1
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Shaikh TG, Waseem S, Ahmed SH, Qadir NA, Piccolo V. SARS-CoV-2 Vaccination and Chilblain-like Lesions: What Do We Know so Far? Dermatol Pract Concept 2022; 12:e2022170. [PMID: 36534559 PMCID: PMC9681186 DOI: 10.5826/dpc.1204a170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION The coronavirus pandemic has caused massive damage to global health care and the economy. The vaccination program has been paced around the globe to return as soon as possible to pre-COVID time. Although all the vaccines have been approved after the rigorous clinical and safety trials, some adverse effects have surfaced and are being reported from different parts of the world. One such side effect is chilblain-like lesions following the COVID vaccination. Chilblain lesions, also known as pernio, are an inflammatory condition usually affecting the acral regions of the body. It is mostly reported from cold and damp areas and has multiple causes associated with it. OBJECTIVE This study aims to review the publicly available data and to provide concise and comprehensive information as well as evaluate the potential pathology, clinical approach, and management of CLL post-vaccination. METHODS An extensive literature search over PubMed, Cochrane library, Google Scholar, and Clinicaltrails. gov from inception till 5th October 2021, without any restriction of language was carried out. All the recruited articles were reviewed, and their bibliographies were also screened for any relevant information. RESULTS 12 studies (10 case reports and 2 case series) were retrieved reporting the incidence of CLL post-vaccination. 8 studies reported incidence in female patients while 5 reported in males, with one study mentioning no gender. Moreover, most of them were either from Europe or the United States of America, except for two cases, reported from Turkey. CONCLUSIONS Although the overall incidence of Chilblains following COVID-19 vaccination is low, there is still a strong need to find out the exact mechanism behind this to redefine the safety and administration criteria of the vaccines and to formulate a proper management protocol.
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Affiliation(s)
| | | | | | | | - Vincenzo Piccolo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
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2
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Piccolo V, Bassi A, Mazzatenta C, Russo T, Argenziano G, Cutrone M, Danielsson Darlington M, Grimalt R. Face mask-induced purpura: another unexpected effect of COVID era. J Eur Acad Dermatol Venereol 2022; 36:e973-e975. [PMID: 35771119 PMCID: PMC9349894 DOI: 10.1111/jdv.18392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Andrea Bassi
- UO Dermatology- Azienda USL Toscana Nord Ovest, Lucca, Italy
| | | | - Teresa Russo
- Dermatology Unit University of Campania, Naples, Italy
| | | | - Mario Cutrone
- Pediatric Dermatology, Ospedale dell'Angelo Venezia, Ospedale San Bortolo Vicenza
| | - Markus Danielsson Darlington
- Department of Dermatology, Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Ramon Grimalt
- International University of Catalunya, Barcelona, Spain
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3
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Zhou Y, Yan H, Li T, Xie M, Li X, Zhao C. New use of old medicine: Nifedipine acts on the TRP family and inflammatory proteins in the treatment of chilblain. Burns 2022; 48:372-380. [PMID: 34103198 DOI: 10.1016/j.burns.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/29/2021] [Accepted: 05/07/2021] [Indexed: 12/14/2022]
Abstract
As a calcium antagonist, the mechanism of nifedipine for treating chilblain has not been reported. In the present study, we established the chilblain model by using -20 ℃ 95% ethanol to freeze the right back foot of SD rats, and investigated the effects of this drug. Hematoxylin-eosin (HE) examination indicated most of pannus in the skin tissue of chilblain rats had disappeared, and the local inflammatory cells were also greatly reduced when given nifedipine at 15.0 mg/kg/d. The enzyme-linked immunosorbent assay (ELISA) revealed that nifedipine inhibited release of inflammatory factors TNF-α, IL-6, IL-1β and VEGF in serum. The RT-PCR analysis showed that nifedipine down regulated mRNA levels of TRPC-6 and VEGF in skin tissue. Furthermore, immunohistochemical examination showed nifedipine inhibited expression of IL-1β, IL-6, and TNF-α inflammatory protein and further inhibited expression of TRP (transient receptor potential) family proteins TRPM-7, TRPC-1, TRPC-3 and TRPC-6 and reduced expression of VEGF in skin and relieved erythema and oedema. This study demonstrated that nifedipine as an old medicine can be new use for the treatment of chilblain by acting on TRPs family and inflammatory proteins.
