Long-term Outcome of Chilblains Associated with SARS-CoV-2
DOI:
https://doi.org/10.2340/00015555-3930Keywords:
chilblains, pernio, perniosis, acral manifestation, SARS-CoV-2, COVID-19, recurrenceAbstract
Numerous cases of chilblains have been observed in the course if the COVID-19 pandemic. The aims of this study were to provide comprehensive follow-up data for patients reporting chilblains, and to determine the risk factors for incomplete recovery. Patients referred to 5 hospitals in France between March and May 2020 for chilblains were surveyed on December 2020. A teleconsultation was offered. Among 82 patients reporting chilblains, 27 (33%) reported complete recovery, 33 (40%) had recurrences of chilblains after their hands and feet had returned to normal, and 22 (27%) developed persistent acral manifestations, mostly acrocyanosis, with or without further recurrences of chilblains. Most recurrences of chilblains occurred during the following autumn and winter. A past history of chilblains was not associated with recurrences or persistent acral manifestations. Women had a significantly higher risk of developing recurrences or persistent acral manifestations (odds ratio 1.30; 95% confidence interval 1.06–1.59). In conclusion, two-thirds of patients reporting chilblains at the start of the COVID-19 pandemic experienced persistent or recurrent acral manifestations after a 10-month follow-up.
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Recalcati S, Barbagallo T, Frasin LA, Prestinari F, Cogliardi A, Provero MC, et al. Acral cutaneous lesions in the time of COVID-19. J Eur Acad Dermatol Venereol 2020; 34: e346-347.
https://doi.org/10.1111/jdv.16533 DOI: https://doi.org/10.1111/jdv.16533
Freeman EE, McMahon DE, Lipoff JB, Rosenbach M, Kovarik C, Takeshita J, et al. Pernio-like skin lesions associated with COVID-19: a case series of 318 patients from 8 countries. J Am Acad Dermatol 2020; 83: 486-492.
https://doi.org/10.1016/j.jaad.2020.05.109 DOI: https://doi.org/10.1016/j.jaad.2020.05.109
Le Cleach L, Dousset L, Assier H, Fourati S, Barbarot S, Boulard C, et al. Most chilblains observed during the COVID-19 outbreak occur in patients who are negative for COVID-19 on polymerase chain reaction and serology testing. Br J Dermatol 2020; 183: 866-874.
https://doi.org/10.1111/bjd.19377 DOI: https://doi.org/10.1111/bjd.19377
Fernandez-Nieto D, Jimenez-Cauhe J, Suarez-Valle A, Moreno-Arrones OM, Saceda-Corralo D, Arana-Raja A, et al. Characterization of acute acral skin lesions in nonhospitalized patients: a case series of 132 patients during the COVID-19 outbreak. J Am Acad Dermatol 2020; 83: e61-e63.
https://doi.org/10.1016/j.jaad.2020.04.093 DOI: https://doi.org/10.1016/j.jaad.2020.04.093
de Masson A, Bouaziz J-D, Sulimovic L, Cassius C, Jachiet M, Ionescu M-A, et al. Chilblains is a common cutaneous finding during the COVID-19 pandemic: a retrospective nationwide study from France. J Am Acad Dermatol 2020; 83: 667-670.
https://doi.org/10.1016/j.jaad.2020.04.161 DOI: https://doi.org/10.1016/j.jaad.2020.04.161
Galván Casas C, Català A, Carretero Hernández G, Rodríguez-Jiménez P, Fernández-Nieto D, Rodríguez-Villa Lario A, et al. Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases. Br J Dermatol 2020; 183: 71-77.
https://doi.org/10.1111/bjd.19163 DOI: https://doi.org/10.1111/bjd.19163
Piccolo V, Neri I, Filippeschi C, Oranges T, Argenziano G, Battarra VC, et al. Chilblain-like lesions during COVID-19 epidemic: a preliminary study on 63 patients. J Eur Acad Dermatol Venereol 2020; 34: e291-293.
https://doi.org/10.1111/jdv.16526 DOI: https://doi.org/10.1111/jdv.16526
Hubiche T, Cardot-Leccia N, Le Duff F, Seitz-Polski B, Giordana P, Chiaverini C, et al. Clinical, laboratory, and interferon-alpha response characteristics of patients with chilblain-like lesions during the COVID-19 pandemic. JAMA Dermatol 2021; 157: 202-206.
https://doi.org/10.1001/jamadermatol.2020.4324 DOI: https://doi.org/10.1001/jamadermatol.2020.4324
Herman A, Peeters C, Verroken A, Tromme I, Tennstedt D, Marot L, et al. Evaluation of chilblains as a manifestation of the COVID-19 pandemic. JAMA Dermatol 2020; 156: 998-1003.
