{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:35:23Z","timestamp":1790721323200,"version":"4.1.0"},"reference-count":44,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T00:00:00Z","timestamp":1668124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>Background: Chilblains\/perniosis is a non-freezing cold injury causing painful inflammatory skin lesions. Its pathogenesis remains poorly understood because it is often studied as secondary to other underlying conditions. Methods: We systematically investigated the population characteristics, symptoms, and predisposing factors of chilblains in healthy adults exposed to cool\/cold environments. We screened PubMed, Embase, and Cochrane Library, and we adopted PRISMA reporting guidelines (PROSPERO: CRD42021245307). The risk of bias was assessed by two independent reviewers (RTI item bank). Random-effects model meta-analyses were performed to calculate the pooled prevalence of histopathological features. Mixed-effects meta-regressions were used to assess other sources of between-study heterogeneity. Results: Thirteen studies (477 patients) were included. Chilblains affect more women than men, up to 12% of the body skin surface, and most frequently, the hands and fingers. Meta-analyses of nine studies (303 patients) showed a frequent presence of perivascular lymphocytic infiltrate (81%), basal epidermal-cell layer vacuolation (67%), papillary dermal edema (66%), and perieccrine lymphocytic infiltrate (57%). Meta-regressions (p \u2264 0.05) showed that smoking and frequent occupational exposure to water increase the likelihood of histopathological features. Conclusions: The population characteristics, symptoms, and predisposing factors of chilblains revealed in this analysis should be incorporated in medical care to improve the condition\u2019s diagnosis and management.<\/jats:p>","DOI":"10.3390\/biology11111651","type":"journal-article","created":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T02:32:01Z","timestamp":1668393121000},"page":"1651","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Population Characteristics, Symptoms, and Risk Factors of Idiopathic Chilblains: A Systematic Review, Meta-Analysis, and Meta-Regression"],"prefix":"10.3390","volume":"11","author":[{"given":"Areti K.","family":"Kapnia","sequence":"first","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1004-8134","authenticated-orcid":false,"given":"Styliani","family":"Ziaka","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5460-8167","authenticated-orcid":false,"given":"Leonidas G.","family":"Ioannou","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irini","family":"Flouri","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Clinical Immunology and Allergy, University of Crete Medical School, 71500 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6853-9238","authenticated-orcid":false,"given":"Petros C.","family":"Dinas","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9823-3915","authenticated-orcid":false,"given":"Andreas D.","family":"Flouris","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1136\/bmj.2.4224.869","article-title":"Observations on Some Normal and Injurious Effects of Cold upon the Skin and Underlying Tissues: III. 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