Are SARS-CoV-2 IgA antibodies in pediatric patients with chilblain-like lesions indicative of COVID-19 asymptomatic or paucisymptomatic infection?

Acral chilblain-like lesions in young patients are one of the commonest skin manifestations reported during COVID-19 pandemic (1-3). Despite the temporal and spatial correlation between the outbreak of pernio-like and the pandemic, the relationship with COVID-19 remains uncertain. Only part of patients had history suggestive for COVID-19 or contacts with confirmed cases, and SARS-CoV-2 infection has been demonstrated in a few of them. We recently described 19 adolescents with chilblain-like lesions who were negative for SARS-CoV-2 by RT-PCR and IgG serology for nucleocapsid protein (4).