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Affiliation(s)
- Yongqiang Zhou
- Guizhou University of Traditional Chinese Medicine, Guiyang 550025, China.
| | - Helv Yan
- Guizhou University of Traditional Chinese Medicine, Guiyang 550025, China
| | - Ting Li
- Guizhou University of Traditional Chinese Medicine, Guiyang 550025, China
| | - Mei Xie
- Guizhou University of Traditional Chinese Medicine, Guiyang 550025, China
| | - Xiuya Li
- Guizhou University of Traditional Chinese Medicine, Guiyang 550025, China
| | - Chunli Zhao
- Guizhou University of Traditional Chinese Medicine, Guiyang 550025, China
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4
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Bassi A, Mazzatenta C, Sechi A, Cutrone M, Vincenzo P. Not only toes and fingers: COVID vaccine‐induced chilblain‐like lesions of the knees. J Eur Acad Dermatol Venereol 2022; 36:e497-e498. [PMID: 35188988 PMCID: PMC9114987 DOI: 10.1111/jdv.18025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Andrea Bassi
- UO Dermatologia Lucca‐ Azienda USL Toscana Nordovest Italy
| | | | - Andrea Sechi
- Dermatologic Unit San Bortolo Hospital Vicenza Italy
| | | | - Piccolo Vincenzo
- Dermatology Unit University of Campania Luigi Vanvitelli Naples Italy
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5
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Piccolo V, Russo T, Mazzatenta C, Bassi A, Argenziano G, Cutrone M, Danielsson Darlington M, Grimalt R. COVID vaccine-induced pustular psoriasis in patients with previous plaque type psoriasis. J Eur Acad Dermatol Venereol 2022; 36:e330-e332. [PMID: 35015916 DOI: 10.1111/jdv.17918] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/05/2022] [Indexed: 11/27/2022]
Affiliation(s)
| | - Teresa Russo
- Dermatology Unit University of Campania, Naples, Italy
| | | | - Andrea Bassi
- UO Dermatology- Azienda USL Toscana Nord Ovest, Lucca, Italy
| | | | - Mario Cutrone
- Pediatric Dermatology, Ospedale dell'Angelo Venezia, Ospedale San Bortolo Vicenza
| | - Markus Danielsson Darlington
- Department of Dermatology, Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Ramon Grimalt
- International University of Catalunya, Barcelona, Spain
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6
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Fennell J, Onel K. Chilblains-Like Lesions in Pediatric Patients: A Review of Their Epidemiology, Etiology, Outcomes, and Treatment. Front Pediatr 2022; 10:904616. [PMID: 35813389 PMCID: PMC9259963 DOI: 10.3389/fped.2022.904616] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Vascular pathologies associated with SARS-CoV-2 infection are poorly understood. Color and sensory changes to the extremities, often referred to as "COVID toes" or chilblains-like lesions, have been widely reported in children and adolescents since the onset of the pandemic, raising the concern that they could be a vasculitis secondary to the infection. However, it is unclear if the lesions are a result of the infection or an epiphenomenon. Most literature focuses on adults, and while there are reports on children and adolescents, many of them are small. This review will help medical care providers better understand the epidemiology, etiology, outcomes, and potential treatments for chilblains-like lesions seen in children and adolescents during the pandemic.
