ReviewJournal of cutaneous pathology2022
A clinicopathological description of COVID-19-induced chilblains (COVID-toes) correlated with a published literature review.
Review in Journal of cutaneous pathology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Epidemiology and clinical evolution of non-multisystem inflammatory syndrome (MIS-C) dermatological lesions in pediatric patients affected by SARS-CoV-2 infection: A systematic review of the literature.European journal of pediatrics · 2022Pooled it
- Chilblain-Like Lesions (CLL) Coinciding With the SARS-CoV-2 Pandemic in Children: A Systematic Review.Journal of cutaneous medicine and surgeryPooled it
- Cutaneous Pediatric Vasculitis: A Clinico-Histopathological Overview of Common and Novel Entities.Dermatopathology (Basel, Switzerland) · 2026Review
- Acrocyanosis: The Least Known Acrosyndrome Revisited With a Dermatologic Perspective.Dermatology research and practice · 2025Review
- Diagnosis and management of COVID toes in outpatients: a case report.Journal of medical case reports · 2024Article
- Histopathology of persistent long COVID toe: A case report.Journal of cutaneous pathology · 2022Article
- The potential role of ischaemia-reperfusion injury in chronic, relapsing diseases such as rheumatoid arthritis, Long COVID, and ME/CFS: evidence, mechanisms, and therapeutic implications.The Biochemical journal · 2022Review
- Multicenter analysis of neutrophil extracellular trap dysregulation in adult and pediatric COVID-19.JCI insight · 2022Article
- Chronic inflammation and calciphylaxis.BMJ case reports · 2022Article
- Multicenter analysis of neutrophil extracellular trap dysregulation in adult and pediatric COVID-19.medRxiv : the preprint server for health sciences · 2022Article
- Viruses, Variants, and Vaccines: How COVID-19 Has Changed the Way We Look at Skin.Current dermatology reports · 2022Review
- A clinicopathological description of COVID-19-induced chilblains (COVID-toes) correlated with a published literature review.Journal of cutaneous pathology · 2022Review
- Cyanotic Fingers and Omicron, Oh My!Indian journal of dermatologyArticle
- Pool Toes: A Case Report.Case reports in dermatologyArticle
Corrections and comments
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe abundance of publications of COVID-19-induced chilblains has resulted in a confusing situation.
methodsThis is a prospective single-institution study from 15 March to 13 May 2020. Thirty-two patients received PCR nasopharyngeal swabs. Of these, 28 patients had a thoracic CT-scan, 31 patients had blood and urine examinations, 24 patients had skin biopsies including immunohistochemical and direct immunofluorescence studies, and four patients had electron microscopy.
resultsCOVID-19-induced chilblains are clinically and histopathologically identical to chilblains from other causes. Although intravascular thrombi are sometimes observed, no patient had a systemic coagulopathy or severe clinical course. The exhaustive clinical, radiological, and laboratory work-up in this study ruled-out other primary and secondary causes. Electron microscopy revealed rare, probable viral particles whose core and spikes measured from 120 to 133 nm within endothelium and eccrine glands in two cases.
conclusionThis study provides further clinicopathologic evidence of COVID-19-related chilblains. Negative PCR and antibody tests do not rule-out infection. Chilblains represent a good prognosis, occurring later in the disease course. No systemic coagulopathy was identified in any patient. Patients presenting with acral lesions should be isolated, and chilblains should be distinguished from thrombotic lesions (livedo racemosa, retiform purpura, or ischemic acral necrosis).
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