventeen who had skin involvement of 57 patients who were diagnosed with MIS-C between December 2020 and February 2021 were included in this prospective study. Demographic information, laboratory findings, and patients' managements were recorded. Skin biopsies were taken simultaneously of each patient. Formalin-fixed, paraffin-embedded skin samples were examined microscopically.Results:The rate of skin rash was 30% in patients with MIS-C and was predominantly the maculopapular type. The anatomical distribution of the rash was evaluated as localized in 10 and generalized in 7 patients. In patients with myocarditis, C-reactive protein and fibrinogen were found to be significantly higher, and lymphocyte and albumin values were found to be low. Herpes-like inclusions were found in the microscopic examination of 2 patients with a history of zona zoster in themselves or in their mother. There was a significant difference between keratinocyte necrosis and some clinical parameters.Discussion:Localized skin lesions appear to be associated with a more severe inflammatory.