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Case Reports
. 2025 May 7;19(1):213.
doi: 10.1186/s13256-025-05254-7.

Chilblain-like lesion associated with coronavirus disease 2019 vaccine in tropical country: a case report

Wasuchon Chaichan  1 , Mati Chuamanochan  1 , Pongsak Mahanupab  2 , Siri Chiewchanvit  1 , Napatra Tovanabutra  3
Affiliations
Case Reports

Chilblain-like lesion associated with coronavirus disease 2019 vaccine in tropical country: a case report

Wasuchon Chaichan et al. J Med Case Rep. .

Abstract

Background: Chilblains have emerged as a cutaneous manifestation following coronavirus disease 2019 vaccination. While there are many case reports on chilblain-like lesions, documentation from tropical countries remains limited. In this context, we report a case detailing chilblain-like lesions associated with coronavirus disease 2019 vaccination in Thailand.

Case presentation: A 35-year-old Thai female patient presented with several painful, red papules on the fingers and toes 9 days after receiving the mRNA-1273 vaccination. Skin biopsy was performed, and the results were consistent with chilblains. Laboratory workup revealed positive result for lupus anticoagulant. The rash completely resolved without any treatment but reappeared following the second vaccine dose.

Conclusion: Chilblain-like lesion following coronavirus disease 2019 vaccination is frequently observed in temperate countries, with few reports from tropical areas. The presence of lupus anticoagulant may contribute to the development of chilblains after coronavirus disease 2019 vaccination.

Keywords: COVID-19 vaccine; Case report; Chilblain-like lesion; Chilblains; Lupus anticoagulant.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical approval for publication was obtained. Consent for publication: Written informed consent was obtained from the patient’s legal guardian for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Multiple painful erythematous papules on the fingers (A) and toes (B, C)
Fig. 2
Fig. 2
Histologic findings of the skin punch biopsy showing papillary dermal edema, perivascular mononuclear cell infiltration (A), and perieccrine lymphocytic infiltration (B)
See this image and copyright information in PMC

References

    1. Prakash S, Weisman MH. Idiopathic chilblains. Am J Med. 2009;122(12):1152–5. 10.1016/j.amjmed.2009.07.011. - PubMed
    1. Lopez S, Vakharia P, Vandergriff T, Freeman EE, Vasquez R. Pernio after COVID-19 vaccination. Br J Dermatol. 2021;185(2):445–7. 10.1111/bjd.20404. - PMC - PubMed
    1. Cribier B, Djeridi N, Peltre B, Grosshans E. A histologic and immunohistochemical study of chilblains. J Am Acad Dermatol. 2001;45(6):924–9. 10.1067/mjd.2001.117861. - PubMed
    1. Souaid K, Oulès B, Sohier P, Deschamps L, Aractingi S, Dupin N. Type I interferon signature in chilblains following SARS-CoV-2 mRNA vaccine: a case report. Acta Derm-Venereol. 2021. 10.2340/00015555-3888. - PMC - PubMed
    1. Cappel MA, Cappel JA, Wetter DA. Pernio (Chilblains), SARS-CoV-2, and COVID toes unified through cutaneous and systemic mechanisms. Mayo Clin Proc. 2021;96(4):989–1005. 10.1016/j.mayocp.2021.01.009. - PMC - PubMed

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