Chilblains

Chilblain
Classification and external resources
ICD-10	T69.1
ICD-9	991.5
DiseasesDB	31219
eMedicine	derm/322

Chilblains ( /ˈtʃɪlbleɪnz/; also known as pernio and perniosis)^[1] are a medical condition that is often confused with frostbite and trench foot. Chilblains are acral ulcers (that is, ulcers affecting the extremities) that occur when a predisposed individual is exposed to cold and humidity. The cold exposure damages capillary beds in the skin, which in turn can cause redness, itching, blisters, and inflammation.^[2] Chilblains are often idiopathic in origin but can be manifestations of serious medical conditions that need to be investigated. Chilblains can be prevented by keeping the feet and hands warm in cold weather. A history of chilblains is suggestive of a connective tissue disease.

Symptoms

The areas most affected are the ears, earlobes, nose, and extremities; feet & toes, hands & fingers.

• Blistering of affected area
• Burning and itching sensation in extremities
• Dermatitis in extremities
• Digital ulceration
• Erythema (blanchable redness of the skin)
• Pain in affected area
• Skin discoloration, red to dark blue
• Symptoms worsen when exposed to warmth

^{[3] [4] [5]}

Duration

With treatment, chilblains usually heal within 7–14 days.

Treatments

• Keep area warm
• Nifedipine may be used in more severe or recurrent cases.^[6] Its vasodilation helps reduce pain, facilitate healing and prevent recurrences.^[7]
• Diltiazem may also be used.^[8]

Prevention

Exposure

• Avoid rapid changes in temperature.
• Wear gloves and socks.
• Use warm footwear.
• Keep hands and feet warm.
• Avoid tight fitting socks/shoes
• Place cotton wool between the toes to improve circulation

Dietary

• Healthy diet
• Exercise to improve circulation
• Avoid alcohol before going out in snow

History

The medieval Bald's Leechbook recommended that chilblains be treated with a mix of eggs, wine, and fennel root.^[9] An old Irish remedy was to place the affected digits in a bowl of water in which potatoes had been boiled.

See also

• Erythrocyanosis crurum
• Equestrian perniosis
• Trench foot
• Frostbite

References

1. ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. ^{[page needed]}
2. ^ Cold Stress: Chilblains. National Institute for Occupational Safety and Health. Retrieved January 6, 2009.
3. ^ Chilblains symptoms
4. ^ Signs & Symptoms
5. ^ Mayo Clinic: Chilblains
6. ^ Rustin, M.H.A.; Newton, Julia A.; Smith, N.P.; Dowd, Pauline M. (2006). "The treatment of chilblains with nifedipine: the results of a pilot study, a double-blind placebo-controlled randomized study and a long-term open trial". British Journal of Dermatology 120 (2): 267–75. doi:10.1111/j.1365-2133.1989.tb07792.x. PMID 2647123. 
7. ^ Simon, T. D.; Soep, JB; Hollister, JR (2005). "Pernio in Pediatrics". Pediatrics 116 (3): e472–5. doi:10.1542/peds.2004-2681. PMID 16140694. 
8. ^ Patra, AK; Das, AL; Ramadasan, P (5/1/2003). "Diltiazem vs. nifedipine in chilblains: A clinical trial". Indian Journal of Dermatology, Venereology, and Leprology 69 (3): 209. PMID 17642888. http://www.ijdvl.com/text.asp?2003/69/3/209/999. 
9. ^ Robert Lacey and Danny Danziger August:The Year 1000: What Life Was Like at the Turn of the First Millennium Little, Brown, 2000 ISBN 0316511579^{[page needed]}

External links

• DermAtlas 1683395337
• Cold stress, National Institute for Occupational Safety and Health