Materiały źródłowe

• #1 Epidemiologic Analysis of Chilblains Cohorts Before and During the COVID-19 Pandemic

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8223123/

  In this cohort study of 1319 patients in northern California diagnosed with chilblains before and during the COVID-19 pandemic, the incidence of chilblains increased during the pandemic. However, the incidence of chilblains was only weakly correlated with the incidence of COVID-19 across 207 location-months, representing 23 geographic locations across 9 months; only 2% of chilblains cases were confirmed as potentially secondary to COVID-19. […] The findings of this study suggest that the weak correlation between incidence of chilblains and incidence of COVID-19 infection may represent changes in pandemic behavior that led to increased diagnosis of chilblains. […] This cohort study found that in northern California, the incidence of chilblains increased during the pandemic but was correlated weakly with the incidence of COVID-19 across 207 location-months. […] Although this study found a weak geographic and temporal correlation of COVID-19 cases with chilblains cases, these findings may have resulted from behavioral changes. Very few cases of chilblains were positive for COVID-19.

• #1 Pernio: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1087946-overview

  The true incidence of pernio is unknown because pernio frequently is unrecognized or misdiagnosed. […] Rates of pernio vary with climate. England, with its cool damp climate, has an annual incidence rate of pernio of 10%. A clustering of pernio cases has been reported from Hong Kong during January and February, with resolution of most cases within a few weeks when the weather warmed. […] Women are affected by pernio more frequently than men. […] Pernio is most frequent in young and middle-aged women and in children.

• #1 Epidemiology of Chilblains During the COVID-19 Pandemic – Dermatology Advisor

  https://www.dermatologyadvisor.com/news/epidemiology-of-chilblains-during-the-covid-19-pandemic/

  The incidence of chilblains increased during the COVID-19 pandemic, study data published in JAMA Dermatology demonstrates. […] A total of 780 chilblains cases were identified from April through December 2020, among whom 59.5% were women and 40.5% were men. […] The total number of chilblains observed during the same months of 2016 through 2019 was 539, indicating significantly increased incidence during the pandemic. […] Before the pandemic, the overall annual incidence rate of chilblains was 5.2 cases (95% confidence interval [CI], 4.8-5.6) per 100,000 person-years. During the pandemic, the estimated annual incidence rate rose to 28.6 (95% CI, 26.8-30.4) per 100,000 person-years. […] School-aged children had the highest incidence of chilblains during the pandemic, with rates more than double those of other age groups.

• #1 Chilblains – WikiSM (Sports Medicine Wiki)

  https://wikism.org/Chilblains

  Most commonly affects children, women less than 40 years old. […] Prevalence varies between 0.9 per 1,000 and 1.7 per 1,000 in the Netherlands. […] More common among women (0.9 to 2.1) than men (.06) per 1000.

• #1 chilblains — Skin For All

  https://skinforall.co.uk/skin-conditions/chilblains

  According to Scleroderma and Reynauds UK, chilblains affect 1 in 10 people in the UK. […] According to the JAMA network, the overall incidence rate of chilblains was 11.5 per 100, 000 person-years from Jan 2016 to Feb 2020. […] Females had a higher incidence of chilblains than males before and during the pandemic. […] Data is limited by patterns that have found that symptoms commonly begin in early winter and resolve by spring.

• #1 Chronic chilblains | The BMJ

  https://www.bmj.com/content/342/bmj.d2708

  Chronic chilblains are cold induced, painful or itching, red-blue lesions on the fingers, feet, ears, or thighs. The condition occurs throughout the world, more commonly in women than men. The average Dutch general practitioner reports four new cases a year. […] Symptoms usually start in early winter and vanish in spring, but often recur the next winter. Sometimes symptoms persist owing to continued exposure to cold, which is commonly associated with work conditions.

• #1 Population Characteristics, Symptoms, and Risk Factors of Idiopathic Chilblains: A Systematic Review, Meta-Analysis, and Meta-Regression

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9687160/

  The increased prevalence in women was a consistent finding in the studies analyzed in this review. […] Meta-analyses of nine studies with 293 chilblains patients showed that, of the seven histopathological features investigated, the most likely to be found are: perivascular lymphocytic infiltrate (positive in 81% of patients), basal epidermal-cell layer vacuolation (67%), papillary dermal edema (66%), and perieccrine lymphocytic infiltrate (57% of patients). […] These population characteristics, symptoms, and predisposing factors of chilblains should be incorporated in medical care to improve the conditions diagnosis and management and support the formulation of prevention guidelines.