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Affiliation(s)
- Jessica Fennell
- Pediatric Rheumatology, Hospital for Special Surgery, New York, NY, United States.,Department of Pediatrics, New York Presbyterian-Weill Cornell, New York, NY, United States
| | - Karen Onel
- Pediatric Rheumatology, Hospital for Special Surgery, New York, NY, United States.,Department of Pediatrics, New York Presbyterian-Weill Cornell, New York, NY, United States
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7
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Sánchez‐García V, Hernández‐Quiles R, de‐Miguel‐Balsa E, Docampo‐Simón A, Belinchón‐Romero I, Ramos‐Rincón J. Are the chilblain-like lesions observed during the COVID-19 pandemic due to severe acute respiratory syndrome coronavirus 2? Systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2022; 36:24-38. [PMID: 34545625 PMCID: PMC8657348 DOI: 10.1111/jdv.17672] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/05/2021] [Accepted: 08/10/2021] [Indexed: 01/07/2023]
Abstract
The expansion of the COVID-19 pandemic has been accompanied by numerous reports of chilblain-like lesions (CLL) in different countries; however, the pathogenesis of these lesions is still unclear. This systematic review and meta-analysis aimed to assess the prevalence of COVID-19 (diagnosed using PCR and/or serology) in patients with CLL. We undertook a literature search in PubMed, Embase, and Scopus (to 15 March 2021), including studies that reported on the number of patients with CLL with positive PCR and/or serology for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or with a clinical suspicion of COVID-19. Regardless of data heterogeneity, a random-effects model was used to pool prevalence estimates. The meta-analysis included 63 original studies, involving 2919 cases of CLL. A subgroup of these patients underwent diagnostic tests for COVID-19 (PCR: n = 1154, 39.5%; serology: n = 943, 32.3%). The pooled prevalence of COVID-19 in the overall sample and in the subgroup who were tested for COVID-19 was, respectively: (i) positive PCR: 2.6% [95% confidence interval (CI) 1.9% to 3.4%] and 5.5% (95% CI, 3.7-7.7%); (ii) positive serology for SARS-CoV-2: 7.2% (95% CI, 4.7-10.2%) and 11.8% (95% CI, 7.9-16.3%); and (iii) positive PCR and/or serology, 15.2% (95% CI, 10.4-20.7%) and 7.5% (95% CI, 5.1-10.3%). Altogether, a small proportion of diagnostic tests for SARS-CoV-2, both PCR and serologies, show positive results in patients with CLL.
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Affiliation(s)
- V. Sánchez‐García
- Dermatology DepartmentAlicante University General Hospital‐ISABIALAlicanteSpain
| | - R. Hernández‐Quiles
- Dermatology DepartmentAlicante University General Hospital‐ISABIALAlicanteSpain
| | - E. de‐Miguel‐Balsa
- Intensive Care DepartmentElche University General HospitalAlicanteSpain
- Clinical Medicine DepartmentUniversity Miguel Hernández of ElcheAlicanteSpain
| | - A. Docampo‐Simón
- Dermatology DepartmentAlicante University General Hospital‐ISABIALAlicanteSpain
| | - I. Belinchón‐Romero
- Dermatology DepartmentAlicante University General Hospital‐ISABIALAlicanteSpain
- Clinical Medicine DepartmentUniversity Miguel Hernández of ElcheAlicanteSpain
| | - J.M. Ramos‐Rincón
- Clinical Medicine DepartmentUniversity Miguel Hernández of ElcheAlicanteSpain
- Internal Medicine DepartmentAlicante University General Hospital‐ISABIALAlicanteSpain
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8
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Seque CA, Enokihara MMSES, Porro AM, Tomimori J. Skin manifestations associated with COVID-19. An Bras Dermatol 2021; 97:75-88. [PMID: 34857407 PMCID: PMC8577992 DOI: 10.1016/j.abd.2021.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/20/2021] [Accepted: 08/22/2021] [Indexed: 01/08/2023] Open
Abstract
