Frostnip & Chilblains (Erythema Pernio)

Key Features

• Frostnip: superficial nonfreezing injury

• Chilblains: inflammatory skin changes caused by exposure to cold without actual freezing of the tissues

Clinical Findings

• Frostnip

  • Involved area has local paresthesias that completely resolve with passive external rewarming

  • Distinct from frostbite in that ice crystals form on the skin but not within tissues and no tissue loss occurs

• Chilblains

  • Skin lesions may be red or purple papular lesions, which are painful or pruritic, with burning or paresthesias

  • May be associated with edema or blistering and aggravated by warmth

  • With continued exposure, ulcerative or hemorrhagic lesions may appear and progress to scarring, fibrosis, and atrophy

Diagnosis

• Diagnoses usually made clinically after a detailed history of cold exposure

Treatment

• Consists of elevating and passively externally rewarming the affected part

• Rewarming can be done by

  • Placing cold fingers in the axilla

  • Removing footwear, drying feet, rewarming, and covering with adequate dry socks or other protective footwear