A Review of COVID-19 Chilblains-like Lesions and Their Differential Diagnoses

Adv Skin Wound Care. 2021 Jul 1;34(7):348-354. doi: 10.1097/01.ASW.0000752692.72055.74.

Abstract

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.

Target audience: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

Learning objectives/outcomes: After participating in this educational activity, the participant will:1. Identify the population most often affected by COVID toes.2. Select the assessments that help differentiate the various conditions that cause chilblains-like lesions.3. Choose appropriate treatment options for the various conditions that cause chilblains-like lesions.

Plain language summary

This review article focuses on the pathogenesis, clinical features, and diagnostic testing of the common pathologies that can manifest as chilblains-like lesions. These differentials include “COVID toes,” Raynaud phenomenon, acrocyanosis, critical limb ischemia, thromboangiitis obliterans, chilblains associated with lupus erythematosus, and idiopathic chilblains. The authors present a helpful mnemonic, ARCTIC, to assist clinicians in recognition and diagnosis.

Publication types

  • Review

MeSH terms

  • COVID-19 / complications
  • COVID-19 / diagnosis*
  • Chilblains / diagnosis*
  • Chilblains / pathology
  • Chilblains / virology
  • Diagnosis, Differential
  • Fingers / pathology
  • Humans
  • Skin Diseases / diagnosis*
  • Skin Diseases / pathology
  • Skin Diseases / virology
  • Symptom Assessment
  • Toes / pathology