|Other names||Pernio, chill burn, perniones, perniosis|
|Toes inflamed by chilblains|
Chilblains, also known as pernio and chill burns are a medical condition that occurs when a predisposed individual is exposed to cold and humidity. Damage to capillary beds in the skin causes blood to perfuse into the nearby tissue too quickly, resulting in redness, itching, inflammation, and blisters. Chilblains can be reduced by keeping the feet and hands warm in cold weather, and avoiding extreme temperature changes.
Chilblain-like symptoms have also been linked to COVID-19. COVID toes, as they are commonly known, have mostly been reported in older children and adolescents. The symptoms are usually mild and disappear without treatment. Their cause is debated: it is uncertain whether "COVID toes" are a delayed consequence of the the viral infection itself (or whether the recognition of the phenomenon may at least partially stem from other environmental factors during the COVID-19 pandemic).
Chilblains can be idiopathic (spontaneous and unrelated to another disease), but may also be a manifestation of another serious medical condition that must be investigated. Related medical conditions include Raynaud's disease, erythromelalgia, frostbite, and trench foot, as well as connective tissue diseases such as lupus or vasculitis.
Signs and symptoms
- Blistering of affected area
- Burning and itching sensation in extremities
- Dermatitis in extremities
- Ulceration (severe cases only)
- Erythema (blanchable redness of the skin)
- Pain in affected area
- Skin discoloration, red to dark blue
Chilblains caused by exposure to low temperatures usually heal within 7–14 days.
- Keep affected area warm, and avoid any extreme temperature changes (including very hot water).
- Keep affected area dry.
- Wear warm shoes, socks and gloves.
- Wear a hat and a scarf to protect the ears and the nose.
- Avoid tight fitting socks/shoes.
- Exercise at least four times a week to improve circulation.
- Quit smoking, as it damages circulation.
Treatment for the condition depends on its cause. Below are some common treatments for chilblains caused by exposure to low temperatures, though some may also apply to other sources of the condition.
- A course of vitamin B, especially nicotinic acid, may improve circulation.
- Soaking in warm water with Epsom salts for 15–20 minutes, 3–4 times a day.
- A topical steroid cream may relieve itching.
- Nifedipine, a vasodilator, may help in some cases. Vasodilation may reduce pain, facilitate healing, and prevent recurrences. It is typically available in an oral pill but can be compounded into a topical formula.
- Diltiazem, a vasodilator, may help.
- Apply a mixture of friar's balsam and a weak iodine solution.
- Avoid restricting the affected area.
The medieval Bald's Leechbook recommended treating chilblains with a mix of eggs, wine, and fennel root, and a modern home remedy is to put garlic on the chilblains. Neither of these remedies has been supported by scientific research.
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In acral chilblain-like lesions, a diffuse dense lymphoid infiltrate of the superficial and deep dermis, as well as hypodermis, with a prevalent perivascular pattern and signs of endothelial activation, are observed.
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- Unusual coronavirus (COVID-19) symptoms: What are they?
- Assessment of Acute Acral Lesions in a Case Series of Children and Adolescents During the COVID-19 Pandemic
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- 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]
- "Remedios caseros para sabañones". saludplena.com (in Spanish). Retrieved 29 December 2016.
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