Chilblain lupus erythematosus (Hutchinson). A clinical and laboratory study of 17 patients.

Chilblain lupus erythematosus (LE) is a chronic unremitting form of LE ssen predominantly in women. It occurs commonly on the digits, calves and heels. Nasal lesions are rare. Chronic facial discoid LE usually appears before the chilblain form but, in most instances, resolves even though the chilblain lesions persists. Transformation to systemic LE occurs more often in those who develop both forms of cutaneous LE simultaneously and in the erythema multiforme syndrome. The chilblain lesions are the result of microvascular injury secondary to exposure to cold and possibly hyperviscosity from immunological abnormalities, Elevated serum gammaglobulins, positive latex factor and speckled pattern antinuclear factor are common. None of the usual treatments for cutaneous LE is effective for the chilblain lesions, probably because none is directed towards prevention and treatment of the microvascular stasis.