• #1 CHILBLAINS | PPT

  https://www.slideshare.net/slideshow/chilblains/236312023

  Chilblains are small lesions caused by inflammation of blood vessels in the extremities upon exposure to cold temperatures. […] Epidemiology on chilblains is limited. It is prevalent in areas of the UK and Europe without central heating. Prevalence in women is more when compared to men than men. women-0.9-2.1 cases per 1000 patients men 0.6 -1.2 cases per 1000 patients. […] Women are more likely to get chilblains than are men. […] Chilblains often get better on their own after a week or two without treatment.

• #1 Population Characteristics, Symptoms, and Risk Factors of Idiopathic Chilblains: A Systematic Review, Meta-Analysis, and Meta-Regression

  https://www.mdpi.com/2079-7737/11/11/1651

  A total of 5227 records were retrieved through our systematic database search and one more record was added via manual search of the reference lists. Of these articles, 1088 were duplicates. Of the 4139 full-text articles assessed for eligibility, 14 articles were excluded due to the non-availability of the full texts. An additional 4112 records were classified as non-eligible, based on our above-mentioned exclusion criteria. Overall, 13 studies met the inclusion criteria. The 13 studies included in this systematic review were conducted in eight countries across Europe, Asia, and North America. The studies did not report external funding and were published between 2001 and 2018. In total, they included data for 477 patients. Of the 477 patients, 205 (43%) were men and 272 (57%) were women, and their weighed average age was 34 years.

• #1 Pernio (chilblains) – UpToDate

  https://www.uptodate.com/contents/pernio-chilblains

  Pernio (chilblains) is a condition characterized by the development of cold-induced erythrocyanotic skin lesions. […] Data on the epidemiology of pernio are limited. Pernio usually occurs following exposure to cold, damp environments, and thus is most common among individuals who live in cold climates. Symptoms commonly begin in early winter and resolve by spring as cold exposure decreases. However, patients may develop recurrences during subsequent winters or persistent disease.

• #1 Chilblains (Pernio): Symptoms and Management — DermNet

  https://dermnetnz.org/topics/chilblains

  Chilblains can affect all age groups, but is most common in young to middle-aged adults, with a female predominance. […] Chilblains are seen in temperate climates rather than in countries with extreme cold where the air is often dry, and appropriate clothing and living conditions minimise the risk. […] The association between COVID-19 and chilblains is still being defined. […] Chilblains are usually diagnosed clinically. Investigations are sometimes required to exclude differential diagnoses or look for causes of secondary chilblains. […] Chilblains usually resolve spontaneously in 1-3 weeks. However, chilblains can become chronic. Recurrences may occur with subsequent exposures or annually.

• #1 Pernio (Chilblains) – Clinical Tree

  https://clinicalpub.com/pernio-chilblains/

  The first epidemiological study to explicate the prevalence of chilblains and its impact on productivity in servicewomen was carried out in 1942 by the US Medical Department of the War Office. The study concluded that at least 50% of questionnaire participants had chilblains by age 40 during World War II (1939-1943). […] Although pernio is most common in young women, it has also been reported in all ages and both sexes. The number of reported cases of pernio is higher during times of wet near-freezing weather, and less common in dry freezing weather or in a bitterly cold climate. Pernio is most commonly encountered in the northern and western parts of the United States; isolated cases have been reported in warmer climates in times of cooler damp weather. […] As shown in a cross-sectional study conducted by the US Army, the yearly rate of cold weather injuries declined from 38.2/100,000 in 1985 to 0.2/100,000 in 1999. This and other observations from clinical practice suggest that the disease is becoming less common with higher standards of home and workplace heating and greater use of appropriate clothing during the cold winter months.