This article will address the main aspects of skin manifestations associated with COVID-19, based on a review of the literature published to date. Since the beginning of the pandemic, more than 1,500 articles have been published on the subject. Regarding the pathophysiology, it is believed that the same mechanisms responsible for the disease in the main target organs also act in the skin, although they are not yet fully elucidated. The actual frequency of dermatological manifestations remains uncertain – it can range from 0.2% to 45%, being close to 6% in systematic reviews. Pioneering studies of large case series conducted in European countries and the USA provide the first information on the main skin manifestations associated with COVID-19 and propose classifications regarding their clinical presentation, pathophysiology, as well as their frequencies. Although there is yet no consensus, maculopapular eruptions are considered the most frequent presentations, followed by erythema pernio-like (EPL) lesions. Manifestations such as urticaria, vesicular conditions and livedo/purpura/necrosis are rare. The time of onset, severity, need for specific treatment and prognosis vary according to the clinical presentation pattern. The increasing histopathological description of skin conditions can contribute to the diagnosis, as well as to the understanding of the pathophysiology. Also, in the dermatological field, the relationship between COVID-19 and androgens has been increasingly studied. Despite all the generated knowledge, the actual biological meaning of skin manifestations remains uncertain. Therefore, the exclusion of the main differential diagnoses is essential for the correlation between skin manifestation and COVID-19.
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Affiliation(s)
- Camila Arai Seque
- Department of Dermatology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | | | - Adriana Maria Porro
- Department of Dermatology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Jane Tomimori
- Department of Dermatology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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9
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Abstract
Coronavirus disease 2019 (COVID-19), an emergent disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout the globe since its discovery in December 2019. Although first appreciated to cause pneumonia, numerous organ systems are now known to be involved. The objective of this article is to review the broad spectrum of cutaneous manifestations reported in association with SARS-CoV-2 infection. The most commonly reported cutaneous manifestations associated with COVID-19 infection include pernio (chilblain)-like acral lesions, morbilliform (exanthematous) rash, urticaria, vesicular (varicella-like) eruptions, and vaso-occlusive lesions (livedo racemosa, retiform purpura). It is important to consider SARS-CoV-2 infection in the differential diagnosis of a patient presenting with these lesions in the appropriate clinical context, as cutaneous manifestations may be present in otherwise asymptomatic individuals, or present before developing other symptoms of infection. With increased access to diagnostic testing, we are beginning to understand the utility and limitations of currently available assays.
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Affiliation(s)
- Ritesh Agnihothri
- Department of Dermatology, University of California San Francisco, 1701 Divisadero Street, 3rd Floor, San Francisco, CA 94115, USA
| | - Lindy P Fox
- Department of Dermatology, University of California San Francisco, 1701 Divisadero Street, 3rd Floor, San Francisco, CA 94115, USA.
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10
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Piccolo V, Mazzatenta C, Russo T, Morandi F, Bassi A, Argenziano G, Valerio E, Grimalt R, Cutrone M. Late-onset pustular skin eruption in a healthy neonate born from COVID-positive mother: a coincidence or a new skin sign of the infection? J Eur Acad Dermatol Venereol 2021; 35:e850-e852. [PMID: 34363639 DOI: 10.1111/jdv.17579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 07/29/2021] [Indexed: 01/04/2023]
Affiliation(s)
- V Piccolo
- Dermatology Unit University of Campania, Naples, Italy
| | - C Mazzatenta
- UO Dermatology- Azienda USL Toscana Nord Ovest, Lucca, Italy
| | - T Russo
- Dermatology Unit University of Campania, Naples, Italy
| | - F Morandi
- UOC Pediatrics- San Leopoldo Mandic Hospital, ASST Lecco, Merate, Italy
| | - A Bassi
- UO Dermatology- Azienda USL Toscana Nord Ovest, Lucca, Italy
| | - G Argenziano
- Dermatology Unit University of Campania, Naples, Italy
| | - E Valerio
- Neonatal intensive care unit, University of Padova, Padova, Italy
