Chilblains: Difference between revisions
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*Mild but uncomfortable inflammatory lesions of skin | *Mild but uncomfortable inflammatory lesions of skin | ||
**Caused by long-term intermittent exposure to damp, nonfreezing ambient temperatures | **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 | *Primarily a disease of women and children | ||
*Rare in U.S.; common in United Kingdom | |||
==Clinical Features== | ==Clinical Features== | ||
*Hands, ears, lower legs, feet most commonly affected | *Hands, ears, lower legs, feet most commonly affected | ||
*Symptoms | *Symptoms | ||
**Tingling, numbness, pruritus, burning paresthesias | **Tingling, numbness, [[pruritus]], burning paresthesias | ||
**Cutaneous manifestations appear up to 12hr after acute exposure | **Cutaneous manifestations appear up to 12hr after acute exposure | ||
**Localized edema, erythema, cyanosis, plaques, nodules | ***Localized edema, erythema, cyanosis, plaques, nodules | ||
***May progress in rare cases to ulcerations, vesicles, and bullae | ***May progress in rare cases to ulcerations, vesicles, and bullae | ||
**Rewarming may result in formation of tender blue nodules which may persist for days | **Rewarming may result in formation of tender blue nodules which may persist for days | ||
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{{Cold injuries DDX}} | {{Cold injuries DDX}} | ||
== | ==Evaluation== | ||
*Clinical diagnosis | |||
==Treatment== | ==Treatment<ref>Ikaheimo T. Frostbite and Other Localized Cold Injuries. In: Tintinalli's Emergency Medicine: A comprehensive study guide. 7th ed. McGraw Hill Medical; 2011: 1331</ref>== | ||
*Affected skin should be rewarmed, gently bandaged, and elevated | *Affected skin should be rewarmed, gently bandaged, and elevated | ||
*Nifedipine 20mg PO TID | *Prophylactic and therapeutic treatment options: | ||
*Topical corticosteroids and oral | **[[Nifedipine]] 20mg PO TID | ||
**[[Pentoxifylline]] 400mg PO TID | |||
**Limaprost 20mcg TID | |||
*[[Topical corticosteroids]] and oral [[steroids]] burst have been shown to be useful | |||
==Disposition== | ==Disposition== | ||
*Discharge if no frostbite or other serious pathology | |||
==See Also== | ==See Also== | ||
[[Cold | *[[Cold injuries]] | ||
==References== | ==References== | ||
<references/> | |||
[[Category: | [[Category:Environmental]] | ||
Revision as of 23:30, 31 December 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
- Clinical diagnosis
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
- Discharge if no frostbite or other serious pathology
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