Chilblains, also known as pernio, is a medical condition in which damage occurs to capillary beds in the skin, most often in the hands or feet, when blood perfuses into the nearby tissue, resulting in redness, itching, inflammation, and possibly blisters.[2]
It occurs most frequently when predisposed individuals, predominantly women,[3] are exposed to cold and humidity. Ulcerated chilblains are referred to as kibes. Temperature-related chilblains can be prevented by keeping the feet and hands warm in cold weather and avoiding exposing these areas to extreme temperature changes. Once the diagnosis of chilblains is made, first-line treatment includes avoiding cold, damp environments and wearing gloves and warm socks.[3]
Nifedipine and amlodipine, which are vasodilators in the class of drugs known as calcium channel blockers, may help in some cases.[7]Vasodilation may reduce pain, facilitate healing, and prevent recurrences.[8] It is typically available in an oral pill but can be compounded into a topical formula.
The word is a compound of Modern Englishchill ‘cold’ and the archaic word blain (now used only in the word in question), meaning ‘swelling’, ‘blister’ or ‘sore’ and derived from Old Englishbleġen, bleġene, having the same meaning.[10]
Historyedit
The medieval Bald's Leechbook recommended treating chilblains with a mixture of eggs, wine, and fennel root.[11] A modern-day home remedy is to put garlic on the chilblains.[12] While neither of these remedies has been supported by scientific research, vasodilating, rubiefacient and warming herbal remedies, both topical and internal are prescribed and efficacious.
COVID-19edit
Chilblain-like symptoms have also been linked to COVID-19.[13][14][15]COVID toes, as they are commonly known,[16][17][18] have mostly been reported in older children and adolescents,[19][18] who often have not had other symptoms of COVID-19.[20] The symptoms are usually mild and disappear without treatment.[19][18] Their cause is debated: it is uncertain whether COVID toes are a delayed consequence of the viral infection itself or are, at least partially, connected to environmental factors during the COVID-19 pandemic.[16][17][21] They may share some of the microscopic features of chilblains caused by lupus.[20] It has been suggested that in the absence of exposure to cold and damp, COVID-19 should be considered as a possible cause of chilblains.[20]
In a study at the dermatology department of Saint-Louis Hospital in Paris, researchers found that most of their study participants carried high levels of autoantibodies, proteins generated by the immune system that inadvertently attack the body's own tissues. Compared with healthy individuals, the participants showed high activity of proteins called type 1 interferons, which switch on pathogen-fighting genes in immune cells.[22]
^James, William D.; Elston, Dirk M.; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac M. (2020). "Dermatoses Resulting From Physical Factors". Andrews' Diseases of the Skin (13th ed.). Elsevier. pp. 18–45. ISBN9780323547536.
^Cold Stress: Chilblains. National Institute for Occupational Safety and Health. Retrieved January 6, 2009.
^ abBeuscher, Tara L.; Andrews, Sarah E. (November 2020). "What Are COVID Toes? A Case Study". Journal of Wound, Ostomy & Continence Nursing. 47 (6): 619–621. doi:10.1097/WON.0000000000000711. PMID 33201148. S2CID 226988942.
^ ab"By the way, doctor: What can I do about chilblains?". Harvard Health. 1 December 2010. Retrieved 31 May 2020.
^ abcde"What are chilblains (pernio)? What causes chilblains?". Medical News Today. 20 December 2017.
^. Chilblains.org. Archived from the original on 2014-11-24. Retrieved 2014-09-02.
^Rustin, M.H.A.; Newton, Julia A.; Smith, N.P.; Dowd, Pauline M. (2006). "The treatment of chilblains with nifedipine: the results of a pilot study, a double-blind placebo-controlled randomized study and a long-term open trial". British Journal of Dermatology. 120 (2): 267–75. doi:10.1111/j.1365-2133.1989.tb07792.x. PMID 2647123. S2CID 13230013.
^Simon, T. D.; Soep, JB; Hollister, JR (2005). "Pernio in Pediatrics". Pediatrics. 116 (3): e472–5. doi:10.1542/peds.2004-2681. PMID 16140694. S2CID 2091725.
