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High prevalence of cryofibrinogenemia in patients with chilblains during the COVID-19 outbreak

Abstract: Background: Many cutaneous manifestations have been described in possible association with the COVID-19 pandemic, including acral lesions resembling chilblains. The underlying pathomechanisms of COVID-19 chilblains are not fully understood. The aim of this study was to describe the clinical, pathological, and laboratory findings of a series of patients who developed chilblains during the COVID-19 outbreak and to investigate the possible factors that could be involved in the pathogenesis of these lesions. Methods: We conducted a prospective cohort study that included 54 patients who presented with chilblains during the highest peak in the incidence of COVID-19 in Cantabria (northern Spain). Skin biopsies were performed on 10 of these patients who presented with recent lesions. Laboratory investigations, including immunological analysis, serological studies, and the assessment of cryoproteins, were also performed. Results: Most patients presented erythematous plaques located on the toes and/or purpuric macules located on the feet. Histopathological findings were compatible with those of idiopathic chilblains. Immunohistochemical evaluation showed C3d and C4d deposits in the vessel walls in seven cases. The autoimmunity panel was negative in most of our series. Cryoprotein testing showed positive cryofibrinogen in two-thirds (66.7%) of the patients assessed. On follow-up, most patients presented almost complete resolution, although six patients required prednisone and antiaggregant drug treatment. Conclusions: This study shows, for the first time to our knowledge, a high prevalence of cryofibrinogenemia in patients with chilblains during the COVID-19 pandemic. Cryofibrinogenemia could be implicated in the pathogenesis of chilblains related to COVID-19.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: International Journal of Dermatology 2020, 59, 1475-1484

Editorial: Wiley

 Fecha de publicación: 17/10/2020

Nº de páginas: 10

Tipo de publicación: Artículo de Revista

 DOI: 10.1111/ijd.15234

ISSN: 0011-9059,1365-4632

Url de la publicación: https://onlinelibrary.wiley.com/doi/10.1111/ijd.15234

Autores/as

GÓMEZ FERNÁNDEZ, CRISTINA

LÓPEZ SUNDH, ANA E.

MARIA CARMEN GONZALEZ VELA

OCEJO VINYALS, JAVIER GONZALO

MAYOR IBARGUREN, ANDER

SALAS VENERO, CARLOS A.

GUTIÉRREZ LARRAÑAGA, MARÍA

ANA TEJERINAPUENTE

TEJERINA PUENTE, ANA