| | - R Grimalt
- International University of Catalunya, Barcelona, Spain
| | - M Cutrone
- Pediatric Dermatology, Ospedale dell'Angelo Venezia, Ospedale San Bortolo, Vicenza, Italy
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11
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Mascitti H, Jourdain P, Bleibtreu A, Jaulmes L, Dechartres A, Lescure X, Yordanov Y, Dinh A. Prognosis of rash and chilblain-like lesions among outpatients with COVID-19: a large cohort study. Eur J Clin Microbiol Infect Dis 2021; 40:2243-2248. [PMID: 34255231 PMCID: PMC8276548 DOI: 10.1007/s10096-021-04305-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 07/05/2021] [Indexed: 10/26/2022]
Abstract
In a large regional observational cohort study of adult (≥ 18 years), outpatients with COVID-19, prevalence, characteristics, and outcome of patients with rash and/or chilblain-like lesions (CLL), compared with population without cutaneous features, were studied. In total, 28,957 outpatients were included; the prevalence of rash and CCL were 9.5% and 3.7%, respectively. Presence of rash was significantly associated with presence of asthenia, shivers or myalgia, respiratory and gastro-intestinal symptoms, and anosmia/ageusia. The presence of CCL was associated with chest pain, chest oppression, nausea/vomiting, and anosmia/ageusia. Patients with CCL were significantly less prone to an unfavourable outcome (hospitalization or death).
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Affiliation(s)
- Hélène Mascitti
- Infectious Disease Department, University Hospital R. Poincaré, APHP, Paris Saclay University, 104 Bd R. Poincaré, 92380, Garches, France
| | - Patrick Jourdain
- Cardiology Department, University Hospital Kremlin Bicêtre, APHP, Paris Saclay University, 104 Bd R. Poincaré, 92380, Garches, France
| | - Alexandre Bleibtreu
- Infectious Disease Department, University Hospital Pitié Salpétrière, APHP, Paris University, Paris, France
| | - Luc Jaulmes
- Centre de Pharmaco-Épidémiologie (Cephepi), Pitié Salpêtrière Hospital, Paris, France
| | - Agnès Dechartres
- Sorbonne Université, INSERM, Institut Pierre Louis D'Epidémiologie Et de Santé Publique, UMR-S 1136, AP-HP, Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie de L'AP-HP (Cephepi), Paris, France
| | - Xavier Lescure
- Infectious Disease Department, University Hospital Bichat, APHP, Paris University, Paris, France
| | - Youri Yordanov
- Emergency Department, University Hospital Saint Antoine, APHP, Paris University, Paris, France
| | - Aurélien Dinh
- Infectious Disease Department, University Hospital R. Poincaré, APHP, Paris Saclay University, 104 Bd R. Poincaré, 92380, Garches, France.
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12
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Piccolo V, Bassi A, Argenziano G, Mazzatenta C, Cutrone M, Neri I, Grimalt R, Russo T. Contemporary occurrence of Chilblain-like lesions and Pityriasis rosea during the COVID-19 pandemic. J Eur Acad Dermatol Venereol 2021; 35:e619-e620. [PMID: 34050995 PMCID: PMC8242472 DOI: 10.1111/jdv.17409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- V Piccolo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - A Bassi
- UO Dermatologia Lucca- Azienda USL Toscana Nordovest, Lucca, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - C Mazzatenta
- UO Dermatologia Lucca- Azienda USL Toscana Nordovest, Lucca, Italy
| | - M Cutrone
- Ambulatorio di Dermatologia Pediatrica, Ospedale dell'Angelo Venezia, Ospedale San Bortolo Vicenza, Venezia, Italy
| | - I Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - R Grimalt
- Universitat Internacional de Catalunya, Barcelona, Spain
| | - T Russo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
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13
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Mazzatenta C, Piccolo V, Pace G, Romano I, Argenziano G, Bassi A. Purpuric lesions on the eyelids developed after BNT162b2 mRNA COVID-19 vaccine: another piece of SARS-CoV-2 skin puzzle? J Eur Acad Dermatol Venereol 2021; 35:e543-e545. [PMID: 34048614 PMCID: PMC8242437 DOI: 10.1111/jdv.17340] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- C Mazzatenta
- UO Dermatologia Lucca- Azienda USL Toscana Nordovest, Lucca, Italy
| | - V Piccolo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - G Pace
