Chilblains

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

Chilblains (pron.: /ˈɪlblnz/; also known as pernio and perniosis)[1] is a medical condition that is often confused with frostbite and trench foot. Chilblains are a tissue injury that occurs 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. Rarely, chilblains in infants, together with severe neurologic disease and unexplained fevers, can be seen in Aicardi–Goutières syndrome, a rare inherited condition.

Contents

Signs and symptoms [edit]

Chilblains from excessively icing the feet

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

Duration [edit]

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

Treatments [edit]

  • Keep area warm
  • Topical steroid cream can relieve itch.
  • Nifedipine may be used in more severe or recurrent cases.[3] Its vasodilation helps reduce pain, facilitate healing and prevent recurrences.[4]
  • Diltiazem may also be used.[5]

There are anecdotal reports that chilblains may be helped by Vitamin D and Calcium supplements. [6]

Prevention [edit]

Exposure [edit]

Recommend three to four times a day soaking in warm water with epsom salts for 15-20 minutes.

Dietary [edit]

  • Healthy diet
  • Exercise to improve circulation
  • Avoid alcohol before going out in snow.[citation needed]

History [edit]

The medieval Bald's Leechbook recommended that chilblains be treated with a mix of eggs, wine, and fennel root.[7]

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. ^ 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. 
  4. ^ Simon, T. D.; Soep, JB; Hollister, JR (2005). "Pernio in Pediatrics". Pediatrics 116 (3): e472–5. doi:10.1542/peds.2004-2681. PMID 16140694. 
  5. ^ 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. 
  6. ^ http://www.patient.co.uk/forums/discuss/the-cure-for-my-chilblains-is--13754
  7. ^ 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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