Pernio (Chilblains)

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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

Evaluation

  • Clinical diagnosis

Treatment[1]

Disposition

  • Discharge if no frostbite or other serious pathology

See Also

References

  1. Ikaheimo T. Frostbite and Other Localized Cold Injuries. In: Tintinalli's Emergency Medicine: A comprehensive study guide. 7th ed. McGraw Hill Medical; 2011: 1331