Multisystem inflammatory syndrome in children (MIS-C) is a novel disease which has been increasingly recognised in recent times. Children present with varied morphological rashes such as non-specific eruptions, polymorphic, maculopapular, morbilliform, diffuse erythroderma, urticaria, reticular, petechial, purpuric, vasculitis lesions, hyperemia of lips, strawberry tongue, periorbital and malar erythema [1, 2].

At the authors’ tertiary care centre, there were 84 children who were diagnosed with MIS-C; among whom 44 (52.4%) had mucocutaneous manifestations. The varied mucocutaneous manifestations have been presented here.

An adolescent girl with Kawasaki phenotype of MIS-C had periungual desquamation in the subacute phase and presented on follow up with livedoid vasculitic rashes distributed over bilateral lower limbs and foot (Fig. 1a-c). A 5-y-old girl presented with desquamation over periungual and extensor aspect of hand on follow up (Fig. 1d). A 1 y 7 mo old girl presented with diffuse urticarial rashes at the time of initial presentation (Fig. 1e, f). A 1 y 3 mo old girl presented with non-specific eruptions over extensor aspects of both hands (Fig. 1g). A 5-y-old boy presented with features of incomplete Kawasaki disease like illness, had strawberry tongue appearance with non-purulent conjunctival congestion (Fig. 1h).

Fig. 1
figure 1

(a-c) An adolescent girl with periungual desquamation and livedoid vasculitis. (d) Desquamation of skin from periungual and external aspect of hand in a 5-y-old girl. (e, f) Diffuse urticarial rashes over bilateral lower limbs in a 1 y 7 mo old girl. (g) Non-specific eruptions over hand in a 1 y 3 mo old girl. (h) Strawberry tongue with lip erythema in a 5-y-old boy

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All children were treated with intravenous immunoglobulins and steroids, and rashes resolved over time. An in-depth knowledge regarding varied mucocutaneous manifestations of MIS-C is important for both pediatricians and dermatologists to suspect and treat MIS-C, especially in the acute phase for a better outcome.