Table 2.
Comparison of the characteristics of patients presenting with Chilblain-like. lesions and other types of skin lesions.
| Patient characteristics | Chilblain-Like (n = 17) | Others (n = 41) | p Value |
|---|---|---|---|
| Female sex, n (%) | 7 (41%) | 20 (49%) | 0.773 |
| Median age, years (IQR) | 29 (24, 47) | 63 (50, 74) | <0.001 |
| Immunosuppression, n (%) | 1 (6%) | 3 (7%) | 1.000 |
| Hypertension, n (%) | 0 | 12 (29%) | 0.012 |
| ACE-i and ARBs use | 0 | 6 (15%) | 0.166 |
| COVID-19 diagnosis, n (%) | 0.003 | ||
| Confirmed | 7 (41.2%) | 34 (82.9%) | |
| Highly suspected | 10 (58.8%) | 7 (17.1%) | |
| COVID-19 symptoms other than cutaneous, n (%) | |||
| Fever | 4 (23%) | 35 (85%) | <0.001 |
| Cough | 6 (35%) | 26 (63%) | 0.050 |
| Dyspnea | 1 (6%) | 23 (56%) | <0.001 |
| Asthenia | 1 (6%) | 15 (37%) | 0.023 |
| Myalgias | 1 (6%) | 14 (34%) | 0.045 |
| Diarrhea | 1 (6%) | 12 (29%) | 0.082 |
| Ageusia | 2 (12%) | 8 (19%) | 0.707 |
| Anosmia | 2 (12%) | 5 (12%) | 1.000 |
| Headache | 0 | 4 (10%) | 0.310 |
| Vomit | 0 | 3 (7%) | 0.548 |
| Chest X-ray performed, n (%) | 5 (29%) | 39 (95%) | <0.0010.060 |
| Normal | 3 (60%) | 4 (10%) | |
| Unilateral interstitial infiltrates | 0 | 2 (5%) | |
| Bilateral interstitial infiltrates | 2 (40%) | 31 (79%) | |
| Other | 0 | 2 (5%) | |
| COVID-19 related parameters | |||
| C-Reactive protein, median mg/dL (IQR) | 0.4 (0.4, 0.4) | 5.9 (3.0, 14.9) | 0.011 |
| Lymphocytes, median cells ^106/L (IQR) | 1800 (1200, 2000) | 800 (600, 1200) | <0.001 |
| Ferritin, median ng/mL (IQR) | 87.5 (40, 197.2) | 615 (232.5, 905.2) | 0.013 |
| LDH, median U/L (IQR) | 177 (164.2, 190.8) | 299 (243.0, 415.0) | 0.120 |
| D-dimer, median ng/mL (IQR) | 200 (200, 300) | 800 (500, 2000) | 0.297 |
| ESR, median mm/h (IQR) | 5 (4, 7) | 38.0 (29, 61.8) | <0.001 |
| Autoimmunity test performed, n (%) | |||
| Anti-nuclear antibodies | 15 (88.2) | 22 (53.6) | |
| Positive | 3 (20%) | 1 (4%) | 0.283 |
| Anti-Ro antibodies | 12 (70%) | 20 (49%) | |
| Positive | 0 | 0 | NC |
| Antibeta-2-glycoprotein antibodies, IgM | 15 (88.23) | 24 (58.53) | |
| Positive | 0 | 0 | NC |
| Antibeta-2-glycoprotein antibodies, IgG | 15 (88.2) | 24 (58.5) | |
| Positive | 1 (7%) | 2 (8%) | 1.000 |
| Anticardiolipin antibodies, IgM | 15 (88.2) | 24 (58.5) | |
| Positive | 0 | 0 | NC |
| Anticardiolipin antibodies, IgG | 15 (88.2) | 24 (58.5) | |
| Positive | 2 (13%) | 2 (8%) | 0.631 |
| Skin biopsy performed, n (%) | 12 (77%) | 30 (73%) | 1.000 |
| Histological pattern according to HE stains | 0.003 | ||
| Chilblain-like pattern | 10 (83%) | 0 | |
| Spongiotic dermatitis | 0 | 8 (27%) | |
| Interface + spongiotic dermatitis | 0 | 6 (20%) | |
| Grover´s disease pattern | 0 | 3 (10%) | |
| Urticariform | 0 | 2 (7%) | |
| Interface dermatitis | 0 | 2 (7%) | |
| Pityrosporum folliculitis | 0 | 2 (7%) | |
| Subcorneal pustulosis | 0 | 2 (%) | |
| Psoriasiform | 1 (8%) | 0 | |
| Thrombotic microangiopathy | 1 (8%) | 1 (3%) | |
| Other | 0 | 4 (13%) | |
| Mucin deposits | 9 (75%) | 1 (3%) | <0.001 |
| Epidermal atrophy | 3 (25%) | 2 (7%) | 0.131 |
| DIF performed, n (%) | 11 (65%) | 19 (46%) | 0.024 |
| Lichenoid | 0 | 2 (10.5%) | |
| Lichenoid + vasculopathic | 3 (27%) | 0 | |
| Negative | 4 (36%) | 14 (74%) | |
| Vasculopathic | 4 (36%) | 3 (15.8%) | <0.001 |
| IHQ Anti-C9 deposits in dermal vessels performed, n (%) | 11 (64.7) | 22 (53.5) | |
| Positive | 10 (91%) | 5 (23%) | <0.001 |
| Treatment | |||
| Hydroxychloroquine | 1 (6%) | 35 (85%) | <0.001 |
| Azithromycin | 0 | 34 (83%) | <0.001 |
| Lopinavir/ritonavir | 1 (6%) | 29 (71%) | <0.001 |
| Systemic corticosteroids | 1 (6%) | 24 (58%) | <0.001 |
| Tocilizumab | 1 (6%) | 14 (34%) | 0.045 |
| Remdesivir | 0 | 5 (12%) | 0.308 |
| Anakinra | 0 | 5 (12%) | 0.308 |
| Siltuximab | 0 | 2 (5%) | 1.000 |
| Hospitalization required | 2 (12%) | 36 (88%) | <0.001 |
| ICU required | 1 (6%) | 18 (44%) | 0.005 |
| Mortality | 0 | 2 (5%) | 1.000 |
ACEi: angiotensin-converting enzyme inhibitors; ARBs: Angiotensin II receptor antagonists; ESR: erythrocyte sedimentation rate; H/E: hematoxylin-eosin; DIF: Direct immunofluorescence; IHQ: immunohistochemistry; ICU: intensive care unit; NC: Not calculable.