We have recently noticed an outbreak of chilblain-like lesions in Italy contemporarily to COVID-19 epidemic. Due to the wellknown lockdown-related difficulties to visit the patients, 1 we created a Google form aimed to collect information about patients presenting with these singular clinical findings. An easy to access and quick tool was chosen by the investigators in order to permit the other colleagues to spend the least amount of time, given the severe health emergency. The form was submitted through social media and email to hundreds of Italian dermatologists and paediatricians. In 5 days, we collected 63 patients through the form, but data are still going to be collected. Here the first preliminary results. No significant difference in gender was noticed (57.4% females vs 47.6% males). The median age was 14 years (IQR: 12-16). Feet alone were mostly affected (85.7%) followed by feet/hands together (7%) and hands alone (6%). Pictures of patients were uploaded in 54 patients, with 31/ 54 presenting with erythematous-oedematous lesions (Fig. 1) and 23/54 with blistering lesions (Fig. 2). Pain and itch were equally observed (27% vs. 27%), followed by pain/itch together shown in 20.6% of patients. Asymptomatic lesions were present in 25.4%. Median time from the onset to clinical diagnosis was 10 days (IQR: 6-15). At time of diagnosis, most patients pre-

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Background: In indolent systemic mastocytosis (ISM), several risk factors of disease progression have been identified. Previous studies, performed with limited patient numbers, have also shown that the clinical course in ISM is stable and comparable to that of cutaneous mastocytosis (CM). The aim of this project was to compare the prognosis of patients with ISM with that of patients with CM. Methods: We employed a dataset of 1993 patients from the registry of the European Competence Network on Mastocytosis (ECNM) to compare outcomes of ISM and CM. Results: We found that overall survival (OS) is worse in ISM compared to CM. Moreover, in patients with typical ISM, bone marrow mastocytosis (BMM), and smoldering SM (SSM), 4.1% of disease progressions have been observed (4.9% of progressions in typical ISM group, 1.7% in BMM, and 9.4% in SSM). Progressions to advanced SM were observed in 2.9% of these patients. In contrast, six patients with CM (1.7%) converted to ISM and no definitive progression to advanced SM was found. No significant differences in OS and event-free survival (EFS) were found when comparing ISM, BMM, and SSM. Higher risk of both progression and death was significantly associated with male gender, worse performance status, and organomegaly. Conclusion: Our data confirm the clinical impact of the WHO classification that separates ISM from CM and from other SM variants.

Our study suggests a significant association between healthcare work, hand/forearm dermatitis and sensitization to formaldehyde and p-phenylenediamine.

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