https://doi.org/10.1001/jamadermatol.2020.2368 DOI: https://doi.org/10.1001/jamadermatol.2020.2368
Bessis D. Impaired type I interferon response in SARS-CoV-2 infection: looking through the cutaneous window. Br J Dermatol 2021; 184: 11-12.
https://doi.org/10.1111/bjd.19596 DOI: https://doi.org/10.1111/bjd.19596
Magro CM, Mulvey JJ, Laurence J, Sanders S, Crowson AN, Grossman M, et al. The differing pathophysiologies that underlie COVID-19-associated perniosis and thrombotic retiform purpura: a case series. Br J Dermatol 2021; 184: 141-150.
https://doi.org/10.1111/bjd.19415 DOI: https://doi.org/10.1111/bjd.19415
Lipsker D. Paraviral eruptions in the era of COVID-19: do some skin manifestations point to a natural resistance to SARS-CoV-2? Clin Dermatol 2020; 38: 757-761.
https://doi.org/10.1016/j.clindermatol.2020.06.005 DOI: https://doi.org/10.1016/j.clindermatol.2020.06.005
Damsky W, Peterson D, King B. When interferon tiptoes through COVID-19: pernio-like lesions and their prognostic implications during SARS-CoV-2 infection. J Am Acad Dermatol 2020; 83: e269-e270.
https://doi.org/10.1016/j.jaad.2020.06.052 DOI: https://doi.org/10.1016/j.jaad.2020.06.052
Maanaoui S, Salez F, Carpentier O. Recurrence of chilblains during a second contact with SARS-CoV-2: a case report. Br J Dermatol 2021; 185: 227-228.
https://doi.org/10.1111/bjd.20070 DOI: https://doi.org/10.1111/bjd.20070
McMahon DE, Gallman AE, Hruza GJ, Rosenbach M, Lipoff JB, Desai SR, et al. Long COVID in the skin: a registry analysis of COVID-19 dermatological duration. Lancet Infect Dis 2021; 21: 313-314.
https://doi.org/10.1016/S1473-3099(20)30986-5 DOI: https://doi.org/10.1016/S1473-3099(20)30986-5
Freeman EE, McMahon DE, Lipoff JB, Rosenbach M, Desai SR, Fassett M, et al. Cold and COVID: recurrent pernio during the COVID-19 pandemic. Br J Dermatol 2021; 185: 214-216.
https://doi.org/10.1111/bjd.19894 DOI: https://doi.org/10.1111/bjd.19894
Signa S, Sementa AR, Coccia MC, Pastorino C, Viglizzo G, Viola S, et al. Recurrence of previous chilblain lesions during the second wave of COVID-19: can we still doubt the correlation with SARS-CoV-2? J Eur Acad Dermatol Venereol 2021; 35: e475-e477.
https://doi.org/10.1111/jdv.17283 DOI: https://doi.org/10.1111/jdv.17283
Recalcati S, Barbagallo T, Tonolo S, Milani M, Fantini F. Relapse of chilblain-like lesions during the second wave of coronavirus disease 19. J Eur Acad Dermatol Venereol 2021; 35: e315-e316.
https://doi.org/10.1111/jdv.17168 DOI: https://doi.org/10.1111/jdv.17168
Moghadam P, Frumholtz L, Jaume L, De Masson A, Jachiet M, Begon E, et al. Frequency of relapse and persistent cutaneous symptoms after a first episode of chilblain-like lesion during the COVID-19 pandemic. J Eur Acad Dermatol Venereol 2021; 35: e566-e568.
https://doi.org/10.1111/jdv.17393 DOI: https://doi.org/10.1111/jdv.17393
Hubiche T, Le Duff F, Fontas E, Rapp J, Chiaverini C, Passeron T. Relapse of chilblain-like lesions during the second wave of the COVID-19 pandemic: a cohort follow-up. Br J Dermatol 2021; 185: 858-859.
https://doi.org/10.1111/bjd.20584 DOI: https://doi.org/10.1111/bjd.20584
Poizeau F, Oger E, Barbarot S, Le Corre Y, Samimi M, Brenaut E, et al. Chilblains during lockdown are associated with household exposure to SARS-CoV-2. A multicentre case-control study. Clin Microbiol Infect 2021 Oct 4 [Online ahead of print].
https://doi.org/10.1016/j.cmi.2021.09.032 DOI: https://doi.org/10.1016/j.cmi.2021.09.032
Creamer D. Reactions to cold. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook's textbook of dermatology. Eighth edn. Wiley-Blackwell, Chichester, West Sussex, UK, 2010: p. 28.65-67.
