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ChilblainsAka: Pernio

Pathophysiology
1. Skin reaction to cold, damp conditions
Symptoms
1. Onset
  1. Lesions following cold exposure
2. Location:
  1. Inflammatory lesions of hands and feet
3. Associated symptoms
  1. Lesions itch, burn or are painful
4. Course
  1. Develops over hours or days and slowly subsides
Signs
1. Rash on hands and feet
  1. Multiple erythematous, purplish Papules or Nodules
Lab: Skin biopsy
1. Blood vessel wall thickening
2. Perivascular lymphocytic infiltrates
3. Edema of papillary Dermis
Management
1. Rest
2. Warmth
3. Antipruritics
4. Analgesics
5. Nifedipine 20 mg PO tid
Prevention
1. Adequate clothing and home heating
2. Short course of UV light at the beginning of winter

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