20/07/2022
📌Chilblains are itchy and/ or tender red or purple areas that occur as a reaction to cold. Chilblains are also known as pernio or perniosis. Chilblains occur several hours after exposure to the cold due to constriction of the small arteries and veins in the skin. They are more likely to develop in those with poor peripheral circulation , noted by red- blue mottled skin on the limbs.
What are the CONTRIBUTING FACTORS?
Other factors contributing to chilblains include?
-Familial tendency to chilblains
-Peripheral vascular dx, due to Dm, smoking, hyperlipidemia
-Low body weight, or malnutrition eg anorexia
-Connective tissue disease, particular lupus or in association with raynaud's phenomenon
--Bone marrow disorders
What are the CLINICAL FEATURES of chilblains?
Each chilblain comes up over a few hours as an itchy red swelling and subsides over 7-14 days or longer . In severe cases, blistering, pustules, scabs and ulcerations can occur. Occasionally the lesions may be ring- shaped. Chillblains may become thickened and persist for months.
Common sites for chilblains are:
-Backs and sides of fingers and toes
-Heels
-Lower legs
-Over fatty lumps- lipoma
-Nose
-Ears
Can chilblains be PREVENTED?
People with a tendency to chilblains must keep their hands and feet warm to reduce risk of chilblains.
⭕️Smoking constricts the blood vessels
⭕️Home and workplace should be well insulated and heated in winter
⭕️Warm clothing should include gloves, thick woolen socks and comfortable protective footwear
⭕️Soaking hands in lukewarm water for several minutes warms them for up to several hours
⭕️Exercise keeps the body warm for a period of time
⭕️Do not sleep with your electric blanket on, but rather use it to warm up your bed and make sure it is switched off before jumping in
⭕️Put lambswool insoles in your footwear
⭕️Heat up the cold shower tiles with warm water before getting into the shower
The following may be useful:
⭕️Opsite dressings/wraps; apply for 2-3 days and reapply within 3 days for regulating temperature
⭕️Hirudoid cream- vasodilator increasing the blood flow to the area usually used for bruising. DO NOT use on an open wound (Can use Vicks Vaporub as well)
⭕️Parsley and Gingko
⭕️Paraffin wax bar- wrapping the foot to dilate blood flow
⭕️Dry needling