Skin manifestations and related clinical characteristics of multisystem inflammatory syndrome in children: A descriptive retrospective cohort study at Texas Children’s Hospital

Abstract

Background

Little is known about the dermatologic manifestations of multisystem inflammatory syndrome in children (MIS-C) in children and adolescents.

Objective

We sought to describe the demographic background, key clinical features, and the clinical consequences of developing rash manifestations in MIS-C patients at Texas Children’s Hospital.

Methods

Descriptive retrospective cohort study of 290 hospitalized eligible patients between May 2020 and April 2022.

Results

Among MIS-C patients, 51% exhibited a rash. We found that younger children (8.62 vs 9.49 years of age, P = .006) and White children (P = .002) had a higher likelihood of developing a rash in association with MIS-C. Additionally, patients without a rash had increased maximum troponin levels (0.11 ng/mL vs 0.07 ng/mL, P = .02) and a higher incidence of cardiac involvement (83.1% vs 72.3%, P = .03) compared to those with a rash but did not significantly affect the length of hospital stay or clinical course. The most commonly observed rash was an erythematous and maculopapular rash on the trunk and/or extremities.

Limitations

Rash characteristics were initially described by a variety of physicians in the pediatric primary care services.

Conclusion

Rash manifestations in MIS-C patients are associated with lower cardiac involvement and decreased troponin levels.