Abstract
ABSTRACT Background During the outbreak of COVID-19 many chilblain-like
lesions are being increasingly reported. The aim of the study is to
evaluate a possible correlation between pernio like skin lesions and
SARS CoV2 infection. Methods All patients underwent not only clinical
and laboratory tests to evaluate a possible underlying connective
disease, but also specific SARS CoV2 investigations such as
oropharyngeal swab and IgG-IgM serology. Results Nine patients, all
children, were recruited. 6/9 had respiratory and systemic symptoms that
preceded cutaneous findings of approximately 2 weeks. The injuries
observed were purplish, erythematous and edematous; four children
reported subjective symptoms, painful and pruritus localized to the sole
of the feet or to the toes, fingers or heels. Concerning blood exams:
3/9 had D-dimer weakly increased, 4 had ANA positivity: two with a title
1:160, one with 1:320 and one with 1:5120 and a speckled pattern. The
latter patient had also ENA SS-A positive and FR positivity, confirmed
at a second check, so as to allow us to make a diagnosis of
connectivity. 4/9 had aPL positivity (IgM). Reactants acute phase were
all negative. Oropharyngeal swabs and serology tests for SARS-CoV2 was
negative (borderline in one patient for IgM). Conclusions Even if we do
not have enough data to prove it, we hypothesize a correlation between
chilblain and SARS-CoV2 infection for an increased number of these
lesions described and also because such lesions appeared when
temperatures were mild and patients were at home in isolation for the
lockdown. Many questions remain open about interaction host-virus.