Abstract: 【Abstract】 Objective To analyze skin manifestations associated with coronavirus disease 19 （COVID-19） in children. Methods Children diagnosed with COVID-19 accompanied by skin manifestations were enrolled from outpatient clinics or teleclinics at the Department of Dermatology, Children′s Hospital, Capital Institute of Pediatrics from November 1st, 2022 to December 10th, 2022, and their clinical characteristics were analyzed. Analysis of variance was used for comparing measurement data, and Fisher′s exact test for comparing enumeration data. Results A total of 61 children with COVID-19 accompanied by skin lesions were included, they were aged from 22 days to 17 years, with an average age of 2.83 ± 2.47 years, and their course of disease ranged from 2 to 14 days. Skin lesions manifested as acute urticaria in 25 cases （41.0%）, eruptive/maculopapular lesions in 10 cases （16.4%）, facial vascular edema in 6 cases （9.8%）, urticarial vasculitis in 5 cases （8.2%）, pityriasis rosea and erythema multiforme each in 4 cases （6.6%）, purpura in 2 cases （3.3%）, mixed skin lesions in 2 cases （3.3%）, and folliculitis, erythema nodosum, as well as angioedema of the limbs each in 1 case （1.6%）. The age of children with different skin manifestations significantly differed （F = 4.67, P < 0.001）. Forty-eight patients （78.69%） presented with generalized skin lesions, while 13 （21.31%） with localized skin lesions; 10 （16.4%） had itching, 3 （4.9%） had a burning sensation, while 48 （78.7%） showed no symptoms. Skin lesions persisted for ≤ 3 days in 36 cases （59.0%） and for > 3 days in 25 cases （41.0%）, and all lesions persisted for less than 2 weeks. All 61 patients had fever up to 38.5 ℃; 1 （1.6%） developed skin lesions before the fever, 41 （67.2%） developed lesions during the fever, and 19 （31.2%） developed lesions after the fever. The skin manifestations significantly differed among various groups divided by the lesion distribution, self-reported symptoms, duration of lesions, and the sequence between fever and lesion onset （all P < 0.05）. No recurrence was observed after recovery, and skin lesions subsided without leaving pigment changes or scars. Conclusion COVID-19 was often accompanied by various skin lesions in children, which mainly manifested as urticaria, and eruptive/maculopapular lesions.

Key words: Skin manifestations, Skin diseases, viral, Child, SARS-CoV-2, Urticaria, Angioedema, Pityriasis rosea, Erythema multiforme