Chilblains

Chilblains
Specialty	Family medicine

Chilblains (/ˈtʃɪlbleɪnz/) — 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 trench foot. Damage to capillary beds in the skin causes redness, itching, inflammation, and sometimes blisters. Chilblains can be reduced by keeping the feet and hands warm in cold weather, and avoiding extreme temperature changes. Chilblains can be idiopathic (spontaneous and unrelated to another disease), but may also be a manifestation of another 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

Chilblains from excessively icing the feet

The areas most affected are the toes, fingers, earlobes, nose.

• Blistering of affected area
• Burning and itching sensation in extremities
• Dermatitis in extremities
• Digital ulceration (severe cases only)
• Erythema (blanchable redness of the skin)
• Pain in affected area
• Skin discoloration, red to dark blue

Chilblains usually heal within 7–14 days.

Prevention

Exposure

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

Other

• Healthy diet, low in inflammatory foods
• Exercise at least four times a week to improve circulation

Treatment

• Keep area warm, and avoid any extreme temperature changes (including very hot water).
• Keep affected area dry.
• Use a topical steroid cream to relieve itch.
• Nifedipine, a vasodilator, may be used in more severe or recurrent cases.Vasodilation helps 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 also be used.
• Apply a mixture of friar's balsam and a weak iodine solution.
• Avoid restricting the affected area.

History

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

See also

• Erythrocyanosis crurum
• Equestrian perniosis
• Frostbite

External links

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