Digital video capillaroscopy of patients with dermal lesions, including erythema nodosum shows pericapillary edema, dilated and abnormal appearing capillaries and microhemorrhages. In children with chilblain lesions, IgA antibodies to SARS–CoV-2 spike protein S1 domain are observed, suggesting that their immune response represents mucosal protection that lessens the likelihood of triggering an IgG response. Acro-ischemia with accompanying skin lesions (bulla, cyanosis) and dry gangrene is likely a combination of arterial vasculitis and coagulopathy compromising perfusion to the fingers, toes and legs. While thrombosis commonly accompanies vasculitis, obliterating arteriolitis can also be a cause for tissue injury [62].