• #1

  https://www.pepidconnect.com/Default.aspx?new=2&accessCode=Chilblains

  Epidemiology […] – Mortality/Morbidity […] – If prolonged/recurrent symptoms – consider associated diseases (e.g., Lupus) […] […] – Incidence/Prevalence […] – True incidence unknown […] – Young and middle-aged women most commonly affected […] – Less common in children, older adults, males […] – Underweight people and those with poor circulation are at increased risk […] – Symptoms most common in early winter to spring

• #1 Chilblains (perniosis) – symptoms and treatment | healthdirect

  https://www.healthdirect.gov.au/chilblains

  Chilblains are not a serious condition and usually there are no long-term effects. […] Chilblains are itchy, swollen and painful lumps or patches of skin on your fingers and toes, which form due to cold. […] Chilblains usually heal in 1 to 3 weeks but can come back when exposed to cold. […] Chilblains (perniosis) are caused by the small blood vessels below the skin’s surface constricting too much. […] You are more likely to develop chilblains if you are sensitive to the cold. […] Other risk factors for getting chilblains are: being a child or teenager, being female, exposure to smoking, having a low body weight, exposure to damp, wind or cold. […] See your doctor if your symptoms are ongoing or you can’t get your pain under control. […] Your doctor will ask about your symptoms and examine your affected skin.

• #1 Trends and Associations of Chilblains Prevalence with Connective Tissu | CCID

  https://www.dovepress.com/trends-and-associations-of-chilblains-prevalence-with-connective-tissu-peer-reviewed-fulltext-article-CCID

  Chilblains, also known as perniosis, are inflammatory skin lesions that have long been associated with exposure to low temperatures. […] This study was designed to examine chilblains documented prevalence and association with autoimmune diseases and COVID-19. […] The study found a low prevalence primarily among young females and a significant correlation with connective tissue disorders like SLE. […] The study also notes a rare occurrence of chilblains in COVID-19 patients, suggesting a possible association that requires further investigation, particularly regarding demographic patterns within this subgroup. […] This study examined the occurrence of chilblains from 2014 to 2021 and its associations with COVID-19 and connective tissue diseases (CTDs). […] The observed correlation of 11.43% between chilblains and CTDs in this study is consistent with other findings suggesting a possible connection, although it underscores how rare this association is.

• #1 Chilblains – Knowledge and References – Taylor & Francis

  https://taylorandfrancis.com/knowledge/Medicine_and_healthcare/Chiropody_%26_podiatry/Chilblains/

  Chilblains are a medical condition that occurs when the skin is exposed to cold temperatures and then rapidly warmed, typically in ambient temperatures above freezing point. This condition is often seen in older individuals with impaired peripheral circulation. […] Small painful or itchy red or purple bumps that form on the fingers or toes as a reaction to cold temperatures are known as chilblains. Swelling and/or blisters are often present. It is a form of localized vasculitis frequently associated with Raynaud’s disease. The disorder affects primarily women, but also children or the elderly, in damp temperate climates. […] The etiology of chilblain LE is still unclear, but vasospasm may play a role in the reaction to coldness; furthermore, many cases of chilblain LE are associated with Raynaud’s phenomenon.

• #1 Population Characteristics, Symptoms, and Risk Factors of Idiopathic Chilblains: A Systematic Review, Meta-Analysis, and Meta-Regression

  https://www.mdpi.com/2079-7737/11/11/1651

  Chilblains, or perniosis, is a localized skin inflammatory disorder of the acral areas, typically observed after exposure to a cool/cold and damp environment. Though its incidence is difficult to estimate, due to underdiagnosis, the overall annual incidence rate in Northern California has been reported as 11.5 cases per 100,000 person-years, while the same figure in the Netherlands varies year on year from 90 to 170 cases per 100,000 person-years. The incidence of chilblains has sharply increased during the COVID-19 pandemic, possibly due to increased self-referral or changes in patient behaviour during the lockdown measures. Chilblains typically affect the dorsal feet or hands causing inflammatory skin lesions that are often painful, and their pathogenesis remains only partly understood. It is likely of microvascular origin, but a number of patient-related and environmental factors appear to contribute to the observed vascular damage. While chilblains are most commonly idiopathic, they are often studied as secondary to underlying conditions, including Raynaud disease, cryofibrinogenemia, blood or connective tissue diseases, and recently, SARS-CoV-2. To improve diagnosis and management, it is vital to focus entirely on chilblains and consider the histopathological features that characterize this disorder. This suggests the need for a systematic review and meta-analysis to uncover important aspects of the condition, as well as to systematically review and critically appraise the quality and clinical aspects of the published studies. Therefore, the present systematic review, meta-analysis, and meta-regression investigated the population characteristics, symptoms, and predisposing factors of chilblains in otherwise healthy adults who were exposed to cool/cold environments.

