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Case Reports
. 2020 Apr 18;6(6):489-492.
doi: 10.1016/j.jdcr.2020.04.011. eCollection 2020 Jun.

Coronavirus (COVID-19) infection-induced chilblains: A case report with histopathologic findings

Athanassios Kolivras  1 , Florence Dehavay  1 , Daphné Delplace  2 , Francesco Feoli  1 , Isabelle Meiers  1 , Laurenzo Milone  3 , Catherine Olemans  1 , Ursula Sass  1 , Anne Theunis  1 , Curtis T Thompson  4   5 , Laura Van De Borne  1 , Bertrand Richert  1
Affiliations
Case Reports

Coronavirus (COVID-19) infection-induced chilblains: A case report with histopathologic findings

Athanassios Kolivras et al. JAAD Case Rep. .
No abstract available

Keywords: COVID-19, coronavirus disease 2019; IFN-I, type I interferon.

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Figures

Fig 1
Fig 1
Coronavirus disease 2019–induced chilblains. Violaceous infiltrated plaques that appeared abruptly on an erythematous background, with features typical of chilblains.
Fig 2
Fig 2
Coronavirus disease 2019–induced chilblains. A, Histopathologic findings simulating chilblain lupus with an absence of significant papillary dermal edema. There is a superficial and deep lymphoplasmacytic infiltrate. B, Vacuolar interface dermatitis with singly necrotic (apoptotic) keratinocytes and smudging of the basement membrane zone. Some of the necrotic keratinocytes are in the superficial layers of the epidermis. (Hematoxylin-eosin stain.)
Fig 3
Fig 3
Coronavirus disease 2019–induced chilblains. A, A predominantly lymphocytic infiltrate with occasional plasma cells, which is tightly cuffing vessels whose walls and lumina are devoid of fibrin deposition and thrombi. B, A perieccrine accentuation to the infiltrate. (Hematoxylin-eosin stain.)
Fig 4
Fig 4
Coronavirus disease 2019–induced chilblains. Coronavirus primo infection–induced chilblains (perniosis) may represent microangiopathic changes induced by an increased type I interferon reaction. The reaction may protect the host from viral replication, thereby explaining why young patients run a short and indolent course of the disease in contrast to older patients with a delayed or insufficient type I interferon reaction, resulting in increased morbidity and mortality.
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References

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