New Delhi, Jan 8 (IANSlife): Chilblains is a medical condition characterised by localized erythematous subcutaneous swelling following exposure to cold. It is also known as ‘Pernio. Dr. Mahima Talwar, Dermatologist with the Fortis Hospital Shalimar Bagh shares the symptoms and treatment for this common ailment.

**Pathogenesis

It occurs as an abnormal reaction of body to cold exposure followed by rewarming. Increased blood viscosity results in sluggish blood flow through superficial vessels, which are already under spasm. Rewarming of skin causes exudation of fluid into surrounding tissue.

**Risk factors

Women are more susceptible

History of Raynaud's disease

May be associated with lupus, leukemia and poliomyelitis.

**Signs and symptoms may include

Localized doughy erythematous swelling in areas exposed to cold specially on dorsal aspect of proximal phalanges of fingers and toes, lower lip , heels and ear within 12 - 24 hours after exposure to cold.

**Severe itching

May be associated with burning sensation

Changes in skin color from red to dark blue

May be accompanied by pain

** Complications

Associated with blistering and ulceration in severe cases

Chronic Pernio- in presence of arterial and systemic disease , it may lead to irreversible changes such as hyperkeratosis , lymphedema and scarring.

**Treatment

Acute lesions are mostly self-limiting. The treatment mainly consists of proper clothing and heating.

Avoid or limit exposure to cold

Cover all exposed areas

Keep hands, feet and face dry, clean and warm.

Phototherapy with UV light may be beneficial.

Antipruritic lotion or topical steroid cream may provide symptomatic relief.

Nifedipine may be used in severe cases.