(HealthDay)—Patients presenting with chilblain-like lesions during the COVID-19 pandemic have histologic and biologic patterns of type I interferonopathy, according to a study published online Nov. 25 in JAMA Dermatology.
Thomas Hubiche, M.D., from Université Côte d’Azur in Nice, France, and colleagues assessed 40 consecutive patients presenting with chilblain-like lesions during the COVID-19 pandemic. Patients underwent skin biopsies, vascular investigations, biologic analyses, interferon-alpha stimulation and detection, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction and serologic analysis.
The researchers found that most patients were young, with a median age of 22 years, and 19 patients were male. Chilblain-like lesions were mostly on the toes. Eleven patients had bullous and necrotic evolution, while 19 had acrocyanosis or cold toes. Just over one-fourth of patients (27.5 percent) had criteria compatible with COVID-19 cases within six weeks of the eruption, although all rapid testing results were negative. SARS-CoV-2 serology results were positive in 12 patients (30 percent). Six in 10 patients had elevated D-dimer concentration levels. All patients tested negative for cryoglobulinemia and parvovirus B19. Lymphocytic inflammation and vascular damage with thickening of venule walls and pericyte hyperplasia were the major histologic findings.
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