McMahon DE, Amerson E, Rosenbach M, Lipoff JB, Moustafa D, Tyagi A, et al. Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: a registry-based study of 414 cases. J Am Acad Dermatol 2021; 85: 46-55.
https://doi.org/10.1016/j.jaad.2021.03.092 DOI: https://doi.org/10.1016/j.jaad.2021.03.092
Kanitakis J, Lesort C, Danset M, Jullien D. Chilblain-like acral lesions during the COVID-19 pandemic ("COVID toes"): histologic, immunofluorescence, and immunohistochemical study of 17 cases. J Am Acad Dermatol 2020; 83: 870-875.
https://doi.org/10.1016/j.jaad.2020.05.145 DOI: https://doi.org/10.1016/j.jaad.2020.05.145
Aschoff R, Zimmermann N, Beissert S, Günther C. Type I interferon signature in chilblain-like lesions associated with the COVID-19 pandemic. Dermatopathol 2020; 7: 57-63.
https://doi.org/10.3390/dermatopathology7030010 DOI: https://doi.org/10.3390/dermatopathology7030010
Ortega-Quijano D, Fernandez-Nieto D, Jimenez-Cauhe J, Cortes-Cuevas JL, Marcos-Mencia D, Rodriguez-Dominguez M, et al. Association between COVID-19 and chilblains: a case-control study. J Eur Acad Dermatol Venereol 2021; 35: e359-e361.
https://doi.org/10.1111/jdv.17195 DOI: https://doi.org/10.1111/jdv.17195
Jabalameli N, Rajabi F, Firooz A, Rezaei N. The overlap between genetic susceptibility to COVID-19 and skin diseases. Immunol Invest 2021 Jan 26 [Epub ahead of print].
https://doi.org/10.1080/08820139.2021.1876086 DOI: https://doi.org/10.1080/08820139.2021.1876086
Volpi S, Picco P, Caorsi R, Candotti F, Gattorno M. Type I interferonopathies in pediatric rheumatology. Pediatr Rheumatol Online J 2016; 14: 35.
https://doi.org/10.1186/s12969-016-0094-4 DOI: https://doi.org/10.1186/s12969-016-0094-4
Campo-Voegeli A, Estrach T, Marti RM, Corominas N, Tuset M, Mascaró JM. Acrocyanosis induced by interferon alpha(2a). Dermatology 1998; 196: 361-363.
https://doi.org/10.1159/000017917 DOI: https://doi.org/10.1159/000017917
Kruit WH, Eggermont AM, Stoter G. Interferon-alpha induced Raynaud's syndrome. Ann Oncol 2000; 11: 1501-1502.
https://doi.org/10.1023/A:1026586629166 DOI: https://doi.org/10.1023/A:1026586629166
Carfì A, Bernabei R, Landi F, Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent symptoms in patients after acute COVID-19. JAMA 2020; 324: 603-605.
https://doi.org/10.1001/jama.2020.12603 DOI: https://doi.org/10.1001/jama.2020.12603
Petersen MS, Kristiansen MF, Hanusson KD, Danielsen ME, á Steig B, Gaini S, et al. Long COVID in the Faroe Islands: a longitudinal study among nonhospitalized patients. Clin Infect Dis 2021; 73: e4058-e4063.
https://doi.org/10.1093/cid/ciaa1792 DOI: https://doi.org/10.1093/cid/ciaa1792
Logue JK, Franko NM, McCulloch DJ, McDonald D, Magedson A, Wolf CR, et al. Sequelae in adults at 6 months after COVID-19 infection. JAMA Netw Open 2021; 4: e210830.
https://doi.org/10.1001/jamanetworkopen.2021.0830 DOI: https://doi.org/10.1001/jamanetworkopen.2021.0830
Salmon-Ceron D, Slama D, De Broucker T, Karmochkine M, Pavie J, Sorbets E, et al. Clinical, virological and imaging profile in patients with prolonged forms of COVID-19: a cross-sectional study. J Infect 2021; 82: e1-4.
https://doi.org/10.1016/j.jinf.2020.12.002 DOI: https://doi.org/10.1016/j.jinf.2020.12.002
Nasserie T, Hittle M, Goodman SN. Assessment of the frequency and variety of persistent symptoms among patients with COVID-19. JAMA Netw Open 2021; 4: e2111417.
https://doi.org/10.1001/jamanetworkopen.2021.11417 DOI: https://doi.org/10.1001/jamanetworkopen.2021.11417
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Copyright (c) 2021 Florence Poizeau, Sébastien Barbarot, Yannick Le Corre, Emilie Brenaut, Mahtab Samimi, Hélène Aubert, Alexis Toubel, Alain Dupuy
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