Chilblains (pernio) refers to a fairly characteristic skin disorder which occurs mainly in children. It consists of doughy, blue swelling of localized areas of cold-exposed skin. Whereas frostbite results from freezing temperatures, chilblains result from exposure to more moderate exposure to temperatures above the freezing point, usually when it is damp and cold but not freezing. It is most common in cold damp climates such as northwestern Europe and the more northern coastal areas of the US.

The skin changes appear about 12-24 hours after cold exposure. The areas involved are usually the cheeks, ears, or hands, and are usually symmetric. Severe cases can progress to skin breakdown and ulceration, but this is unusual.

Chilblains get better without treatment1 in one to three weeks. Naturally, avoidance of additional cold exposure during recovery makes sense. The main reason to be aware of them is that they can mimic more exotic medical conditions and may lead to a lot of unnecessary lab work.

1Nifedipine has been used for severe cases with tissue breakdown. Dermatology in General Medicine, Fitzpatrick et al, McGraw-Hill, 1993; p. 1583-1584

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