• #1 Epidemiology of Chilblains During the COVID-19 Pandemic – Dermatology Advisor

  https://www.dermatologyadvisor.com/news/epidemiology-of-chilblains-during-the-covid-19-pandemic/

  Across 207 location-months, COVID-19 incidence was mildly correlated with chilblains incidence 30 days later (Spearman coefficient: 0.18; P =.01). […] The investigators noted that the reasons for the association remain unexplored; increased care-seeking behaviors during the pandemic may have led to incidental discovery of chilblains.

• #1 Snotwatch COVID-toes: An ecological study of chilblains and COVID-19 diagnoses in Victoria, Australia | PLOS Global Public Health

  https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0000488

  The COVID-19 pandemic has caused widespread illness with varying clinical manifestations. One less-commonly-reported presentation of COVID-19 infection is chilblain-like lesions. […] Our study statistically suggests that chilblains are significantly associated with COVID-19 infections in a primary care setting. This has major implications for clinicians aiming to diagnose COVID-19 infections or determine the cause of a presentation of chilblains. […] Our findings showed that COVID-19 disorder diagnoses were most strongly associated with chilblains presentations in the same week, whereas suspected COVID-19 disorder was associated with chilblains presentations in the preceding and following weeks more strongly. […] Our Victorian ecological study of chilblains and COVID-19 showed a significant association between these presentations in Victorian general practices during the first two years of the COVID-19 pandemic. Using novel statistical methodology, our study can inform epidemiological understanding of COVID-19 circulation in a given region and population. Additionally, existing research to ascertain the causal relationship between the novel coronavirus and chilblains is scant. However, the size of association found in our study demonstrates that further investigation is warranted.

• #1 Chilblain-like lesion associated with coronavirus disease 2019 vaccine in tropical country: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-025-05254-7

  Chilblains have emerged as a cutaneous manifestation following coronavirus disease 2019 vaccination. […] The occurrence of chilblain in the context of COVID-19 or after COVID-19 vaccination may indicate a common mechanism involving the immune response targeting spike RNA or protein. […] Chilblains are a common cutaneous manifestation of COVID-19, and a few cases of chilblains have also been reported following mRNA COVID-19 vaccination. […] The mechanism of chilblains in COVID-19 involves the immune response targeting viral spike RNA or protein, leading to the activation of type I interferon. […] The immune response was triggered by the COVID-19 mRNA vaccine, possibly similar to the response after COVID-19 infection, which can also triggers chilblains. […] The presence of lupus anticoagulant may contribute to the development of chilblains after COVID-19 vaccination. […] Given the limitation of this finding to a single case, additional case reports, or ideally, prospective studies in similar contexts are needed to better understand the role of antiphospholipid antibodies in patients who develop chilblains following COVID-19 vaccination.

• #1

  https://www.nursingcenter.com/journalarticle?Article_ID=5938087&Journal_ID=54015&Issue_ID=5938070

  GENERAL PURPOSE: To familiarize wound care practitioners with the differential diagnoses of chilblains-like lesions that could be associated with the complications of COVID-19. […] The purpose of this educational activity is to familiarize the wound care practitioner with the differential diagnoses of chilblains-like lesions (CLLs) that may be associated with complications of COVID-19. […] A preliminary systematic review of 46 studies (including case reports and series) found acrocutaneous lesions to be the most commonly reported skin manifestation of COVID-19 infection. […] Estimates on the prevalence of CLLs in patients with COVID-19 range from 2% to 20%. […] The clinical diagnosis of COVID toes is based on physical examination and history of possible exposure to COVID-19. […] The differential diagnoses of CLLs are extensive. COVID toes, Raynaud phenomenon or disease, acrocyanosis, CLI, thromboangiitis obliterans, CHLE, and idiopathic chilblains all have similar clinical manifestations. […] It is critical to classify CLLs to ensure proper management and limit conflation. With the advent of COVID-19, it is exceedingly important for clinicians to differentiate CLLs suggestive of alternative dermatologic pathologies from coronavirus infection.

