Increasing evidence suggests pernio-like lesions are cutaneous manifestations of coronavirus infectious disease 2019 (COVID-19).
To describe clinical and pathologic findings of pernio-like lesions in patients with confirmed or suspected COVID-19.
An international dermatology registry was circulated to health care providers worldwide through the American Academy of Dermatology, International League of Dermatologic Societies, and other organizations.
We documented 505 patients with dermatologic manifestations associated with COVID-19, including 318 (63%) with pernio-like lesions. Patients with pernio-like lesions were generally young and healthy, with relatively mild COVID-19. Of 318 patients with confirmed or suspected COVID-19 by providers, 23 (7%) were laboratory-confirmed COVID-19 positive, and 20 others (6%) were close contacts of patients with confirmed COVID-19. Given current testing criteria, many patients lacked COVID-19 testing access. For 55% of patients, pernio-like lesions were their only symptom. In patients with other COVID-19 symptoms, pernio-like lesions typically appeared after other symptoms. Pernio-like lesions lasted a median of 14 days (interquartile range, 10-21 days).
A case series cannot estimate population-level incidence or prevalence. In addition, there may be confirmation bias in reporting. We cannot exclude an epiphenomenon.
Pernio-like skin changes of the feet and hands, without another explanation, may suggest COVID-19 infection and should prompt confirmatory testing.Le texte complet de cet article est disponible en PDF.
Key words : chilblains, COVID-19, dermatology, pernio, public health
Abbreviations used : COVID-19, Ig, PCR, SARS-CoV-2
| Funding sources: None.
| Conflicts of interest: Drs Freeman, Lipoff, Rosenbach, Kovarik, Takeshita, Hruza, and Fox are part of the American Academy of Dermatology (AAD) Covid-19 Ad Hoc Task Force. Dr French is president of the International League of Dermatological Societies. Dr Hruza is immediate past president of the AAD. Dr Thiers is the president of the AAD. Author McMahon has no conflicts of interest to disclose.
| IRB approval status: The registry was reviewed by the Partners Healthcare (Massachusetts General Hospital) Institutional Review Board and was determined to not meet the definition of Human Subjects Research.
| Reprints not available from the authors.