- Pediatrician Self Employed, Treviso, Italy
| | - I Romano
- Dermatology Unit - Department of Medicine DIMED, University of Padua, Padova, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - A Bassi
- UO Dermatologia Lucca- Azienda USL Toscana Nordovest, Lucca, Italy
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14
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Errichetti E. COVID-19-related chilblain-like lesions and idiopathic perniosis: Additional variables possibly influencing dermoscopic pattern. Dermatol Ther 2021; 34:e14985. [PMID: 33993592 PMCID: PMC8209921 DOI: 10.1111/dth.14985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 05/12/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Enzo Errichetti
- Institute of Dermatology, "Santa Maria della Misericordia" University Hospital, Udine, Italy
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15
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Piccolo V, Bassi A, Argenziano G, Mazzatenta C, Cutrone M, Neri I, Grimalt R, Russo T. BNT162b2 mRNA COVID-19 vaccine-induced chilblain-like lesions reinforces the hypothesis of their relationship with SARS-CoV-2. J Eur Acad Dermatol Venereol 2021; 35:e493-e494. [PMID: 33914966 PMCID: PMC8242785 DOI: 10.1111/jdv.17320] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- V Piccolo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - A Bassi
- UO Dermatologia- Azienda USL Toscana Nordovest, Lucca, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - C Mazzatenta
- UO Dermatologia- Azienda USL Toscana Nordovest, Lucca, Italy
| | - M Cutrone
- Ambulatorio di Dermatologia Pediatrica, Ospedale dell'Angelo Venezia, Ospedale San Bortolo Vicenza, Venezia, Italy
| | - I Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - R Grimalt
- Universitat Internacional de Catalunya, Barcelona, Spain
| | - T Russo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
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16
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Signa S, Sementa AR, Coccia MC, Pastorino C, Viglizzo G, Viola S, Volpi S, Occella C, Bleidl D, Acquila M, Castagnola E, Ravelli A, Manunza F. 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. [PMID: 33871076 PMCID: PMC8251000 DOI: 10.1111/jdv.17283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/22/2021] [Accepted: 04/13/2021] [Indexed: 02/01/2023]
Affiliation(s)
- S Signa
- UOSD Centro Malattie Autoinfiammatorie e Immunodeficienze, IRCCS Istituto Giannina Gaslini, Genoa, Italy.,Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), Università di Genova, Genoa, Italy
| | - A R Sementa
- UOC Anatomia Patologica, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - M C Coccia
- UOC Anatomia Patologica, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - C Pastorino
- UOC Dermatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - G Viglizzo
- UOC Dermatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - S Viola
- UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - S Volpi
- UOSD Centro Malattie Autoinfiammatorie e Immunodeficienze, IRCCS Istituto Giannina Gaslini, Genoa, Italy.,Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), Università di Genova, Genoa, Italy
| | - C Occella
- UOC Dermatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - D Bleidl
- UOC Dermatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - M Acquila
- UOC Laboratori Analisi, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - E Castagnola
- UOC Malattie Infettive, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - A Ravelli
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), Università di Genova, Genoa, Italy.,UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - F Manunza
- UOC Dermatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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17
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Jindal R, Chauhan P, Goyal D, Shirazi N. Idiopathic perniosis presenting as acral purpuric lesions: Clustering of cases before COVID-19 pandemic and their comparison with chilblain like lesions reported in the literature. Dermatol Ther 2021; 34:e14951. [PMID: 33740317 PMCID: PMC8250052 DOI: 10.1111/dth.14951] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 02/16/2021] [Accepted: 03/11/2021] [Indexed: 11/29/2022]
