Introduction
During the outbreak of COVID-19 many skin manifestations have been
reported, and among these, in very significant numbers, newly eruptions
like vascular and peculiar pernio-like skin lesions have been described
in observational studies11Piccolo
V, Neri I, Filippeschi C et Al. 2020 Chilblain-like lesions during
COVID-19 epidemic: a preliminary study on 63 patients
J
Eur Acad Dermatol Venereol. 2020 Apr 24. doi: 10.1111/jdv.16526,22Galván
Casas C, Català A, Carretero Hernández G, et al. Classification of the
cutaneous manifestations of COVID-19: a rapid prospective nationwide
consensus study in Spain with 375 cases [published online ahead of
print, 2020 Apr 29]. Br J Dermatol. 2020;10.1111/bjd.19163.
doi:10.1111/bjd.19163,33Nerea
Landa, Marta Mendieta-Eckert et al. Chilblain-like lesions on feet and
hands during the COVID-19 Pandemic. International Journal of
Dermatology. 2020 doi: 10.1111/ijd.14937,44Recalcati
S, Barbagallo T, Frasin LA, et al. Acral cutaneous lesions in the time
of COVID-19 [published online ahead of print, 2020 Apr
24]. J Eur Acad Dermatol Venereol . 2020;10.1111/jdv.16533.
doi:10.1111/jdv.16533.Pernio, also referred to as chilblains, is a
rare inflammatory condition. Chilblains derives from two Old English
words ”chill” (cold) and ”blegen” (sore). Most commonly, pernio affects
acral skin and develops among susceptible individuals who are exposed to
cold, the lesions usually appear in fall or winter and disappear in
spring or early summer. It is typically idiopathic and acute,
nevertheless chronic forms also
exist55Whitman
PA, Crane
JS, Pernio (Chilblains) StatPearls [Internet]. Treasure Island
(FL): StatPearls Publishing; 2020-.
2019 Nov 4. The diagnosis of pernio is largely clinical and based on
a thorough history and physical exam. The differential diagnosis
must exclude diseases that can often be confused with other forms of
pernio or vasculitic processes like LES or other conditions for example
Raynaud phenomenon, acrocyanosis, cryoglobulinemia, cold panniculitis
and Interferonopathies. The prognosis of pernio is good with
minimal chronic sequelae.Single or multiple erythematous, purplish,
edematous lesions appear, accompanied by intense pain, itching, or
burning. Usually, pernio affects the toes and dorsum of the proximal
phalanges66Tamara D. Simon, MD et Al. Pernio in Pediatrics.Pediatrics. 2005
Sep;116(3):e472-5.. Since March 2020, children with red and painful
skin lesions, referable to chilblain have come to our attention. The
injuries occurred in children and adolescents, however, in good health
conditions, with suggestive history and established contact with SARS
CoV2 patients. The increase in the number of cases of chilblain-like
lesions compared to the cases with which we come into contact in our
clinical practice every year, in association with the mild temperatures
observed in those months in Southern Italy and the concomitant lockdown,
led us to hypothesize a possible correlation with SARS Cov2 infection,
so, the aim of the study is to evaluate this.