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General Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Chilblain, also known as pernio, is a superficial injury typically occurring after one to 5 hours in cold, wet conditions at temperatures below 16°C (50°F). Small erythematous papules appear on the skin, most often on the dorsal surface of the fingers, though the ears, face, shins, and feet may also be affected. The lesions are swollen, tender, itchy, and painful. Upon rewarming, the skin becomes inflamed, red, and hot to the touch, with an itching or burning sensation that may continue for several hours.18 It is during this rewarming phase that chilblain becomes thermographically visible. Recovery from chilblain is usually complete without lasting effects.
Environmental Injuries
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Soo Jung Kim, Alexander V. Nguyen
Differential diagnosis: Pernio may be differentiated from chilblain lupus erythematosus, cryoglobulinemia, acrocyanosis, RP, cold panniculitis, leukemia cutis, and COVID-19 associated vasculitis of the digits in the right clinical context.
Clinical presentations for chronic venous diseases
Published in Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland, Manual of Venous and Lymphatic Diseases, 2017
Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland
Chilblains (pernio) occur in susceptible individuals with exposure to cold. Acute chilblains are characterized by symmetrical intense itching, numbness or burning of the toes and fingers and less commonly of the nose, ears and cheeks shortly after exposure to cold or damp conditions, that disappears within a few weeks. There are single or multiple erythematous, brownish or purple–blue skin lesions that may progress to blisters or ulcers.
COVID toes following vaccination
Published in Baylor University Medical Center Proceedings, 2022
Annia Cavazos, Anasua Deb, Upama Sharma, Kenneth Nugent
Dermatologic adverse effects after COVID-19 vaccination reported in the literature to date include anaphylaxis, maculopapular exanthema, angioedema, urticaria-angioedema syndrome, toxic epidermal necrolysis, Stevens-Johnson syndrome, drug reaction with eosinophilia and systemic symptoms, anaphylaxis with severe respiratory and cardiovascular symptoms, cutaneous and systemic mastocytosis, pernio or chilblains, cosmetic filler reactions, flare of herpes zoster and herpes simplex, and pityriasis rosea–like reactions.18 The exact pathophysiologic mechanism for each of these adverse effects is not fully understood, but pernio or chilblains after vaccination suggests an immunological mechanism, similar to the mechanism seen with COVID-19 infection.19 A few reports in the literature have found the occurrence of COVID toes or chilblains following COVID-19 vaccination and have proposed an immunologic mechanism.20–23 Of these four case reports, three were after vaccination with BNT162b221–23 and one was after vaccination with mRNA-1273.20 Histopathology examination of the skin biopsy showed lymphocytic infiltrates20,22; however, SARS-CoV2 virus was not detected by immunohistochemistry23 or immunofluorescence.22 A registry-based study utilizing the American Academy of Dermatology/International League of Dermatological Societies COVID-19 registry reported eight cases of pernio-like reactions after COVID-19 vaccination.18
Cutaneous manifestations of COVID-19 in skin of color: a firsthand perspective of three cases in a tertiary care center in India
Published in Postgraduate Medicine, 2021
Shivam Goyal, Smitha Prabhu, Shashikiran U, Sathish B. Pai, Afsal Mohammed
Exanthematous or morbilliform rash has been noted mostly on the trunk, either at disease onset or at the time of recovery [4]. Pernio (chilblain)-like acral lesion or ‘COVID toes’ present across the age spectrum as purpuric or erythematous macules over fingers, elbows, toes, and lateral aspect of feet [5]. Resolution occurs in 2 to 8 weeks. Rarely, it can progress to recalcitrant digital ischemia [6]. Acute urticaria is the next common finding noted with or without concomitant fever [1–3,11]. The varied cutaneous findings have also been described in pregnancy in a case report where maculopapular rash and urticaria-like lesions were simultaneously present [7]. Recently HZ has been suggested as an alarming sign for a recent subclinical SARS CoV2 infection [8,9]. Retiform purpura has also been described as one of the cutaneous findings [10].
Cutaneous manifestations related to the COVID-19 pandemic: a review article
Published in Cutaneous and Ocular Toxicology, 2021
Hamideh Molaee, Fakhri Allahyari, Seyed Naser Emadi, Shokofeh Radfar, Zahra Razavi
The prevalence of cutaneous manifestations in patients with COVID-19 has been estimated to be from 1.8% to about 25% localized in the various parts of the body15,18. The most prominent skin signs and symptoms during the COVID-19 pandemic are categorized as below: exanthema; such as maculopapular lesions, vesicular eruptions, and chicken pox-like lesions, Allergic manifestations; urticaria and maculopapular rash, Vascular reactions; petechiae, purpura, lesions of livedo reticularis. Other less common skin manifestations of chilblain (pernio), erythema multiforme, pityriasis rosea or a combination of different skin lesions, etc. may also be seen1,19,26. The skin sign and symptoms may develop from three days before to 13 days after the diagnosis of COVID-19. Interestingly, in 12.5% of cases, the skin lesions developed before the pulmonary symptoms. The majority of the skin lesions (69.4%) were observed on the trunk, but in 19.4% of cases, skin lesions were found on the limbs19.