• #1

  https://ijms.info/IJMS/article/view/1648

  Pseudo-chilblains have been associated with COVID-19. […] Many patients reported as pseudo-chilblains of COVID-19 lack confirmed infection. […] Infection confirmation, photographic documentation and histopathology are critical to establish homogeneity in reported pseudo-chilblains during this global pandemic. […] Further work clarifying the relationship of acral eruptions and COVID-19 is necessary. […] In COVID-19-infected adults, pseudo-chilblains were reported primarily from North America and Europe, occurring in both sexes over a wide age-range, affected well and ill patients, favored the hands and feet and could be symptomatic or asymptomatic. […] Most patients had extracutaneous symptoms. […] Resolution time ranged from 1 week to 50 days. […] There was marked variation in treatment strategies and appearance of pseudo-chilblains relative to entire disease course. […] Biopsies were infrequently performed but findings similar to classical chilblains were described. […] We identified 13 studies (29 patients). […] Epidemiologic analysis of chilblains cohorts before and during the COVID-19 pandemic.

• #1 Population Characteristics, Symptoms, and Risk Factors of Idiopathic Chilblains: A Systematic Review, Meta-Analysis, and Meta-Regression

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9687160/

  Chilblains/perniosis is a non-freezing cold injury, most commonly idiopathic, and it affects the dorsal feet or hands, fingers, feet, and toes, causing painful inflammatory skin lesions. […] The present systematic review investigated the population characteristics, symptoms, and predisposing factors of chilblains in otherwise healthy adults who are exposed to cool/cold environments. […] The incidence of chilblains has sharply increased during the COVID-19 pandemic, possibly due to increased self-referral or changes in patient behaviour during the lockdown measures. […] To improve diagnosis and management, it is vital to focus entirely on chilblains and consider the histopathological features that characterize this disorder. […] The population characteristics, symptoms, and predisposing factors of chilblains revealed in this analysis should be incorporated in medical care to improve the conditions diagnosis and management.

• #1 Trends and Associations of Chilblains Prevalence with Connective Tissu | CCID

  https://www.dovepress.com/trends-and-associations-of-chilblains-prevalence-with-connective-tissu-peer-reviewed-fulltext-article-CCID

  Specifically, SLE emerged as the most common CTD linked to chilblains, particularly among younger women, reaffirming the known demographic overlap between chilblains and SLE. […] The study revealed an uncommon association with the notably low co-occurrence rate (0.033%) of chilblains in COVID-19 positive patients. […] Further investigation is warranted to explore this potential link, given that the exact mechanism connecting COVID-19 and chilblains remains elusive. […] In conclusion, this research sheds light on the epidemiology and associations of chilblains within the context of autoimmune diseases and COVID-19.

• #1 Chilblain lupus erythematosus – Wikipedia

  https://en.wikipedia.org/wiki/Chilblain_lupus_erythematosus

  Only about 70 CHLE patients have been documented to as of 2008, including two families with an autosomal dominant-inherited form known as familial CHLE. While familial CHLE typically first appears in early childhood, sporadic CHLE typically affects middle-aged females. […] In about 18% of cases, CHLE progresses to SLE and is accompanied by discoid lupus erythematosus lesions or other types of cutaneous lupus erythematosus. In patients who also have concurrent cutaneous lupus erythematosus, this percentage is even higher. In a study involving seventeen patients, discoid lupus erythematosus developed one to fourteen years after the onset of CHLE.

• #1 Chilblains Associated with Chronic Chikungunya in: The American Journal of Tropical Medicine and Hygiene Volume 106 Issue 2 (2022)

  https://www.ajtmh.org/view/journals/tpmd/106/2/article-p380.xml

  Chikungunya fever is an endemic disease in northeastern Brazil, and its typical clinical presentation is characterized by fever, polyarthralgia (with or without arthritis), and diffuse rash. […] Chilblains are characterized by skin lesions (macules, papules, plaques, or nodules) that begin 12 to 24 hours markedly after cold exposure and resolve within a few weeks. […] The most frequently reported and most studied disease in which chilblains are found is systemic lupus erythematosus (SLE). […] There are no pathognomonic histopathological or serological findings to confirm its diagnosis. […] The pathogenesis is unclear. Cold-induced vasoconstriction resulting in hypoxia that stimulates an inflammatory response is a potential mechanism. […] Given the patients extensive list of autoimmune comorbidities, it is hypothesized that chilblains occurred secondary to an immunological phenomenon with vascular repercussion after cold exposure in the ICU as a trigger.

