Pernio

Pernio, also referred to as chilblains, is a rare inflammatory condition. Chilblains derives from two Old English words "chill" ( cold ) and "blegen" (sore). Most commonly, pernio affects acral skin and primarily results as a response to cold, damp conditions. It is typically idiopathic and acute; however, chronic forms also exist.  Secondary pernio has associations with other conditions--the most common being the association with systemic lupus erythematosus (chilblain lupus erythematosus or CHLE). As a result, even though most pernio cases are idiopathic, the presentation of pernio should prompt the provider to screen for some of the more common secondary conditions known to trigger pernio.  Epidemiologically, pernio typically affects women more often than men and is more common among people residing in cold climates.  The diagnosis is largely clinical and based on a thorough history and physical exam. Biopsies are not a recommendation as the histopathologic findings are non-specific.  Treatment often focuses on prevention. Avoidance of the cold is vital in the prevention of development of the lesions, and several medications, most commonly nifedipine and other calcium channel blockers, have been implicated in aiding in the resolution of existing lesions. Overall, the prognosis of pernio is good with minimal chronic sequelae.