Chilblain-like lesions coinciding with the SARS-CoV-2 pandemic.

Abstract

Chilblain-like lesions (CLL) coinciding with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been described. Previous systematic reviews suggest CLL are associated with younger age, an equal sex ratio, negative testing for SARS-CoV-2, and mild to no extracutaneous symptoms. A systematic review was conducted according to PRISMA guidelines on CLL coinciding with SARS-CoV-2 to clarify the demographic characteristics, clinical features, and resolution outcomes of these skin findings. One hundred and twenty-eight studies, published between March 2020 and January 2022, met inclusion criteria and were summarized in this review, representing 4,982 cases of CLL. Available data showed a slight female predominance (55%, n=2471/4472). Mean age was 25 years, ranging from 0 to 95 years. Most cases were not associated with extracutaneous symptoms (63%, n=1649/2636). Overall, 19% (n=347/1838) of patients tested positive for SARS-CoV-2 using polymerase chain reaction (PCR), serology, or tissue biopsy. Clinical course was generally benign with 80% (n=979/1224) of cases resolving, and 47% (n=204/432) resolving without receiving treatment. In summary, this review provides a comprehensive summary of CLL associated with SARS-CoV-2. CLL occurred at a mean age of 25 years with slight female predominance. The majority had negative COVID-19 testing, no extracutaneous symptoms, and resolved without recurrence.