^Patra, AK; Das, AL; Ramadasan, P (2003). "Diltiazem vs. nifedipine in chilblains: A clinical trial". Indian Journal of Dermatology, Venereology and Leprology. 69 (3): 209–11. PMID 17642888.
^https://en.wiktionary.org/wiki/chilblain Retrieved at 8.45 on Wednesday 20/12/23.
^Robert Lacey and Danny Danziger August: The Year 1000: What Life Was Like at the Turn of the First Millennium Little, Brown, 2000 ISBN0316511579[page needed]
^"Remedios caseros para sabañones". saludplena.com (in Spanish). Retrieved 29 December 2016.
^Wollina U, Karadağ AS, Rowland-Payne C, Chiriac A, Lotti T (2020). "Cutaneous signs in COVID-19 Patients: a review". Dermatologic Therapy. 33 (5): e13549. doi:10.1111/dth.13549. PMC7273098. PMID 32390279.
^Young S, Fernandez AP (2020). "Skin manifestations of COVID-19". Cleveland Clinic Journal of Medicine. doi:10.3949/ccjm.87a.ccc031. PMID 32409442.
^Kaya G, Kaya A, Saurat JH (June 2020). "Clinical and histopathological features and potential pathological mechanisms of skin lesions in COVID-19: review of the literature". Dermatopathology. 7 (1): 3–16. doi:10.3390/dermatopathology7010002. PMC7583593. PMID 32608380. In acral chilblain-like lesions, a diffuse dense lymphoid infiltrate of the superficial and deep dermis, as well as hypodermis, with a prevalent perivascular pattern and signs of endothelial activation, are observed.
^ abMassey PR, Jones KM (May 2020). "Going viral: A brief history of chilblain-like skin lesions ("COVID toes") amidst the COVID-19 pandemic". Seminars in Oncology. 47 (5): 330–334. doi:10.1053/j.seminoncol.2020.05.012. PMC7245293. PMID 32736881.
^ abBristow IR, Borthwick AM (June 2020). "The mystery of the COVID toes – turning evidence-based medicine on its head". Journal of Foot and Ankle Research. 13 (1): 38. doi:10.1186/s13047-020-00408-w. PMC7309429. PMID 32576291.
^ abcRocha, Kelvin Oliveira; Zanuncio, Virgínia Vinha; Freitas, Brunnella Alcântara Chagas de; Lima, Luciana Moreira (2021). ""COVID toes": A meta-analysis of case and observational studies on clinical, histopathological, and laboratory findings". Pediatric Dermatology. 38 (5): 1143–1149. doi:10.1111/pde.14805. ISSN 1525-1470. PMC8646534. PMID 34515379.
^ abWalker DM, Tolentino VR (June 2020). "COVID-19: The impact on pediatric emergency care". Pediatric Emergency Medicine Practice. 17 (Suppl 6-1): 1–27. PMID 32496723.
^ abcLadha MA, Luca N, Constantinescu C, Naert K, Ramien ML (August 2020). "Approach to chilblains during the COVID-19 pandemic". Journal of Cutaneous Medicine and Surgery. 24 (5): 504–517. doi:10.1177/1203475420937978. PMID 32741218.
^Unusual coronavirus (COVID-19) symptoms: What are they?
