Observational studyThe British journal of dermatology2021
Type I interferon response and vascular alteration in chilblain-like lesions during the COVID-19 outbreak.
Observational study in The British journal of dermatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.
- COVID-19 Vasculitis and vasculopathy-Distinct immunopathology emerging from the close juxtaposition of Type II Pneumocytes and Pulmonary Endothelial Cells.Seminars in immunopathology · 2022Pooled it
- Immune-Based Cytokine Signatures of Prolonged Pandemic-Associated Chilblains.The Journal of infectious diseases · 2026Article
- The seven enigmas of SARS-CoV-2: from the past to the future.Journal of human immunity · 2025Article
- Enhanced TLR7-dependent production of type I interferon by pDCs underlies pandemic chilblains.The Journal of experimental medicine · 2025Article
- Article
- Diagnosis and management of COVID toes in outpatients: a case report.Journal of medical case reports · 2024Article
- Development of chilblain lesions during the COVID-19 pandemic is strongly associated with cold weather: a retrospective analysis of patients from a single centre in the USA.Clinical and experimental dermatology · 2024Article
- Molecular evidence for SARS-CoV-2 in samples collected from patients with morbilliform eruptions since late 2019 in Lombardy, northern Italy.Environmental research · 2022Article
- "COVID toes": A true viral phenomenon or a diagnosis without a leg to stand on?JAAD international · 2022Review
- COVID-associated non-vasculitic thrombotic retiform purpura of the face and extremities: A case report.Clinical case reports · 2022Article
- Chilblains outbreak during COVID-19 pandemic: A Type-I interferonopathy?Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2022Article
- Pernio and early SARS-CoV-2 variants: natural history of a prospective cohort and the role of interferon.The British journal of dermatology · 2022Article
- Purple toes following critical COVID-19 infection.Pediatric dermatology · 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
- Autoantibodies in COVID-19 correlate with antiviral humoral responses and distinct immune signatures.Allergy · 2022Article
- Complement-mediated microvascular injury and thrombosis in the pathogenesis of severe COVID-19: A review.World journal of experimental medicine · 2022Review
- Pandemic chilblains: Are they SARS-CoV-2-related or not?Clinical immunology (Orlando, Fla.) · 2022Article
- Multicenter analysis of neutrophil extracellular trap dysregulation in adult and pediatric COVID-19.medRxiv : the preprint server for health sciences · 2022Article
- Lack of association between pandemic chilblains and SARS-CoV-2 infection.Proceedings of the National Academy of Sciences of the United States of America · 2022Article
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Authors and funding
31 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe outbreak of chilblain-like lesions (CLL) during the COVID-19 pandemic has been reported extensively, potentially related to SARS-CoV-2 infection, yet its underlying pathophysiology is unclear.
objectivesTo study skin and blood endothelial and immune system activation in CLL in comparison with healthy controls and seasonal chilblains (SC), defined as cold-induced sporadic chilblains occurring during 2015 and 2019 with exclusion of chilblain lupus.
methodsThis observational study was conducted during 9-16 April 2020 at Saint-Louis Hospital, Paris, France. All patients referred with CLL seen during this period of the COVID-19 pandemic were included in this study. We excluded patients with a history of chilblains or chilblain lupus. Fifty patients were included.
resultsHistological patterns were similar and transcriptomic signatures overlapped in both the CLL and SC groups, with type I interferon polarization and a cytotoxic-natural killer gene signature. CLL were characterized by higher IgA tissue deposition and more significant transcriptomic activation of complement and angiogenesis factors compared with SC. We observed in CLL a systemic immune response associated with IgA antineutrophil cytoplasmic antibodies in 73% of patients, and elevated type I interferon blood signature in comparison with healthy controls. Finally, using blood biomarkers related to endothelial dysfunction and activation, and to angiogenesis or endothelial progenitor cell mobilization, we confirmed endothelial dysfunction in CLL.
conclusionsOur findings support an activation loop in the skin in CLL associated with endothelial alteration and immune infiltration of cytotoxic and type I IFN-polarized cells leading to clinical manifestations.
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