{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T20:13:13Z","timestamp":1776024793653,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T00:00:00Z","timestamp":1593734400000},"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":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Over the last months, during the COVID\u201019 pandemic, a growing number of chilblain\u2010like lesions were reported mainly in children and rarely in young adults. The relationship with SARS\u2010CoV\u20102 infection was postulated, often without any laboratory, instrumental or clinical confirmation. The disclosure of information about chilblain\u2010like lesions as a COVID\u201019 manifestation in social media has created concern in children\u2019s families and paediatricians.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To verify whether the chilblain\u2010like lesions were caused by SARS\u2010CoV\u20102 infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective study on a case series including children who presented with acral lesions at the Pediatric Dermatology Outpatient and Pediatric Emergency Unit of the University of Bologna, from 1 April to 30 April 2020. We reported demographical, laboratory and clinical features, history of close contact with COVID\u201019 patients, presence of similar skin lesions in other family members, precipitating and risk factors for chilblain onset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We evaluated eight patients (five females, three males) aged between 11 and 15\u00a0years. We excluded acute or previous SARS\u2010CoV\u20102 infection with RT\u2010PCR nasopharyngeal swab, serum antibody levels using chemiluminescent immunoassays. Other acute infections causing purpuric lesions at the extremities were negative in all patients. Skin lesion biopsy for histological and immunohistochemical evaluation was made in two cases and was consistent with chilblain. PCR assay on skin lesion biopsy for parvovirus B19, Mycoplasma pneumoniae and SARS\u2010CoV\u20102 was performed in a patient and resulted negative. We identified common precipitating and risk factors: physical (cold and wet extremities, low BMI), cold and wet indoor and outdoor environment, behaviours, habits and lifestyle. We therefore reached a diagnosis of primary chilblains.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>During the COVID\u201019 pandemic, a \u2018cluster\u2019 of primary chilblains developed in predisposed subjects, mainly teenagers, due to cold exposure in the lockdown period. Laboratory findings support our hypothesis, although it is also possible that an unknown infectious trigger may have contributed to the pathogenesis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.16751","type":"journal-article","created":{"date-parts":[[2020,6,13]],"date-time":"2020-06-13T20:25:36Z","timestamp":1592079936000},"page":"2630-2635","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Major cluster of paediatric \u2018true\u2019 primary chilblains during the COVID\u201019 pandemic: a consequence of lifestyle changes due to lockdown"],"prefix":"10.1111","volume":"34","author":[{"given":"I.","family":"Neri","sequence":"first","affiliation":[{"name":"Division of Dermatology Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna 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