Chilblains

Chilblains are a localised form of vasculitis.  They are also known as pernio.  Chilblains most frequently occur in the elderly and symptoms get worse each year unless precipitating factors are avoided.  They can also occur in children, but symptoms fade overtime with growth. 

Chilblains are tender red or purple bumps, usually appearing on extremities, in particular feet, after exposure to cold, some patients also report an itching sensation.  Cold causes constriction of the small arteries in the veins of the skin and rewarming results in the leakage of blood into tissues and the swelling of skin.  They are sometimes aggravated by sun exposure.  In some cases they can also be related to connective tissue disease such as lupus. 

Risk factors for those likely to suffer from chilblains include the following:-

(a)       Those suffering from peripheral vascular disease or at risk of peripheral vascular disease including diabetics and smokers;

(b)       Those with a family history or chilblains or peripheral vascular disease;

(c)        Those suffering from connective tissue diseases such as lupus or Raynaud's disease; and

(d)       Those suffering from poor nutrition including those with eating disorders.

Chilblains generally respond poorly to treatment, with treatments focusing on the relief of symptoms.  Topical corticosteroid cream can be applied to relieve itching and swelling, vasodilator medication may be prescribed to prevent vein and artery constriction and antibiotics may be prescribed to assist with the treatment of secondary infection, otherwise treatment options focus upon prevention by reducing the risk of the patient's peripheral exposure to cold conditions which cause vascular constriction.