Chilblains in Southern California: two case reports and a review of the literature

Journal of Medical Case Reports

Anita S Pakula³  Anne M Arikian¹  Rebecca Gordon² 

[1] UCLA Department of Family Medicine Family Health Center, 1920 Colorado Avenue, Santa Monica, CA 90404, USA;UCLA Department of Rheumatology, 2020 Santa Monica Blvd., Suite 540, Santa Monica, CA 90403, USA;UCLA Division of Dermatology, 10833 Le Conte Avenue, CHS 52-121, Los Angeles, CA 90095, USA

关键词: Secondary chilblains;    Perniosis;    Pernio;    Idiopathic chilblains;    Chilblains;    Chilblain lupus;   

Others  :  1180972
DOI  :  10.1186/1752-1947-8-381

 received in 2014-03-25, accepted in 2014-09-01,  发布年份 2014

【 摘 要 】

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 1

A 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 2

A 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.

【 授权许可】

   
2014 Gordon et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 3.

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