• #1 Population Characteristics, Symptoms, and Risk Factors of Idiopathic Chilblains: A Systematic Review, Meta-Analysis, and Meta-Regression

  https://www.mdpi.com/2079-7737/11/11/1651

  Chilblains affected from 2.8 ± 6.2% to 11.5 ± 13.4% of the patients’ body skin surface. The most frequently affected skin areas were the hands, fingers, feet, and toes. A total of 21 clinical symptoms or findings were reported, the most frequent being papules, nodules, and itching. It is important to note that “pain” was reported as a symptom of chilblains in several studies, yet there were no quantitative data available for summary statistics or meta-analysis. […] Meta-analyses of nine studies showed that the pooled proportion of patients with chilblains that tested positive for different histopathological and serologic features were as follows: 81% for perivascular lymphocytic infiltrate, 67% for basal epidermal-cell layer vacuolation, 66% for papillary dermal edema, and 57% for perieccrine lymphocytic infiltrate. In our investigation of other sources of heterogeneity using meta-regression analyses, we found that the prevalence of histopathological features related to chilblains was significantly explained by the between-study heterogeneity, in terms of smoking, type of occupation, and study size.

• #1 Chilblains (perniosis) – symptoms and treatment | healthdirect

  https://www.healthdirect.gov.au/chilblains

  The best treatment is staying warm and protecting your affected skin. […] You can lower your risk of getting chilblains by keeping your hands, feet and body warm, avoiding cold, damp and windy conditions, exercising regularly to improve your circulation, not smoking, as this affects your circulation. […] Very rarely, chilblains may be associated with blood or bone marrow disorders, or conditions like lupus or Raynaud’s disease. […] Chilblains may also be a sign you have peripheral vascular disease, which reduces blood flow to your feet and hands.

• #1 Letter for the article Trends and Associations of Chilblains Prevalenc | CCID

  https://www.dovepress.com/comment-on-ldquotrends-and-associations-of-chilblains-prevalence-with–peer-reviewed-fulltext-article-CCID

  While the study provides valuable insights into the prevalence of chilblains and its associations with connective tissue diseases (CTDs) and COVID-19, several limitations and areas for improvement should be noted. […] Future studies should include data from multiple geographic locations with diverse climates and ethnic compositions. Collaborating with international healthcare systems could provide a more comprehensive understanding of chilblains epidemiology and its associations. […] Future research should include an analysis of medication use and its impact on chilblains prevalence. […] Future studies should incorporate molecular and immunological analyses to explore these mechanisms. […] Future research should aim to address these limitations by including more diverse populations, validating diagnoses through multiple data sources, and exploring the clinical and molecular mechanisms underlying these associations.

• #1 Snotwatch COVID-Toes: An ecological study of chilblains and COVID-19 diagnoses in Victoria, Australia | medRxiv

  https://www.medrxiv.org/content/10.1101/2022.04.21.22274140v1

  The COVID-19 pandemic has caused widespread illness with varying clinical manifestations. One less-commonly-reported presentation of COVID-19 infection is chilblain-like lesions. […] We conducted an ecological analysis of chilblain presentations in comparison with confirmed and suspected COVID-19 infections in a primary care setting to establish that a relationship exists between the two. […] Our study statistically demonstrates that chilblains are significantly associated with COVID-19 infections in a primary care setting. This has major implications for clinicians aiming to diagnose COVID-19 infections or determine the cause of a presentation of chilblains. Additionally, we demonstrate the utility of large-scale primary care data and its potential application to monitoring the spread of COVID-19 infections across the state, supporting current epidemiological efforts for COVID-19 tracking.

• #1 From Chilblains (Pernio) to Coeliac Disease—Should We Still Consider It Random?

  https://www.mdpi.com/2227-9067/9/12/1972

  Coeliac disease (CD) is a gluten-triggered, immune-mediated inflammatory disease occurring in genetically predisposed individuals, causing a variety of gastrointestinal and extraintestinal symptoms. […] In the workup of chilblains (pernio) in children, an active case finding for coeliac disease should be conducted with coeliac-specific serology testing. […] The prevalence is reported to be 0.9 to 1.7 per 1000, mostly affecting women and young to middle-aged adults. Although well described, childhood pernio seems to be uncommon and possibly under-diagnosed. […] In accordance with the literature’s recommendations, we performed an extensive workup and screening for possible associated and underlying autoimmune diseases. […] The question of whether pernio and coeliac disease are pathogenically related remains open. […] However, keeping in mind the possibility of the spontaneous resolution of chilblains, it is difficult to draw a definite conclusion. Further studies are needed to help us better understand the possible association between these two entities.

