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How Do You Know If You Have Chilblains?

Yes this is quite a scary picture of  someone with chilblains, and in this blog post, Stefan will tell you have to recognize them and how to treat them.

BACKGROUND

Chilblains are tender red or purple mottled like bumps that occur as a reaction to the cold and can occasionally be itchy in nature. They are a localised form of vasculitis. Chilblains are also known as pernio or perniosis.

WHO IS AFFECTED

Chilblains most commonly affects the elderly and children in damp, temperate climates. Chilblains in children may recur each winter for a few years and then clear up. Chilblains in elderly people tend to get worse every year unless precipitating factors are avoided.

CAUSE

Chilblains generally occurs several hours after exposure to the cold. Cold causes constriction of the small arteries and veins in the skin. They can be sometimes aggravated by sun exposure, because rewarming results in leakage of blood into the tissues and swelling of the skin. Chilblains are less common in countries where the cold is more extreme because the air is drier and people are better equipped for the weather. Chilblains are more likely to develop in those with poor peripheral circulation, noted by blue-red mottled skin on the limbs (acrocyanosis).

ASSOCIATED FACTORS

Other factors contributing to chilblains include:

  • Familial tendency to chilblains
  • Peripheral vascular disease, due to diabetes, smoking, High cholesterol
  • Low body weight or malnutrition
  • Hormonal changes: chilblains can improve during pregnancy
  • Connective tissue disease, mostly lupus erythematosus or, in association with Raynaud phenomenon, systemic sclerosis.
  • Bone marrow disorders

PRESENTATION

Each chilblain can occur several hours following exposure to cold climates and can present as an itchy red swelling and subsides over the next seven to fourteen days or longer. In severe cases, blistering, pustules, scabs and ulceration can occur. Occasionally the lesions may be ring-shaped. Chilblains may become thickened and persist for months.

Common sites for chilblains are:

  • Backs and sides of the fingers and toes
  • Heels
  • Lower legs
  • Thighs
  • Wrists of babies
  • Over a fatty lump (lipoma)
  • Nose
  • Ears

TREATMENT

Chilblains generally respond poorly to treatment. Topical corticosteroid cream applied accurately for a few days are beneficial to relieve the itch and swelling while antibiotic ointment or oral antibiotics for secondary infections are commonly used.

PREVENTION

People with a tendency to chilblains must keep their hands and feet warm to reduce the risk of chilblains. Warming of the extremities must be achieved in a gradual manner and not abruptly to prevent permanent damage. Other preventative measures may include:

  • Avoid Nicotine products such as cigarettes as they can constrict the blood vessels, so smokers must stop smoking.
  • Home and workplace should be heated in winter.
  • Warm clothing should include gloves, thick woollen socks and comfortable protective footwear.
  • Medicines that constrict blood vessels should be minimised, including caffeine, decongestants and diet aids.
  • Ointments such as Hirudoid cream can aid to minimise bruising and relieve pain and inflammation
  • Vigorous indoor exercise keeps the body warm
  • Soaking hands in warm water for several minutes warms them for up to several hours.

Thanks for reading,

Stefan

We have HICAPS available in our clinic, which means that our patients can claim from their private health fund straight away

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Shop 2/17-19 East Parade
Sutherland, NSW 2232

Tel: 02 9542 3491
Email: info@sutherlandpodiatry.com.au