{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T16:13:52Z","timestamp":1761495232587,"version":"build-2065373602"},"reference-count":30,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinical Immunology"],"published-print":{"date-parts":[[2022,4]]},"DOI":"10.1016\/j.clim.2022.108984","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T19:51:08Z","timestamp":1648065068000},"page":"108984","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Pandemic chilblains: Are they SARS-CoV-2-related or not?"],"prefix":"10.1016","volume":"237","author":[{"given":"Axel","family":"De Greef","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre G.","family":"Coulie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Baeck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.clim.2022.108984_bb0005","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.jdin.2020.12.003","article-title":"Skin manifestations of COVID-19: A worldwide review","volume":"2","author":"Tan","year":"2021","journal-title":"JAAD Int."},{"issue":"3","key":"10.1016\/j.clim.2022.108984_bb0010","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/j.jaad.2020.05.145","article-title":"Chilblain-like acral lesions during the COVID-19 pandemic (\u201cCOVID toes\u201d): histologic, immunofluorescence, and immunohistochemical study of 17 cases","volume":"83","author":"Kanitakis","year":"2020","journal-title":"J. Am. Acad. Dermatol."},{"issue":"6","key":"10.1016\/j.clim.2022.108984_bb0015","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1111\/bjd.20707","article-title":"Type I interferon response and vascular alteration in chilblain-like lesions during the COVID-19 outbreak","volume":"185","author":"Frumholtz","year":"2021","journal-title":"Br. J. Dermatol."},{"issue":"9","key":"10.1016\/j.clim.2022.108984_bb0020","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1001\/jamadermatol.2020.2368","article-title":"Evaluation of chilblains as a manifestation of the COVID-19 pandemic","volume":"156","author":"Herman","year":"2020","journal-title":"JAMA Dermatol."},{"issue":"9","key":"10.1016\/j.clim.2022.108984_bb0025","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1001\/jamadermatol.2020.2340","article-title":"Assessment of acute Acral lesions in a case series of children and adolescents during the COVID-19 pandemic","volume":"156","author":"Roca-Gin\u00e9s","year":"2020","journal-title":"JAMA Dermatol."},{"issue":"11","key":"10.1016\/j.clim.2022.108984_bb0030","doi-asserted-by":"crossref","first-page":"2630","DOI":"10.1111\/jdv.16751","article-title":"Major cluster of paediatric \u2018true\u2019 primary chilblains during the COVID-19 pandemic: a consequence of lifestyle changes due to lockdown","volume":"34","author":"Neri","year":"2020","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"issue":"11","key":"10.1016\/j.clim.2022.108984_bb0035","doi-asserted-by":"crossref","first-page":"e689","DOI":"10.1111\/jdv.16776","article-title":"Recent outbreak of chilblain-like lesions is not directly related to SARS-CoV-2 infection","volume":"34","author":"Rouanet","year":"2020","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"issue":"6","key":"10.1016\/j.clim.2022.108984_bb0040","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.11369","article-title":"Bilateral chilblain-like lesions of the toes characterized by microvascular remodeling in adolescents during the COVID-19 pandemic","volume":"4","author":"Discepolo","year":"2021","journal-title":"JAMA Netw. Open"},{"issue":"0","key":"10.1016\/j.clim.2022.108984_bb0045","article-title":"Clinical and coagulation characteristics of 7 patients With critical COVID-2019 pneumonia and acro-ischemia","volume":"41","author":"Zhang","year":"2020"},{"key":"10.1016\/j.clim.2022.108984_bb0050","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.trsl.2020.04.007","article-title":"Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases","volume":"220","author":"Magro","year":"2020","journal-title":"Transl. Res."},{"issue":"2","key":"10.1016\/j.clim.2022.108984_bb0055","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1056\/NEJMoa2015432","article-title":"Pulmonary vascular Endothelialitis, thrombosis, and angiogenesis in Covid-19","volume":"383","author":"Ackermann","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"10.1016\/j.clim.2022.108984_bb0060","article-title":"Characterization of acute Acro-ischemic lesions in non-hospitalized patients: a case series of 132 patients during the COVID-19 outbreak","author":"Fernandez-Nieto","year":"2020","journal-title":"J. Am. Acad. Dermatol."},{"issue":"8","key":"10.1016\/j.clim.2022.108984_bb0065","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1001\/jamadermatol.2021.2120","article-title":"Epidemiologic analysis of chilblains cohorts before and during the COVID-19 pandemic","volume":"157","author":"McCleskey","year":"2021","journal-title":"JAMA Dermatol."},{"issue":"2","key":"10.1016\/j.clim.2022.108984_bb0070","doi-asserted-by":"crossref","first-page":"e100","DOI":"10.1111\/jdv.16974","article-title":"Why are chilblains underreported in Nordic countries during the COVID-19 pandemic? An analysis of Google trends","volume":"35","author":"Kluger","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"issue":"12","key":"10.1016\/j.clim.2022.108984_bb0075","doi-asserted-by":"crossref","first-page":"e444","DOI":"10.1111\/1346-8138.15567","article-title":"Skin manifestations in COVID-19: the tropics experience","volume":"47","author":"Rerknimitr","year":"2020","journal-title":"J. Dermatol."},{"issue":"2","key":"10.1016\/j.clim.2022.108984_bb0080","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/j.jaad.2020.05.109","article-title":"Pernio-like skin lesions associated with COVID-19: A case series of 318 patients from 8 countries","volume":"83","author":"Freeman","year":"2020","journal-title":"J. Am. Acad. Dermatol."