Cold stress, National Institute for Occupational Safety and Health
March 17, 2024
chilblains, also, known, pernio, medical, condition, which, damage, occurs, capillary, beds, skin, most, often, hands, feet, when, blood, perfuses, into, nearby, tissue, resulting, redness, itching, inflammation, possibly, blisters, other, namespernio, pernion. Chilblains also known as pernio is a medical condition in which damage occurs to capillary beds in the skin most often in the hands or feet when blood perfuses into the nearby tissue resulting in redness itching inflammation and possibly blisters 2 ChilblainsOther namesPernio perniones perniosis 1 Toes inflamed by chilblainsPronunciation ˈ tʃ ɪ l b l eɪ n z SpecialtyInternal medicine podiatryIt occurs most frequently when predisposed individuals predominantly women 3 are exposed to cold and humidity Ulcerated chilblains are referred to as kibes Temperature related chilblains can be prevented by keeping the feet and hands warm in cold weather and avoiding exposing these areas to extreme temperature changes Once the diagnosis of chilblains is made first line treatment includes avoiding cold damp environments and wearing gloves and warm socks 3 Chilblains can be idiopathic spontaneous and unrelated to another disease but similar symptoms may also be a manifestation of another serious medical condition that must be investigated Related medical conditions include Raynaud syndrome erythromelalgia frostbite and trench foot as well as connective tissue diseases such as lupus or vasculitis In infants affected by Aicardi Goutieres syndrome a rare inherited condition which affects the nervous system chilblain like symptoms occur together with severe neurologic disturbances and unexplained fevers Contents 1 Signs and symptoms 2 Prevention 2 1 Exposure 2 2 Other 3 Treatment 4 Etymology 5 History 6 COVID 19 7 See also 8 References 9 External linksSigns and symptoms edit nbsp Chilblains of the feet caused by excessive exposure to cold and humidityThe areas most affected are the toes fingers earlobes nose citation needed Blistering of affected area Burning and itching sensation in extremities Dermatitis in extremities Ulceration severe cases only Erythema blanchable redness of the skin Pain in affected area Skin discoloration red to dark blueChilblains caused by exposure to low temperatures usually heal within 7 14 days Prevention editExposure edit Keep affected area warm and avoid any extreme temperature changes including very hot water 4 5 Keep affected area dry 6 Wear warm shoes socks and gloves 5 Wear a hat and a scarf to protect the ears and the nose 5 Avoid tight fitting socks shoes Other edit Exercise at least four times a week to improve circulation 5 Quit smoking as it damages circulation 4 Treatment editNifedipine and amlodipine which are vasodilators in the class of drugs known as calcium channel blockers may help in some cases 7 Vasodilation may reduce pain facilitate healing and prevent recurrences 8 It is typically available in an oral pill but can be compounded into a topical formula Diltiazem a vasodilator may help 9 Apply a mixture of friar s balsam and a weak iodine solution 5 Etymology editThe word is a compound of Modern English chill cold and the archaic word blain now used only in the word in question meaning swelling blister or sore and derived from Old English bleġen bleġene having the same meaning 10 History editThe medieval Bald s Leechbook recommended treating chilblains with a mixture of eggs wine and fennel root 11 A modern day home remedy is to put garlic on the chilblains 12 While neither of these remedies has been supported by scientific research vasodilating rubiefacient and warming herbal remedies both topical and internal are prescribed and efficacious COVID 19 editChilblain like symptoms have also been linked to COVID 19 13 14 15 COVID toes as they are commonly known 16 17 18 have mostly been reported in older children and adolescents 19 18 who often have not had other symptoms of COVID 19 20 The symptoms are usually mild and disappear without treatment 19 18 Their cause is debated it is uncertain whether COVID toes are a delayed consequence of the viral infection itself or are at least partially connected to environmental factors during the COVID 19 pandemic 16 17 21 They may share some of the microscopic features of chilblains caused by lupus 20 It has been suggested that in the absence of exposure to cold and damp COVID 19 should be considered as a possible cause of chilblains 20 In a study at the dermatology department of Saint Louis Hospital in Paris researchers found that most of their study