Chilblains in immune-mediated inflammatory diseases: a review.
Dubey, Shirish Joshi, Nilay Stevenson, Olivia
Dubey, Shirish
Joshi, Nilay
Stevenson, Olivia
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Oxford University Hospitals NHS Foundation Trust; University of Oxford; Kettering General Hospital NHS Foundation Trust; Sandwell and West Birmingham NHS Trust; et al.
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Publication date
2022-11-28
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Abstract
Chilblains were first described over a hundred years ago as cutaneous inflammatory lesions, typically on the digits, occurring on cold exposure. Chilblains can be primary, or secondary to a number of conditions such as infections, including COVID-19, and immune-mediated inflammatory disorders (IMIDs) with SLE being the commonest. Chilblain lupus erythematosus (CHLE) was first described in 1888 as cold-induced erythematous lesions before the terms 'chilblains' or 'perniosis' were coined. Diagnostic criteria exist for both chilblains and CHLE. Histopathologically, CHLE lesions show interface dermatitis with perivascular lymphocytic infiltrate. Immunofluorescence demonstrates linear deposits of immunoglobulins and complement in the dermo-epidermal junction. This narrative review focuses on chilblains secondary to immune-mediated inflammatory disorders, primarily the epidemiology, pathogenesis and treatment of CHLE.
Citation
Dubey S, Joshi N, Stevenson O, Gordon C, Reynolds JA. Chilblains in immune-mediated inflammatory diseases: a review. Rheumatology (Oxford). 2022 Nov 28;61(12):4631-4642. doi: 10.1093/rheumatology/keac231.
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Article