Chilblains: Difference between revisions
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*Affected skin should be rewarmed, gently bandaged, and elevated | *Affected skin should be rewarmed, gently bandaged, and elevated | ||
*Prophylactic and therapeutic treatment options: | *Prophylactic and therapeutic treatment options: | ||
**Nifedipine 20mg PO TID | **[[Nifedipine]] 20mg PO TID | ||
**Pentoxifylline 400mg PO TID | **[[Pentoxifylline]] 400mg PO TID | ||
**Limaprost 20mcg TID | **Limaprost 20mcg TID | ||
*Topical corticosteroids and oral | *[[Topical corticosteroids]] and oral [[steroids]] burst have been shown to be useful | ||
==Disposition== | ==Disposition== | ||
Revision as of 00:47, 14 November 2016
Background
- Mild but uncomfortable inflammatory lesions of skin
- Caused by long-term intermittent exposure to damp, nonfreezing ambient temperatures
- Symptoms precipitated by acute exposure to cold
- Primarily a disease of women and children
- Rare in U.S.; common in United Kingdom
Clinical Features
- Hands, ears, lower legs, feet most commonly affected
- Symptoms
- Tingling, numbness, pruritus, burning paresthesias
- Cutaneous manifestations appear up to 12hr after acute exposure
- Localized edema, erythema, cyanosis, plaques, nodules
- May progress in rare cases to ulcerations, vesicles, and bullae
- Rewarming may result in formation of tender blue nodules which may persist for days
Differential Diagnosis
Cold injuries
- Generalized
- Freezing
- Non-freezing
Evaluation
- Usually clinical
Treatment[1]
- Affected skin should be rewarmed, gently bandaged, and elevated
- Prophylactic and therapeutic treatment options:
- Nifedipine 20mg PO TID
- Pentoxifylline 400mg PO TID
- Limaprost 20mcg TID
- Topical corticosteroids and oral steroids burst have been shown to be useful
Disposition
See Also
References
- ↑ Ikaheimo T. Frostbite and Other Localized Cold Injuries. In: Tintinalli's Emergency Medicine: A comprehensive study guide. 7th ed. McGraw Hill Medical; 2011: 1331