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During SARS-CoV-2 pandemic, an outbreak of chilblain-like lesions has been developed, even if the relationship with the virus infection is still debated. We report the good results obtained in 12 patients with chilblain lesions and the use of oral cinnarizine, a piperazine derivative with many pharmacological properties among whom antihistaminic and calcium channel blocking activities.

We recently came across a 64-year-old woman who developed pruritic papules on both hands previously affected by vitiligo since 30 years earlier. The lesion firstly appeared 5 days after the first dose of BNT162b2 mRNA COVID-19 Vaccine, then faded away, thus recurring 24 hours soon after the second dose with a more extensive and symptomatic eruption. The patient noticed and referred a worsening of skin condition after sun exposure.

During the second wave of infection, we came across an otherwise healthy 12-year-old girl with a 3-week history of erythematous-edematous and ulcerated lesions of the toes (Figure 1), compatible with the diagnosis of CLL. Similar lesions already appeared during the first wave of March-April 2020 and resolved spontaneously in 3 months. Apart from CLL, the patient contemporarily developed a classical mildly itchy pityriasis rosea (PR) on the trunk (Figure 2), that was the major reason of complaint in this occasion.

SARS-CoV-2 infection has spread all over the world in the last year, causing millions of COVID-19 cases among humans with a large variability of symptoms and signs, including those on the skin. Among these, a contemporary cluster of chilblain-like lesions with no certain relationship with the infection has been reported. The aim of this paper is to delineate a profile of chilblain-like lesions and to establish the state-of-the-art knowledge about this new phenomenon.