},{"issue":"5","key":"10.1016\/j.clim.2022.108984_bb0085","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1111\/bjd.19377","article-title":"Most chilblains observed during the COVID-19 outbreak occur in patients who are negative for COVID-19 on polymerase chain reaction and serology testing","volume":"183","author":"Le Cleach","year":"2020","journal-title":"Br. J. Dermatol."},{"issue":"1","key":"10.1016\/j.clim.2022.108984_bb0090","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1111\/jdv.17672","article-title":"Are the chilblain-like lesions observed during the COVID-19 pandemic due to severe acute respiratory syndrome coronavirus 2? Systematic review and meta-analysis","volume":"36","author":"S\u00e1nchez-Garc\u00eda","year":"2022","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"issue":"11","key":"10.1016\/j.clim.2022.108984_bb0095","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1111\/cup.13830","article-title":"Perniosis during the COVID-19 pandemic: negative anti-SARS-CoV-2 immunohistochemistry in six patients and comparison to perniosis before the emergence of SARS-CoV-2","volume":"47","author":"Ko","year":"2020","journal-title":"J. Cutan. Pathol."},{"issue":"4","key":"10.1016\/j.clim.2022.108984_bb0100","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1111\/bjd.19327","article-title":"SARS-CoV-2 endothelial infection causes COVID-19 chilblains: histopathological, immunohistochemical and ultrastructural study of seven paediatric cases","volume":"183","author":"Colmenero","year":"2020","journal-title":"Br. J. Dermatol."},{"issue":"4","key":"10.1016\/j.clim.2022.108984_bb0105","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1111\/bjd.19338","article-title":"COVID-19 chilblain-like lesion: immunohistochemical demonstration of SARS-CoV-2 spike protein in blood vessel endothelium and sweat gland epithelium in a polymerase chain reaction-negative patient","volume":"183","author":"Santonja","year":"2020","journal-title":"Br. J. Dermatol."},{"issue":"4","key":"10.1016\/j.clim.2022.108984_bb0110","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1016\/j.jaad.2020.06.1018","article-title":"New insights in COVID-19-associated chilblains: A comparative study with chilblain lupus erythematosus","volume":"83","author":"Battesti","year":"2020","journal-title":"J. Am. Acad. Dermatol."},{"key":"10.1016\/j.clim.2022.108984_bb0115","article-title":"Chilblains observed during the COVID-19 pandemic cannot be distinguished from the classic, cold-related chilblains","author":"De Greef","year":"2022","journal-title":"Accepted for publication in Eur. J. Dermatol."},{"issue":"1","key":"10.1016\/j.clim.2022.108984_bb0120","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1111\/pde.14903","article-title":"RNAscope in situ hybridization and RT-PCR for detection of SARS-CoV-2 in chilblain-like lesions: A clinical, laboratory and histopathological study","volume":"39","author":"Robustelli Test","year":"2022","journal-title":"Pediatr. Dermatol."},{"key":"10.1016\/j.clim.2022.108984_bb0125","doi-asserted-by":"crossref","first-page":"109959","DOI":"10.1016\/j.mehy.2020.109959","article-title":"A chilblain epidemic during the COVID-19 pandemic. A sign of natural resistance to SARS-CoV-2?","volume":"144","author":"Lipsker","year":"2020","journal-title":"Med. Hypotheses"},{"issue":"6515","key":"10.1016\/j.clim.2022.108984_bb0130","doi-asserted-by":"crossref","DOI":"10.1126\/science.abd4585","article-title":"Autoantibodies against type I IFNs in patients with life-threatening COVID-19","volume":"370","author":"Bastard","year":"2020","journal-title":"Science."},{"issue":"6515","key":"10.1016\/j.clim.2022.108984_bb0135","doi-asserted-by":"crossref","DOI":"10.1126\/science.abd4570","article-title":"Inborn errors of type I IFN immunity in patients with life-threatening COVID-19","volume":"370","author":"Zhang","year":"2020","journal-title":"Science."},{"issue":"12","key":"10.1016\/j.clim.2022.108984_bb0140","doi-asserted-by":"crossref","first-page":"2527","DOI":"10.1084\/jem.20161596","article-title":"Type I interferon-mediated monogenic autoinflammation: the type I interferonopathies, a conceptual overview","volume":"213","author":"Rodero","year":"2016","journal-title":"J. Exp. Med."},{"issue":"5","key":"10.1016\/j.clim.2022.108984_bb0145","doi-asserted-by":"crossref","first-page":"590","DOI":"10.23736\/S0392-0488.20.06709-7","article-title":"Monogenetic causes of chilblains, panniculitis and vasculopathy: the type I interferonopathies","volume":"155","author":"Papa","year":"2020","journal-title":"G. Ital. Dermatol. Venereol."},{"issue":"2","key":"10.1016\/j.clim.2022.108984_bb0150","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1001\/jamadermatol.2020.4324","article-title":"Clinical, laboratory, and interferon-alpha response characteristics of patients with chilblain-like lesions during the COVID-19 pandemic","volume":"157","author":"Hubiche","year":"2021","journal-title":"JAMA Dermatol."}],"container-title":["Clinical Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1521661622000651?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1521661622000651?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T16:05:59Z","timestamp":1761494759000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1521661622000651"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":30,"alternative-id":["S1521661622000651"],"URL":"https:\/\/doi.org\/10.1016\/j.clim.2022.108984","relation":{},"ISSN":["1521-6616"],"issn-type":[{"type":"print","value":"1521-6616"}],"subject":[],"published":{"date-parts":[[2022,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Pandemic chilblains: Are they SARS-CoV-2-related or not?","name":"articletitle","label":"Article Title"},{"value":"Clinical Immunology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.clim.2022.108984","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 The Author(s). Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"108984"}}