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 Release 24.0, April 2009
 
Chapter : ch34. Environmental Health Section : Low Environmental Temperatures
  Chilblains (Pernio)

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Overview :

Chilblains (also known as pernio) is a reversible form of mild cutaneous cold injury (frostbite). It may overlap with immersion or trench foot.

 

Clinical features:

(1) Skin lesions develop after exposure to cold, typically during the winter months.

(2) The skin of the ears, fingers, heel, and/or toes tend to be affected.

(3) Affected areas may initially show painful erythema, swelling and/or pruritis.

(4) With further exposure subcutaneous vesicles, bluish discoloration, tenderness, scaling and desquamation may develop.

(5) Eschars may form on the hands and feet with persistent pain (pernio).

(6) While the skin lesions reverse after removal from the cold and wet, pain may persist for some time afterwards.

 

Risk factors:

(1) mild peripheral vascular disease

(2) spina bifida

(3) Raynaud's phenomenon, vasculitis or cold agglutinins

(4) improper clothing for cold weather

(5) excessive moisture or perspiration

 

  References:

Barnett JS, Menelaus MB. Chapter 5: Pressure sores and pathological fractures. pages 51-65 (page 51). IN: Broughton NS, Menelaus MB (editors). Menelaus' Orthopaedic Management of Spina Bifida Cystica, Thrid Edition. W.B. Saunders. 1998.

Hamlet MP. Chapter 5: Nonfreezing cold injuries. pages 129-134. IN: Auerbach PS. Wilderness Medicine, Fourth Edition. Mosby. 2001.

 

 

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