• #2 Population Characteristics, Symptoms, and Risk Factors of Idiopathic Chilblains: A Systematic Review, Meta-Analysis, and Meta-Regression

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9687160/

  Chilblains/perniosis is a non-freezing cold injury, most commonly idiopathic, and it affects the dorsal feet or hands, fingers, feet, and toes, causing painful inflammatory skin lesions. […] The present systematic review investigated the population characteristics, symptoms, and predisposing factors of chilblains in otherwise healthy adults who are exposed to cool/cold environments. […] The incidence of chilblains has sharply increased during the COVID-19 pandemic, possibly due to increased self-referral or changes in patient behaviour during the lockdown measures. […] To improve diagnosis and management, it is vital to focus entirely on chilblains and consider the histopathological features that characterize this disorder. […] The population characteristics, symptoms, and predisposing factors of chilblains revealed in this analysis should be incorporated in medical care to improve the conditions diagnosis and management.

• #2 Population Characteristics, Symptoms, and Risk Factors of Idiopathic Chilblains: A Systematic Review, Meta-Analysis, and Meta-Regression

  https://www.mdpi.com/2079-7737/11/11/1651

  Chilblains, or perniosis, is a localized skin inflammatory disorder of the acral areas, typically observed after exposure to a cool/cold and damp environment. Though its incidence is difficult to estimate, due to underdiagnosis, the overall annual incidence rate in Northern California has been reported as 11.5 cases per 100,000 person-years, while the same figure in the Netherlands varies year on year from 90 to 170 cases per 100,000 person-years. The incidence of chilblains has sharply increased during the COVID-19 pandemic, possibly due to increased self-referral or changes in patient behaviour during the lockdown measures. Chilblains typically affect the dorsal feet or hands causing inflammatory skin lesions that are often painful, and their pathogenesis remains only partly understood. It is likely of microvascular origin, but a number of patient-related and environmental factors appear to contribute to the observed vascular damage. While chilblains are most commonly idiopathic, they are often studied as secondary to underlying conditions, including Raynaud disease, cryofibrinogenemia, blood or connective tissue diseases, and recently, SARS-CoV-2. To improve diagnosis and management, it is vital to focus entirely on chilblains and consider the histopathological features that characterize this disorder. This suggests the need for a systematic review and meta-analysis to uncover important aspects of the condition, as well as to systematically review and critically appraise the quality and clinical aspects of the published studies. Therefore, the present systematic review, meta-analysis, and meta-regression investigated the population characteristics, symptoms, and predisposing factors of chilblains in otherwise healthy adults who were exposed to cool/cold environments.

• #2 Pernio: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1087946-overview

  The true incidence of pernio is unknown because pernio frequently is unrecognized or misdiagnosed. […] Rates of pernio vary with climate. England, with its cool damp climate, has an annual incidence rate of pernio of 10%. A clustering of pernio cases has been reported from Hong Kong during January and February, with resolution of most cases within a few weeks when the weather warmed. […] Women are affected by pernio more frequently than men. […] Pernio is most frequent in young and middle-aged women and in children.

• #2 Chilblains (perniosis) – symptoms and treatment | healthdirect

  https://www.healthdirect.gov.au/chilblains

  Chilblains are not a serious condition and usually there are no long-term effects. […] Chilblains are itchy, swollen and painful lumps or patches of skin on your fingers and toes, which form due to cold. […] Chilblains usually heal in 1 to 3 weeks but can come back when exposed to cold. […] Chilblains (perniosis) are caused by the small blood vessels below the skin’s surface constricting too much. […] You are more likely to develop chilblains if you are sensitive to the cold. […] Other risk factors for getting chilblains are: being a child or teenager, being female, exposure to smoking, having a low body weight, exposure to damp, wind or cold. […] See your doctor if your symptoms are ongoing or you can’t get your pain under control. […] Your doctor will ask about your symptoms and examine your affected skin.