participants carried high levels of autoantibodies proteins generated by the immune system that inadvertently attack the body s own tissues Compared with healthy individuals the participants showed high activity of proteins called type 1 interferons which switch on pathogen fighting genes in immune cells 22 See also editEquestrian perniosis Erythrocyanosis crurum Raynaud s diseaseReferences edit James William D Elston Dirk M Treat James R Rosenbach Misha A Neuhaus Isaac M 2020 Dermatoses Resulting From Physical Factors Andrews Diseases of the Skin 13th ed Elsevier pp 18 45 ISBN 9780323547536 Cold Stress Chilblains National Institute for Occupational Safety and Health Retrieved January 6 2009 a b Beuscher Tara L Andrews Sarah E November 2020 What Are COVID Toes A Case Study Journal of Wound Ostomy amp Continence Nursing 47 6 619 621 doi 10 1097 WON 0000000000000711 PMID 33201148 S2CID 226988942 a b By the way doctor What can I do about chilblains Harvard Health 1 December 2010 Retrieved 31 May 2020 a b c d e What are chilblains pernio What causes chilblains Medical News Today 20 December 2017 Chilblains org 1 Online Source for Treatments Prevention Relief Advice Chilblains org Archived from the original on 2014 11 24 Retrieved 2014 09 02 Rustin M H A Newton Julia A Smith N P Dowd Pauline M 2006 The treatment of chilblains with nifedipine the results of a pilot study a double blind placebo controlled randomized study and a long term open trial British Journal of Dermatology 120 2 267 75 doi 10 1111 j 1365 2133 1989 tb07792 x PMID 2647123 S2CID 13230013 Simon T D Soep JB Hollister JR 2005 Pernio in Pediatrics Pediatrics 116 3 e472 5 doi 10 1542 peds 2004 2681 PMID 16140694 S2CID 2091725 Patra AK Das AL Ramadasan P 2003 Diltiazem vs nifedipine in chilblains A clinical trial Indian Journal of Dermatology Venereology and Leprology 69 3 209 11 PMID 17642888 https en wiktionary org wiki chilblain Retrieved at 8 45 on Wednesday 20 12 23 Robert Lacey and Danny Danziger August The Year 1000 What Life Was Like at the Turn of the First Millennium Little Brown 2000 ISBN 0316511579 page needed Remedios caseros para sabanones saludplena com in Spanish Retrieved 29 December 2016 Wollina U Karadag AS Rowland Payne C Chiriac A Lotti T 2020 Cutaneous signs in COVID 19 Patients a review Dermatologic Therapy 33 5 e13549 doi 10 1111 dth 13549 PMC 7273098 PMID 32390279 Young S Fernandez AP 2020 Skin manifestations of COVID 19 Cleveland Clinic Journal of Medicine doi 10 3949 ccjm 87a ccc031 PMID 32409442 Kaya G Kaya A Saurat JH June 2020 Clinical and histopathological features and potential pathological mechanisms of skin lesions in COVID 19 review of the literature Dermatopathology 7 1 3 16 doi 10 3390 dermatopathology7010002 PMC 7583593 PMID 32608380 In acral chilblain like lesions a diffuse dense lymphoid infiltrate of the superficial and deep dermis as well as hypodermis with a prevalent perivascular pattern and signs of endothelial activation are observed a b Massey PR Jones KM May 2020 Going viral A brief history of chilblain like skin lesions COVID toes amidst the COVID 19 pandemic Seminars in Oncology 47 5 330 334 doi 10 1053 j seminoncol 2020 05 012 PMC 7245293 PMID 32736881 a b Bristow IR Borthwick AM June 2020 The mystery of the COVID toes turning evidence based medicine on its head Journal of Foot and Ankle Research 13 1 38 doi 10 1186 s13047 020 00408 w PMC 7309429 PMID 32576291 a b c Rocha Kelvin Oliveira Zanuncio Virginia Vinha Freitas Brunnella Alcantara Chagas de Lima Luciana Moreira 2021 COVID toes A meta analysis of case and observational studies on clinical histopathological and laboratory findings Pediatric Dermatology 38 5 1143 1149 doi 10 1111 pde 14805 ISSN 1525 1470 PMC 8646534 PMID 34515379 a b Walker DM Tolentino VR June 2020 COVID 19 The impact on pediatric emergency care Pediatric Emergency Medicine Practice 17 Suppl 6 1 1 27 PMID 32496723 a b c Ladha MA Luca N Constantinescu C Naert K Ramien ML August 2020 Approach to chilblains during the COVID 19 pandemic Journal of Cutaneous Medicine and Surgery 24 5 504 517 doi 10 1177 1203475420937978 PMID 32741218 Unusual coronavirus COVID 19 symptoms What are they Nicoletta Lanese 2021 10 07 We might finally know what causes COVID toes livescience com Retrieved 2022 01 08 External links edit nbsp Look up chilblains in Wiktionary the free dictionary nbsp Wikimedia Commons has media related to Chilblains DermAtlas 1683395337 Cold stress National Institute for Occupational Safety and Health Retrieved from https en wikipedia org w index php title Chilblains amp oldid 1200834709, wikipedia, wiki, book, books, library,
