Synonym. Pernio.
Chilblain
is a recurrent localized erythema and swelling caused by exposure to cold. In
people predisposed by poor peripheral circulation even moderate exposure may
produce chilblain. Acute chilblain is the mildest form of cold injury. This
occurs chiefly on the hands, feet, ears and face of poorly nourished children,
the onset being favored by dampness. Patients are usually unaware of the injury
at first, but later burning, itching and rubor call it to their attention. The
areas are bluish red, the color disappearing on pressure, and are decidedly
cool to the touch, and sometimes clammy due to excessive sweating. Chronic
chilblains occur repeatedly during cold weather and disappear during warm
weather. The affected extremities are cold, cyanotic and often hyperhidrotic.
Treatment.
The treatment is general, as well as local. The circulation should be improved
by regular exercise, and a diet of high vitamin content. Niacin, 0.1 gm.
t.i.d., and Rutin, 0.06 gm. t.i.d., or Banthine 0.05 gm. or Roniacol 0.05 gm.
t.i.d. are used with benefit. Corticoid therapy is useful. The parts should be
cleansed with water and massaged gently with some warm oil each day, and should
be protected against injury and exposure to cold or dampness. If the feet are
affected, woolen socks should be worn at night during the cold months. During
the day two pairs should be worn, and thick boots are advisable. Electric pads
should be used now and then to warm the parts. Hydrocortone ointment may be
applied.