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Going viral: A brief history of Chilblain-like skin lesions ("COVID toes") amidst
the COVID-19 pandemic
#MMPMID32736881
Massey PR
; Jones KM
Semin Oncol
2020[Oct]; 47
(5
): 330-334
PMID32736881
show ga
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of the
COVID-19 global pandemic, is notable for an expanding list of atypical
manifestations including but not limited to coagulopathies, renal dysfunction,
cardiac injury and a multisystem inflammatory syndrome in children. In addition,
SARS-CoV-2 has been purportedly linked to multiple cutaneous manifestations,
among them chilblain-like skin lesions, also known as "COVID toes." Driven in
large part by social media, dermatologists around the world reported a dramatic
increase in the frequency of chilblain-like diagnoses early in the COVID-19
pandemic, often in members of the same family. This phenomenon has been captured
in a rapidly expanding medical literature. As of this writing, the chilblain-like
presentation has been reported to occur predominantly in younger, minimally
symptomatic patients and to emerge late in the COVID-19 disease course. Evidence
of SARS-CoV-2 infection is not consistently found when these patients are
evaluated by polymerase chain reaction. A robust antiviral immune response in
young patients that induces microangiopathic changes has been posited as a
mechanism. Herein we review the rapid evolution of the literature regarding
chilblain-like skin lesions early in the COVID-19 global pandemic.
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