Population Characteristics, Symptoms, and Risk Factors of Idiopathic Chilblains: A Systematic Review, Meta-Analysis, and Meta-Regression

Overview

Journal Biology (Basel)

Publisher MDPI

Specialty Biology

Date 2022 Nov 24

PMID 36421364

Authors

Areti K Kapnia

Styliani Ziaka

Leonidas G Ioannou

Irini Flouri

Petros C Dinas

Andreas D Flouris

Affiliations

Soon will be listed here.

Abstract

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 ( ≤ 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's diagnosis and management.

Citing Articles

Population Characteristics, Symptoms, and Risk Factors of Idiopathic Chilblains: A Systematic Review, Meta-Analysis, and Meta-Regression.

Kapnia A, Ziaka S, Ioannou L, Flouri I, Dinas P, Flouris A Biology (Basel). 2022; 11(11).

PMID: 36421364 PMC: 9687160. DOI: 10.3390/biology11111651.

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