Search Our Scientific Publications & Authors

JAMA Netw Open 2021 06 1;4(6):e2111676. Epub 2021 Jun 1.

Department of Dermatology, University of California, Davis.

CMAJ Open 2021 Apr-Jun;9(2):E585-E591. Epub 2021 May 21.

Whitehorse General Hospital (Poole), Whitehorse, Yukon; Department of Surgery (Poole), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Whitehorse General Hospital (Gauthier), Yukon Hospital Corporation, Whitehorse, Yukon; University of Saskatchewan (Gauthier), Saskatoon, Sask.; Department of Surgery (MacLennan), McMaster University, Hamilton, Ont.; Harvard T.H. Chan School of Public Health (MacLennan), Boston, Mass.

Background: We identified the need to modernize frostbite management in our northern centre and implemented a treatment protocol in 2015. Our aim was to describe the clinical course of patients presenting to the hospital since the implementation of the protocol.

Methods: This was a retrospective case series from Whitehorse General Hospital, Whitehorse, Yukon Territory, Canada. Read More

J Burn Care Res 2021 May 16. Epub 2021 May 16.

Department of Surgery, Hennepin Healthcare, Minneapolis, MN.

Background: Frostbite is a high morbidity, high-cost injury that can lead to digit or limb necrosis requiring amputation. Our primary aim is to describe the rate of readmission following frostbite injury. Our secondary aims are to describe the overall burden of care, cost, and characteristics of repeat hospitalizations of frostbite-injured people. Read More

Clin Dermatol 2021 Jan-Feb;39(1):84-91. Epub 2021 Jan 14.

Department of Dermatology, Icahn School of Medicine at Mt Sinai, New York, New York; Department of Pediatrics, Icahn School of Medicine at Mt Sinai, New York, New York. Electronic address:

The emergence of the coronavirus disease 2019 (COVID-19) worldwide pandemic has been associated with a new constellation of cutaneous features in children. Among the unusual dermatologic presentations are the so-called COVID toes, inflammatory nodules of the feet and toes, sometimes involving the hands and fingers. These lesions mimic acral pernio, the synonym being chilblains. Read More

Clin Dermatol 2021 Jan-Feb;39(1):149-162. Epub 2020 Dec 14.

Unit of Dermatology, Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Skin is one of target organs affected by the novel coronavirus SARS-CoV-2, and in response to the current COVID-19 pandemic, a fast body of literature has emerged on related cutaneous manifestations. Current perspective is that the skin is not only a bystander of the general cytokines storm with thrombophilic multiorgan injury, but it is directly affected by the epithelial tropism of the virus, as confirmed by the detection of SARS-CoV-2 in endothelial cells and epithelial cells of epidermis and eccrine glands. In contrast with the abundance of epidemiologic and clinical reports, histopathologic characterization of skin manifestations is limited. Read More

Clin Dermatol 2021 Jan-Feb;39(1):12-22. Epub 2020 Dec 17.

Dermatology Unit, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy.

A wide range of cutaneous signs are attributed to COVID-19 infection. This retrospective study assesses the presence and impact of dermatologic manifestations related to the spread of COVID-19 in Lombardy, the geographic district with the first outbreak in Italy. A cohort of 345 patients with laboratory confirmed COVID-19 was collected from February 1, 2020 to May 31, 2020. Read More

Cutis 2021 Mar;107(3):139-142

Ms. Clawson is from Eastern Virginia Medical School, Norfolk. Dr. Tabata is from the Department of Internal Medicine, Massachusetts General Hospital, Boston. Dr. Ko is from the Department of Dermatology, Stanford University, California.

During the coronavirus disease 2019 (COVID-19) pandemic, there has been a rise in the diagnosis of acral lesions, including chilblains-like lesions, ischemia, and retiform purpura. Understanding the differences in presentation and severity of illness between children and adult patients is important for physicians to understand risk stratification and management of these lesions. We reviewed the literature on the acral lesions seen in children and adults with COVID-19 infection to offer guidelines for diagnosis and treatment. Read More

OTA Int 2020 Jun 22;3(2):e079. Epub 2020 May 22.

Department of Orthpaedic Surgery, MetroHealth Medical Center, Cleveland, OH.

Background: Tissue plasminogen activator (tPA) is a thrombolytic agent increasingly being employed for the treatment of acute frostbite. Although tPA has been shown with success to increase digit salvage rates, data on potential complications, including risk of hemorrhage, is limited. As a result, acute trauma is considered a contraindication to use in many institution-based protocols. Read More

Cutis 2021 Feb;107(2):90-94

Ms. Schwartzberg is from the New York Institute of Technology College of Osteopathic Medicine, Old Westbury. Dr. Lin is from the Department of Dermatology, St. John's Episcopal Hospital, Far Rockaway, New York. Dr. Jorizzo is from the Department of Dermatology, Wake Forest Baptist Health, Winston-Salem, North Carolina, and Weill Cornell Medicine Dermatology, New York, New York.