• #2 Trends and Associations of Chilblains Prevalence with Connective Tissu | CCID

  https://www.dovepress.com/trends-and-associations-of-chilblains-prevalence-with-connective-tissu-peer-reviewed-fulltext-article-CCID

  Specifically, SLE emerged as the most common CTD linked to chilblains, particularly among younger women, reaffirming the known demographic overlap between chilblains and SLE. […] The study revealed an uncommon association with the notably low co-occurrence rate (0.033%) of chilblains in COVID-19 positive patients. […] Further investigation is warranted to explore this potential link, given that the exact mechanism connecting COVID-19 and chilblains remains elusive. […] In conclusion, this research sheds light on the epidemiology and associations of chilblains within the context of autoimmune diseases and COVID-19.

• #2

  https://www.pepidconnect.com/Default.aspx?new=2&accessCode=Chilblains

  Epidemiology […] – Mortality/Morbidity […] – If prolonged/recurrent symptoms – consider associated diseases (e.g., Lupus) […] […] – Incidence/Prevalence […] – True incidence unknown […] – Young and middle-aged women most commonly affected […] – Less common in children, older adults, males […] – Underweight people and those with poor circulation are at increased risk […] – Symptoms most common in early winter to spring

• #2 Population Characteristics, Symptoms, and Risk Factors of Idiopathic Chilblains: A Systematic Review, Meta-Analysis, and Meta-Regression

  https://www.mdpi.com/2079-7737/11/11/1651

  Chilblains affected from 2.8 ± 6.2% to 11.5 ± 13.4% of the patients’ body skin surface. The most frequently affected skin areas were the hands, fingers, feet, and toes. A total of 21 clinical symptoms or findings were reported, the most frequent being papules, nodules, and itching. It is important to note that “pain” was reported as a symptom of chilblains in several studies, yet there were no quantitative data available for summary statistics or meta-analysis. […] Meta-analyses of nine studies showed that the pooled proportion of patients with chilblains that tested positive for different histopathological and serologic features were as follows: 81% for perivascular lymphocytic infiltrate, 67% for basal epidermal-cell layer vacuolation, 66% for papillary dermal edema, and 57% for perieccrine lymphocytic infiltrate. In our investigation of other sources of heterogeneity using meta-regression analyses, we found that the prevalence of histopathological features related to chilblains was significantly explained by the between-study heterogeneity, in terms of smoking, type of occupation, and study size.

• #2 Pernio (chilblains) – UpToDate

  https://www.uptodate.com/contents/pernio-chilblains

  Pernio (chilblains) is a condition characterized by the development of cold-induced erythrocyanotic skin lesions. […] Data on the epidemiology of pernio are limited. Pernio usually occurs following exposure to cold, damp environments, and thus is most common among individuals who live in cold climates. Symptoms commonly begin in early winter and resolve by spring as cold exposure decreases. However, patients may develop recurrences during subsequent winters or persistent disease.

• #2 Population Characteristics, Symptoms, and Risk Factors of Idiopathic Chilblains: A Systematic Review, Meta-Analysis, and Meta-Regression

  https://www.mdpi.com/2079-7737/11/11/1651

  This systematic review, meta-analysis, and meta-regression shows that chilblains have a higher prevalence in women and is typically diagnosed in people at their 30s, although it can be seen in people as old as 80 years. It typically affects 3 to 12% of the patient’s body skin surface, and it is most frequently observed in the hands, fingers, feet, and toes. These population characteristics, symptoms, and predisposing factors of chilblains should be incorporated in medical care to improve the condition’s diagnosis and management and support the formulation of prevention guidelines.

• #3 CHILBLAINS | PPT

  https://www.slideshare.net/slideshow/chilblains/236312023

  Chilblains are small lesions caused by inflammation of blood vessels in the extremities upon exposure to cold temperatures. […] Epidemiology on chilblains is limited. It is prevalent in areas of the UK and Europe without central heating. Prevalence in women is more when compared to men than men. women-0.9-2.1 cases per 1000 patients men 0.6 -1.2 cases per 1000 patients. […] Women are more likely to get chilblains than are men. […] Chilblains often get better on their own after a week or two without treatment.

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