Document Detail


Chilblains in Southern California: two case reports and a review of the literature.
MedLine Citation:
PMID:  25416648     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Chilblains or perniosis is an acrally located cutaneous eruption that occurs with exposure to cold. Chilblains can be classified into primary and secondary forms. The primary or idiopathic form is not associated with an underlying disease and is clinically indistinguishable from the secondary form. The secondary form is associated with an underlying condition such as connective tissue disease, monoclonal gammopathy, cryoglobulinemia, or chronic myelomonocytic leukemia. Histopathology cannot accurately help distinguish the primary from secondary forms of chilblains. This article will raise the awareness of chilblains by presenting two unusual case reports of chilblains in men from Southern California with discussion of the appropriate evaluation and treatment of this condition.Case presentations: Case 1A 56-year-old Caucasian man presented in January to a Southern California primary care clinic with a report of tingling and burning in both feet, followed by bluish discoloration and swelling as well as blistering. He had no unusual cold exposure prior to the onset of his symptoms. He had a history of "white attacks" in his hands consistent with Raynaud's phenomenon. His symptoms gradually resolved over a 3-week period.Case 2A 53-year-old Caucasian man also presented to a Southern California clinic in January with a 3-week history of painful tingling in his toes, and subsequent purplish-black discoloration of the toes in both feet. His symptoms occurred 1 week after a skiing trip. He had partial improvement with warming measures. His symptoms resolved 2 weeks after his initial presentation.
CONCLUSIONS: Chilblains is a relatively uncommon entity in warmer climates but can present during the winter months. Primary care providers in warmer climates such as Southern California in the USA may be unfamiliar with its presentation. It can be diagnosed clinically by the appearance of typical lesions during the cold damp season. Through a thorough history, physical examination and selected laboratory evaluation, underlying connective tissue disease or a mimic such as vasculitis or cutaneous leukemia can be excluded.
Authors:
Rebecca Gordon; Anne M Arikian; Anita S Pakula
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-22
Journal Detail:
Title:  Journal of medical case reports     Volume:  8     ISSN:  1752-1947     ISO Abbreviation:  J Med Case Rep     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-22     Completed Date:  -     Revised Date:  2014-11-25    
Medline Journal Info:
Nlm Unique ID:  101293382     Medline TA:  J Med Case Rep     Country:  -    
Other Details:
Languages:  ENG     Pagination:  381     Citation Subset:  -    
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