{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:49:28Z","timestamp":1790225368222,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,10,17]],"date-time":"2020-10-17T00:00:00Z","timestamp":1602892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Many cutaneous manifestations have been described in possible association with the COVID\u201019 pandemic, including acral lesions resembling chilblains. The underlying pathomechanisms of COVID\u201019 chilblains are not fully understood. The aim of this study was to describe the clinical, pathological, and laboratory findings of a series of patients who developed chilblains during the COVID\u201019 outbreak and to investigate the possible factors that could be involved in the pathogenesis of these lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a prospective cohort study that included 54 patients who presented with chilblains during the highest peak in the incidence of COVID\u201019 in Cantabria (northern Spain). Skin biopsies were performed on 10 of these patients who presented with recent lesions. Laboratory investigations, including immunological analysis, serological studies, and the assessment of cryoproteins, were also performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most patients presented erythematous plaques located on the toes and\/or purpuric macules located on the feet. Histopathological findings were compatible with those of idiopathic chilblains. Immunohistochemical evaluation showed C3d and C4d deposits in the vessel walls in seven cases. The autoimmunity panel was negative in most of our series. Cryoprotein testing showed positive cryofibrinogen in two\u2010thirds (66.7%) of the patients assessed. On follow\u2010up, most patients presented almost complete resolution, although six patients required prednisone and antiaggregant drug treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study shows, for the first time to our knowledge, a high prevalence of cryofibrinogenemia in patients with chilblains during the COVID\u201019 pandemic. Cryofibrinogenemia could be implicated in the pathogenesis of chilblains related to COVID\u201019.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.15234","type":"journal-article","created":{"date-parts":[[2020,10,18]],"date-time":"2020-10-18T05:24:21Z","timestamp":1602998661000},"page":"1475-1484","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["High prevalence of cryofibrinogenemia in patients with chilblains during the COVID\u201019 outbreak"],"prefix":"10.1111","volume":"59","author":[{"given":"Cristina","family":"G\u00f3mez\u2010Fern\u00e1ndez","sequence":"first","affiliation":[{"name":"Division of Dermatology Hospital Universitario Marqu\u00e9s de Valdecilla University of Cantabria IDIVAL Santander Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana E.","family":"L\u00f3pez\u2010Sundh","sequence":"additional","affiliation":[{"name":"Division of Dermatology Hospital Universitario Marqu\u00e9s 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