Approach to Chilblains During the COVID-19 Pandemic [Formula: see text]

J Cutan Med Surg. 2020 Sep/Oct;24(5):504-517. doi: 10.1177/1203475420937978. Epub 2020 Aug 3.


Coronavirus disease (COVID-19) chilblains is a well-reported cutaneous pattern of severe acute respiratory syndrome coronavirus (SARS-CoV-2). Through this narrative review, we provide an evidence-based overview of idiopathic and secondary chilblains, distinguishing features of COVID-19 chilblains, and a systematic clinical approach to history, examination, investigations, and treatment. In the absence of cold or damp exposure, COVID-19 should be considered as a cause of acute chilblains. The timing of onset of COVID-19 chilblains relative to active SARS-CoV-2 viremia remains unclear. Patients with suspected COVID-19 chilblains should thus follow public health guidelines for COVID-19 testing and self-isolation.

Keywords: SARS-CoV-2; chilblains; coronavirus; pernio; perniosis; severe acute respiratory syndrome coronavirus 2; toes.

Publication types

  • Review

MeSH terms

  • Betacoronavirus*
  • COVID-19
  • COVID-19 Testing
  • Chilblains / diagnosis*
  • Chilblains / etiology
  • Clinical Laboratory Techniques / methods*
  • Coronavirus Infections / complications*
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology
  • Humans
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology
  • SARS-CoV-2