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Chilblains

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

Chilblains (; 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. Damage to capillary beds in the skin causes redness, itching, inflammation, and sometimes blisters.[2] Chilblains can be reduced by keeping the feet and hands warm in cold weather, and avoiding extreme temperature changes. 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.

Contents

  • Signs and symptoms 1
  • Prevention 2
    • Exposure 2.1
    • Other 2.2
  • Treatment 3
  • History 4
  • See also 5
  • References 6
  • External links 7

Signs and symptoms

Chilblains from excessively icing the feet

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

Chilblains usually heal within 7–14 days.

Prevention

Exposure

  • Avoid rapid changes in temperature (including from cold to hot).[3]
  • Wear warm shoes, socks and gloves.[3]
  • Wear a hat and a scarf to protect the ears and the nose.[3]
  • Avoid tight fitting socks/shoes.
  • Place cotton wool between the toes to improve circulation.[3]
  • 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[3]

Treatment

  • Keep area warm, and avoid any extreme temperature changes (including very hot water).
  • Keep affected area dry.[4]
  • Use a topical steroid cream to relieve itch.
  • Nifedipine, a vasodilator, may be used in more severe or recurrent cases.[5]Vasodilation helps reduce pain, facilitate healing and prevent recurrences.[6] It is typically available in an oral pill but can be compounded into a topical formula.
  • Diltiazem, a vasodilator, may also be used.[7]
  • Apply a mixture of friar's balsam and a weak iodine solution.[3]
  • There are anecdotal reports that Vitamin D and calcium supplements may help.[8]
  • Avoid restricting the affected area.[9]

History

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

See also

References

  1. ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier.  
  2. ^ Cold Stress: Chilblains. National Institute for Occupational Safety and Health. Retrieved January 6, 2009.
  3. ^ a b c d e f "What are chilblains (pernio)? What causes chilblains?". Medical News Today. 
  4. ^ "Chilblains.org - #1 Online Source for Treatments, Prevention, Relief Advice". Chilblains.org. 
  5. ^ 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.  
  6. ^ Simon, T. D.; Soep, JB; Hollister, JR (2005). "Pernio in Pediatrics". Pediatrics 116 (3): e472–5.  
  7. ^ Patra, AK; Das, AL; Ramadasan, P (2003). "Diltiazem vs. nifedipine in chilblains: A clinical trial". Indian Journal of Dermatology, Venereology, and Leprology 69 (3): 209–11.  
  8. ^ "The cure for my chilblains is...". Patient.info. 
  9. ^ "Chilblains.com.au - Information, Treatment and Prevention". Chilblains.com.au - Information, Treatment and Prevention. 
  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

External links

  • Cold stress, National Institute for Occupational Safety and Health

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