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).
Reference:
- (1) Simon TD, Soep JB, Hollister JR. Pernio in pediatrics. Pediatrics. 2005 Sep;116(3):e472-5. doi: 10.1542/peds.2004-2681. PMID: 16140694.
- (2) Jordaan H.F. The diagnosis and management of perniosis (chilblains). SA Fam Pract 2007;49(6): 28-29
- (3) AlMahameed, A., Pinto, D.S. Pernio (Chilblains). Curr Treat Options Cardio Med 10, 128–135 (2008). https://doi.org/10.1007/s11936-008-0014-0