key: cord-0723222-w4pqzbcr authors: Joob, Beuy; Wiwanitkit, Viroj title: Chilblains‐like lesions and COVID‐19 date: 2020-05-26 journal: Pediatr Dermatol DOI: 10.1111/pde.14238 sha: 9ddb22c986bda28a4d5e9609d9bd0e2c77455307 doc_id: 723222 cord_uid: w4pqzbcr The publication entitled “Chilblains‐like lesions in children following suspected Covid‐19 infection” is very interesting [1]. Colonna et al. reported four children with suspected COVID‐19 cases with “[h]istology from one case showed signs of vasculitis with evident fibrin thrombus [1].” While various skin findings have been reported with COVID‐19 infection, the chilblains lesions have been reported from Italy and Spain, and sporadically from China, the starting point of disease pandemic [2‐5]. This article is protected by copyright. All rights reserved Dear Editor, The publication entitled "Chilblains-like lesions in children following suspected Covid-19 infection" is very interesting [1] . Colonna et al. reported four children with suspected COVID-19 cases with "[h]istology from one case showed signs of vasculitis with evident fibrin thrombus [1] ." While various skin findings have been reported with COVID-19 infection, the chilblains lesions have been reported from Italy and Spain, and sporadically from China, the starting point of disease pandemic [2] [3] [4] [5] . However, it should be noted that chilblains-like lesions have not been reported from endemic areas in tropical areas (such as Southeast Asia and South America). For example, in our country, Thailand, we have not seen any patients presenting with this skin finding despite having over 3,000 cases reported as of 11 th May 2020. The rarity of chilblains-like lesions in tropical countries suggests the importance of weather, particularly cold exposure, as a possible co-factor for this vasculopathy noted in associated with in COVID-19 infection. Pathophysiologically, chilblains can result from an excessive abnormal vascular response to cold that leads to cutaneous inflammation. None Chilblains-like lesions in children following suspected Covid-19 infection COVID-19 can present with a rash and be mistaken for dengue Various forms of skin rash in COVID-19: a reply Accepted Article This article is protected by copyright. All rights reserved Clinical and coagulation characteristics of 7 patients with critical COVID-2019 pneumonia and acro-ischemia. Zhonghua Xue Ye Xue Za Zhi Characterization of acute acro-ischemic lesions in non-hospitalized patients: a case series of 132 patients during the COVID-19 outbreak