Patients with coronavirus disease 2019 (COVID-19) present with multisystem signs and symptoms, including dermatologic manifestations. The recent literature has revealed that dermatologic manifestations of COVID-19 often are early onset and provide helpful cues to a timely diagnosis. We compiled the relevant emerging literature regarding the dermatologic manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) so that physicians can be aware of the various clinical cutaneous presentations in this time of high incidence of COVID-19. Read More

Int J Biometeorol 2021 Apr 4. Epub 2021 Apr 4.

Biophysics and Biomedical Modeling Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Avenue, Natick, MA, 01760-5007, USA.

This paper describes a Cold Weather Ensemble Decision Aid (CoWEDA) that provides guidance for cold weather injury prevention, mission planning, and clothing selection. CoWEDA incorporates current science from the disciplines of physiology, meteorology, clothing, and computer modeling. The thermal performance of a cold weather ensemble is defined by endurance times, which are the time intervals from initial exposure until the safety limits are reached. Read More

Int J Environ Res Public Health 2021 03 16;18(6). Epub 2021 Mar 16.

Department of Neurology, Faculty of Medicine, Medical University of Gdansk, Debinki 1, 80-211 Gdansk, Poland.

(1) Background: Today's elite alpinists target K2 and Everest in midwinter. This study aimed to asses and compare weather at the summits of both peaks in the climbing season (Everest, May; K2, July) and the midwinter season (January and February). (2) Methods: We assessed environmental conditions using the ERA5 dataset (1979-2019). Read More

Dermatopathology (Basel) 2021 Mar 6;8(1):45-48. Epub 2021 Mar 6.

Department of Dermatology, ASST Lecco, Alessandro Manzoni Hospital, 23900 Lecco, Italy.

Petrified ears is an uncommon clinical entity. It describes auricular cartilage hardening, due usually to ectopic calcification or, less commonly, ossification. The most common causes are frostbite and mechanical trauma. Read More

Rev Med Suisse 2021 Mar;17(732):646-652

Service de dermatologie et vénéréologie, CHUV, 1011 Lausanne.

Since the beginning of the COVID-19 pandemic, dermatologists around the world have reported patients with chilblain-like skin lesions on their toes, called COVID-toes. Surprisingly, the majority of these patients do not develop COVID-19 symptoms, and their nasal swabs and serological tests are unable to confirm SARS-CoV-2 infection, despite a clear exposure to the virus. Recent evidence suggests that these patients mount a robust type I interferon response to SARS-CoV-2, making them resistant to the infection. Read More

Ann Dermatol Venereol 2021 06 12;148(2):69-70. Epub 2021 Mar 12.

Service de dermatologie, Hôpital Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France; Université Paris Est Créteil EpiDermE, 61, avenue du Général-de-Gaulle, 94000 Créteil, France. Electronic address:

Am J Med Sci 2020 Nov 22. Epub 2020 Nov 22.

Division of Internal Medicine, Rutgers Robert Wood Johnson Medical School/ Saint Peter's University Hospital, New Brunswick, NJ, USA.

J Dermatol 2021 May 21;48(5):e242-e243. Epub 2021 Mar 21.

Department of Dermatology, Faculty of Medicine, Pharmaceutical Health Sciences, Kanazawa University, Kanazawa, Japan.

Dermatol Ther 2021 05 27;34(3):e14951. Epub 2021 Mar 27.

Department of Pathology, HIHT University, Dehradun, India.

Perniosis/chilblains are the acral inflammatory skin lesions developing in susceptible individuals as an abnormal reaction to cold. In the absence of a discernible cause, it is labeled as idiopathic perniosis (IP). With the ongoing COVID-19 pandemic, there was an upsurge of reports of chilblain like lesions (CLL) especially in young patients possibly implicated to the SARS-CoV-2 virus. Read More

Mayo Clin Proc 2021 04 21;96(4):989-1005. Epub 2021 Jan 21.

Department of Dermatology, Mayo Clinic, Rochester, MN. Electronic address:

Pernio or chilblains is characterized by erythema and swelling at acral sites (eg, toes and fingers), typically triggered by cold exposure. Clinical and histopathologic features of pernio are well described, but the pathogenesis is not entirely understood; vasospasm and a type I interferon (IFN-I) immune response are likely involved. During the coronavirus disease 2019 (COVID-19) pandemic, dermatologists have observed an increase in pernio-like acral eruptions. Read More

J Burn Care Res 2021 Feb 28. Epub 2021 Feb 28.

