Chilblains

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

Chilblains (/ˈɪlblnz/; also known as pernio and perniosis)[1] 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 trench foot. The cold exposure damages capillary beds in the skin, which in turn causes redness, itching, blisters, and inflammation.[2] Chilblains can be prevented by keeping the feet and hands warm in cold weather. Chilblains can be idiopathic, but may also be a manifestation of a serious medical condition that needs to be investigated. A history of chilblains is suggestive of a connective tissue disease (such as lupus). Chilblains in infants, together with severe neurologic disease and unexplained fevers, can be seen in Aicardi–Goutières syndrome, a rare inherited condition.

Signs and symptoms[edit]

Chilblains from excessively icing the feet

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

Duration[edit]

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

Treatment[edit]

  • Keep area warm
  • Apply a chilblains treatment cream.
  • Keep affected area dry.[3]
  • Use a topical steroid cream to relieve itch.
  • Nifedipine may be used in more severe or recurrent cases.[4] Its vasodilation helps reduce pain, facilitate healing and prevent recurrences.[5]
  • Diltiazem may also be used.[6]
  • Apply a mixture of friar's balsam and a weak iodine solution[7]
  • There are anecdotal reports that Vitamin D and Calcium supplements may help.[8]
  • Avoid restricting the affected area.[9]

Historical[edit]

The medieval Bald's Leechbook recommended that chilblains be treated with a mix of eggs, wine, and fennel root.[10]

Prevention[edit]

Exposure[edit]

  • Avoid rapid changes in temperature (from cold to warm).[7]
  • Wear warm shoes, socks and gloves.[7]
  • Wear a hat and a scarf to protect the ears and the nose.[7]
  • Avoid tight fitting socks/shoes
  • Place cotton wool between the toes to improve circulation[7]
  • Recommend soaking in warm water with Epsom salts for 15–20 minutes, 3–4 times a day.

Other[edit]

  • Healthy diet
  • Exercise at least four times a week to improve circulation[7]
  • Avoid alcohol before going out in the snow.[citation needed]

See also[edit]

References[edit]

  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. ^ http://chilblains.org
  4. ^ 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. 
  5. ^ Simon, T. D.; Soep, JB; Hollister, JR (2005). "Pernio in Pediatrics". Pediatrics 116 (3): e472–5. doi:10.1542/peds.2004-2681. PMID 16140694. 
  6. ^ 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): 209–11. PMID 17642888. 
  7. ^ a b c d e f http://www.medicalnewstoday.com/articles/172191.php
  8. ^ http://www.patient.co.uk/forums/discuss/the-cure-for-my-chilblains-is--13754
  9. ^ http://www.chilblains.com.au
  10. ^ 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[edit]

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