A retrospective study of cases presenting with chilblains (Perniosis) in Out Patient Department Of Dermatology, Nepal Medical College and Teaching Hospital (NMCTH).

Chilblains (Perniosis/Pernio) is characterized by painful red-to-purple papular lesions involving the fingers or toes due to non-freezing damp cold that resolves with symptomatic treatment. As in winters, cold is moderate to severe in Kathmandu, this retrospective study was undertaken to find out the incidence of chilblains cases, seeking health care in the Out Patient Department of Dermatology, Nepal Medical College and Teaching Hospital. Cases of chilblains were noted in the months of October to December 2009, January to March 2010, October to December 2010 and January to March 2011. Out of total 49 cases maximum patients (n=25; male 10, female 15) were in the age group of 7-20 years. Rest of them (n=18; male 7, female 11) were in the age group of 21-40 years and only 6 (male 2, female 4) were in the age group of 41-65 years. Amongst all the cases 30 patients were females (61.2%) and 19 were males (38.8%). Most of (79.6%) the chilblain victims sought health care during the months of December to February -- coldest time of the years. The patients were advised to protect their acral parts from cold exposure as far as practicable by wearing shocks and gloves. They were advised not to warm their extremities all on a sudden, after exposure to cold, as this causes vasospasm and makes the condition worse. Extremities should be warmed gradually. Assessing the severity of the condition topical allocation of steroid ointment and/or anti allergic drugs was prescribed, when felt needed.