Department of Surgery, University of Colorado School of Medicine.

While much has been published on efficacy and safety of systemic thrombolytics in the treatment of acute frostbite, there has been limited investigation into administration outside a tertiary care setting. Here, we present a single-center experience with remote initiation of intravenous tissue plasminogen activator (tPA) at referring hospitals prior to transfer to a regional burn center. A modified Hennepin Quantification Score based on tissue involvement was used to determine eligibility for tPA and to quantify severity of amputation. Read More

South Med J 2021 03;114(3):180-185

From the Department of Surgery and Clinical and Translational Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia.

Objectives: The etiology of vasopressor-induced digital necrosis is poorly understood, but the skin changes resemble those of frostbite, and it is known from experience that patients taking vasopressors have decreased digital temperatures. We aimed to examine the effects of norepinephrine use on surface temperatures of the distal extremities because there have been no studies examining this relation.

Methods: Surface temperatures of all digits, palms, and soles were measured using an infrared thermometer in patients receiving different rates of norepinephrine infusion in the intensive care unit and compared with those not receiving any vasopressors. Read More

J Eur Acad Dermatol Venereol 2021 Jun 11;35(6):e359-e361. Epub 2021 Mar 11.

Servicio de Dermatología. Hospital, Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.

J Eur Acad Dermatol Venereol 2021 Jun 14;35(6):e357-e359. Epub 2021 Mar 14.

Dermatology Division - IRCCS Policlinico di Sant'Orsola, Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Italy.

J Cutan Med Surg 2021 May-Jun;25(3):344-345. Epub 2021 Feb 24.

70401 Division of Dermatology, Department of Medicine, University of Calgary, Canada.

J Cutan Med Surg 2021 May-Jun;25(3):342-343. Epub 2021 Feb 24.

16516 Department of Dermatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Cantabria, Spain.

Eur J Radiol 2021 Apr 17;137:109605. Epub 2021 Feb 17.

Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China. Electronic address:

Purpose: This article reviews the pathological mechanisms and progress of imaging of severe frostbite to assist in the search for targets for clinical diagnosis and treatment of severe frostbite. This review also aims to provide strong evidence for clinical diagnosis and treatment of deep frostbite.

Methods: The review was based on the summary and analysis of the existing literature, and explored the pathological mechanism of deep frostbite and the advantages and disadvantages of imaging diagnostic methods. Read More

J Eur Acad Dermatol Venereol 2021 May 23;35(5):e315-e316. Epub 2021 Feb 23.

Dermatology Unit, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy.

Front Physiol 2020 25;11:597638. Epub 2021 Jan 25.

Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.

: T2 mapping and diffusion tensor imaging (DTI) enable the detection of changes in the skeletal muscle microenvironment. We assessed T2 relaxation times, DTI metrics, performed histological characterization of frostbite-induced skeletal muscle injury and repair, and provided diagnostic imaging biomarkers. : Thirty-six Sprague Dawley rats (200 ± 10 g) were obtained. Read More

Dermatol Online J 2021 Jan 15;27(1). Epub 2021 Jan 15.

Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA.

The severe acute respiratory syndrome coronavirus two (SARS-CoV-2), which causes the 2019 coronavirus disease (COVID-19), has infected patients worldwide. Physicians have increasingly identified cutaneous findings as a significant clinical manifestation of COVID-19. In this review, we describe the clinical presentation, onset, duration, associated symptoms, treatment, and outcome of cutaneous manifestations thus far reported to be related to COVID-19. Read More

Ann Dermatol Venereol 2021 Jun 9;148(2):94-100. Epub 2021 Jan 9.

Universities of Tours and Nantes, inserm 1246-SPHERE, 37000 Tours, France; Tours University Hospital, Department of Dermatology, 37044 Tours Cedex 9, France; Tours University Hospital, Clinical Investigation Center-INSERM 1415, 37000 Tours, France. Electronic address:

Background: A marked increase in frequency of acute acral eruptions (AAE) was observed in children during the COVID-19 pandemic in the spring period.

Objectives: In this observational multicenter study, based on children with AAE, we aimed to assess the proportion of household members possibly infected by SARS-CoV-2.

Methods: We collected data from all children observed with AAE, prospectively from April 7, 2020 to June 22, 2020, and retrospectively since February 28, 2020. Read More

J Eur Acad Dermatol Venereol 2021 May 2;35(5):e316-e318. Epub 2021 Mar 2.

Ambulatorio di Dermatologia Pediatrica, Ospedale dell'Angelo Venezia, Ospedale San Bortolo Vicenza, Vicenza, Italy.