Abstract
Perniosis/chilblains are the acral inflammatory skin lesions developing in susceptible individuals as an abnormal reaction to cold. In the absence of a discernible cause, it is labeled as idiopathic perniosis (IP). With the ongoing COVID-19 pandemic, there was an upsurge of reports of chilblain like lesions (CLL) especially in young patients possibly implicated to the SARS-CoV-2 virus. Twelve clinically suspected and histopathologically confirmed cases of IP seen from November 2019 through February 2020 were retrospectively recruited. Clinical, dermoscopic, and histopathological characteristics of these were reviewed and compared with CLL reported in the literature. Mean age of patients was 26.58 ± 15.18 years with an equal male to female ratio. Characteristic histopathology findings were spongiosis (100%), dermal edema (100%), perivascular lymphocytic infiltrate (100%) with peri-eccrine accentuation (66.7%), keratinocyte necrosis (50%), focal basal vacuolar damage (58.3%), and lymphocytic vasculitis (58.3%). Significant dermoscopy findings were variable background color ranging from dull red and violaceous to copper red and brown orange, coiled vessels (44.4%) and orange-red structureless areas (63.9%). Lesions over palms and soles preferentially had white dots/clods and lines (38.9%). There appears no exclusive histopathological as well as dermoscopy features of CLL and IP, yet certain clues can be appreciated. Keratinocyte necrosis and severe dermal edema favors IP, whereas fibrin thrombi with involvement of both superficial and deep dermal vessels favor CLL. Dermoscopically presence of irregular, linear or branching vessels, red/purple dots and clods and gray brown reticule supports CLL while white dots/clods and lines supports IP.
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Affiliation(s)
- Rashmi Jindal
- Department of Dermatology, Venereology and Leprosy, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
| | - Payal Chauhan
- Department of Dermatology, Venereology and Leprosy, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
| | - Dikshita Goyal
- Department of Dermatology, Venereology and Leprosy, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
| | - Nadia Shirazi
- Department of Pathology, HIHT University, Dehradun, India
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18
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Piccolo V, Bassi A, Russo T, Mazzatenta C, Baraldi M, Argenziano G, Neri I, Cutrone M. Chilblain-like lesions and COVID-19: second wave, second outbreak. J Eur Acad Dermatol Venereol 2021; 35:e316-e318. [PMID: 33545745 PMCID: PMC8014111 DOI: 10.1111/jdv.17145] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/05/2021] [Accepted: 01/28/2021] [Indexed: 02/03/2023]
Affiliation(s)
- V Piccolo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - A Bassi
- UO Dermatologia Lucca- Azienda USL Toscana Nordovest, Lucca, Italy
| | - T Russo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - C Mazzatenta
- UO Dermatologia Lucca- Azienda USL Toscana Nordovest, Lucca, Italy
| | - M Baraldi
- Pediatria, Ospedale di Dolo Mirano, Aulss3, Venezia, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - I Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - M Cutrone
- Ambulatorio di Dermatologia Pediatrica, Ospedale dell'Angelo Venezia, Ospedale San Bortolo Vicenza, Vicenza, Italy
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19
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Chilblain-Like Lesions during COVID-19 Pandemic: The State of the Art. Life (Basel) 2021; 11:life11010023. [PMID: 33401712 PMCID: PMC7823415 DOI: 10.3390/life11010023] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 12/27/2020] [Accepted: 12/31/2020] [Indexed: 02/07/2023] Open
Abstract
SARS-CoV-2 infection has spread all over the world in the last year, causing millions of COVID-19 cases among humans with a large variability of symptoms and signs, including those on the skin. Among these, a contemporary cluster of chilblain-like lesions with no certain relationship with the infection has been reported. The aim of this paper is to delineate a profile of chilblain-like lesions and to establish the state-of-the-art knowledge about this new phenomenon.
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