Chilblains

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Chilblains
Synonyms	Pernio, perniosis
Pronounce
Specialty	Dermatology
Symptoms	Redness, itching, inflammation, blisters
Complications	Infection, ulceration
Onset	Cold weather
Duration	1–3 weeks
Types	N/A
Causes	Cold exposure, poor circulation
Risks	Raynaud's phenomenon, smoking, poor nutrition
Diagnosis	Clinical diagnosis
Differential diagnosis	Frostbite, Raynaud's phenomenon, erythromelalgia
Prevention	Warm clothing, avoiding cold exposure
Treatment	Warming, topical corticosteroids, nifedipine
Medication	Nifedipine, topical corticosteroids
Prognosis	N/A
Frequency	Common in cold climates
Deaths	N/A

Chilblains from excessively icing the feet

Chilblains (also known as pernio and perniosis) is a medical condition that occurs when a predisposed individual is exposed to cold and humidity, causing tissue damage. It is often confused with frostbite and hypothermia, as they share similar symptoms and environmental conditions, but chilblains is a separate condition that does not involve freezing or necessarily extreme cold.

Presentation

Chilblains presents as painful inflammation of small blood vessels in the skin, typically in response to a sudden warming from cold temperatures. The condition can cause itching, red patches, swelling and blistering on extremities, such as the hands and feet.

Causes and Risk Factors

The exact cause of chilblains is not well understood, but it's thought to be an abnormal reaction of the body to cold exposure followed by rewarming. Rewarming of cold skin can cause small blood vessels under the skin to expand more quickly than nearby larger blood vessels can handle, resulting in a bottleneck effect and the subsequent inflammation. Risk factors include:

• Poor circulation
• Family history of chilblains
• Regular exposure to cold and humidity
• Being underweight
• Certain conditions such as Raynaud's disease, lupus, and rheumatoid arthritis.

Diagnosis

Diagnosis of chilblains is typically based on the clinical presentation of symptoms and the patient's history of exposure to cold. Imaging or other diagnostic tests are usually not necessary.

Treatment

Treatment of chilblains primarily focuses on relieving symptoms and preventing the condition from recurring. Home remedies include warming the skin gently (without direct heat, which can cause burns), keeping the skin dry and moisturized, and avoiding cold exposure as much as possible. For severe or recurring cases, medical treatment may be necessary. This could include a prescription for a drug to improve circulation, topical corticosteroids to reduce inflammation, or antibiotics if an infection develops.

Prevention

Prevention is a key component in managing chilblains. This includes keeping the extremities warm in cold weather, using appropriate protective clothing, and making lifestyle changes to improve circulation such as quitting smoking or regular exercise.

See Also

• Frostbite
• Raynaud's disease
• Lupus

References

1. "Chilblains". Mayo Clinic. Retrieved 2021-09-01.
2. "Chilblains". NHS UK. Retrieved 2021-09-01.

External Links

• DermNet NZ: Chilblains
• American Academy of Dermatology: Chilblains

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