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For further information, see CMDT Part 37-05: Frostnip & Chilblain (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


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


  • 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

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