clinical features

Last edited 05/2022

  • Clinical features suggestive of chilblains are that the lesions often may be very itchy at first and are sometimes painful on rewarming.
  • Chilblains characteristically occur during the colder months of the year and resolve completely during the warmer weather.
    • This seasonal variation may not be seen in advanced cases (1).
  • Single or multiple, usually symmetric, erythematous, brownish, yellowish, or violaceous papules, patches, or plques resting on a cool, edematous base (3).
  • Lesions appear in crops (or single) as red edematous papules, patches, or plaques on peripherally exposed areas such as fingers and toes (known as trenchfoot and kibes), nose and earlobes.
    • Other areas such as the thighs, hips, or abdomen may be affected occasionally (1,2).
  • Often there is associated tenderness, intense pruritus and burning sensation (2).
  • Lesions are generally symmetrical and bilateral – the thumbs are affected relatively infrequently.
  • Lesions become a deep purple or reddish-purple colour.
    • The swellings may increase in size - occasionally forming blisters; itchiness may be replaced by pain and soreness.
  • Usually self-limiting
    • If there is re-exposure to cold then tender blue nodules may occur and may persist for 10–14 days.
  • Severe complications: skin laceration, ulceration, permanent discoloration, and scarring (2).

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