Summary about Disease
Chilblains (also known as pernio) are small, itchy, red or purple patches that develop on the skin, usually on the fingers, toes, ears, and nose. They are a reaction to cold, damp conditions and poor circulation. While generally not serious, they can be uncomfortable and, in rare cases, lead to complications like blistering or infection.
Symptoms
Small, itchy, red patches on the skin, typically on fingers, toes, ears, or nose.
Patches may become purple or dark blue.
Burning or itching sensation.
Swelling.
Pain.
In severe cases, blisters or skin ulcers can develop.
Causes
Chilblains are caused by repeated exposure to cold, damp conditions. The cold causes small blood vessels near the surface of the skin to constrict. When the skin is then exposed to warmth, these blood vessels may expand too quickly, leading to leakage of blood into the surrounding tissues. This causes inflammation and the characteristic symptoms of chilblains. Poor circulation can also contribute to the development of chilblains.
Medicine Used
Topical corticosteroids: Creams or ointments containing corticosteroids can help reduce inflammation and itching.
Nifedipine: This is a calcium channel blocker that can improve circulation and is sometimes prescribed for recurrent or severe chilblains.
Pentoxifylline: This medication can improve blood flow and may be used in some cases.
Topical Local Anesthetics: Can help provide temporary pain relief.
Is Communicable
No, chilblains are not communicable (not contagious). It is a reaction to environmental conditions and not caused by an infection.
Precautions
Keep warm: Dress warmly in cold weather, paying particular attention to protecting hands, feet, ears, and nose.
Avoid rapid temperature changes: Warm up gradually after being exposed to the cold.
Keep skin dry: Moisture can worsen chilblains.
Improve circulation: Regular exercise can help improve circulation.
Avoid tight clothing and shoes: These can restrict blood flow.
Moisturize: Keep skin well-moisturized to prevent dryness and cracking.
Wool socks and gloves: Wear wool or other warm materials to protect extremities.
How long does an outbreak last?
Chilblains typically heal within 1-3 weeks, especially if the affected area is kept warm and dry. However, they can recur during cold weather. In some cases, they may persist for longer, particularly if they are severe or if there are underlying circulation problems.
How is it diagnosed?
Chilblains are usually diagnosed based on a physical examination and a description of the symptoms and the circumstances in which they developed (exposure to cold, damp conditions). In some cases, a doctor may order tests to rule out other conditions with similar symptoms, such as Raynaud's phenomenon or vasculitis. A skin biopsy is rarely needed.
Timeline of Symptoms
Initial exposure to cold: Skin becomes cold and potentially damp.
Within hours of rewarming: Redness and itching begin.
Next few days: Patches become more pronounced, may turn purple, and swelling can occur. Burning and pain may increase.
1-3 weeks (with proper care): Symptoms gradually subside and the skin heals. Blisters or ulcers may take longer to heal and could require medical attention.
Important Considerations
Underlying conditions: Individuals with poor circulation, diabetes, or autoimmune diseases may be more susceptible to chilblains.
Secondary infection: Blisters or broken skin can become infected. Seek medical attention if you notice signs of infection (increased pain, redness, swelling, pus).
Differential diagnosis: Ensure the symptoms are actually chilblains and not other conditions like frostbite, Raynaud's phenomenon, or connective tissue diseases. A doctor's assessment is important, especially for recurrent or severe cases.
Prevention is key: Focus on keeping extremities warm and dry during cold weather.