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Chilblains

Chilblains, also called perniosis or pernio, are a skin inflammation, most commonly seen on the fingers and toes, caused by prolonged exposure to low but not freezing temps and damp.Tight shoes can also contribute by irritating and pressing on the skin of the toes, especially the little toe. Despite the discomfort, chilblains don't cause any permanent damage to tissue. Not everyone exposed to cold and damp conditions will develop chilblains, which leads some researchers to believe that those who do are overly sensitive to changes in weather and temperature. The elderly, sedentary, teenagers and people with medical conditions (such as anaemia) are most susceptible. Chilblains are a painful abnormal reaction of the small blood vessels in the skin when exposed to cold temperatures. Chilblains usually occur several hours after exposure to the cold in temperate humid climates. The cold causes constriction of the small blood vessels in the skin and if rewarming of the skin happens too rapidly, there is leakage of blood into the tissues as the blood vessels do not respond quickly enough to this rewarming. Chilblains are not very common in countries where the cold is more extreme as the air is drier. The living conditions and clothing used in these climates are protective. Chilblains are more likely to develop in those with poor circulation , but chilblains are still common in those with good circulation.

Chilblains often show up in the form of swelling and discoloration and sometimes blisters, sores, and painful nodules under the skin. They can itch something fierce and scratching can lead to a secondary infection. If they're bad enough they can cause numbness and long-lasting temperature sensitivity due to autonomic nerve damage. The body's circulatory system comprises arteries, veins and capillaries that shunt blood to every cell. The circulatory system is sensitive to temperature. In hot conditions, the body expands blood vessels close to the skin so that excess heat can be lost to the air, thereby cooling the body. In cold weather, these blood vessels constrict to conserve body heat. This constriction can starve extremities - such as the toes - of blood and warmth, if your peripheral circulation is sluggish Chilblain may also occur on a pressure bearing area such as a bunion. The cold causes constriction of the small blood vessels in the skin and if rewarming of the skin happens too rapidly, there is leakage of blood into the tissues as the blood vessels do not respond quickly enough to this rewarmin.

Cause of Chilblains

Common causes of Chilblains

  • Abnormal reaction to cold.
  • Chilled skin.
  • Damp living conditions.
  • Familial tendency.
  • Diabetes.
  • Smoking.
  • Hyperlipidaemia.
  • Poor nutrition.
  • Hormonal changes.
  • Lupus erythematosus.
  • Bone marrow disorders
  • Hormonal imbalance.
  • Anemia.

Symptoms of Chilblains

Common Symptoms of Chilblains

  • Burning sensation on the skin.
  • Red, swollen patches.
  • Intense itching
  • Dry skin.
  • Ulceration..
  • Pain.
  • Itchy.
  • Surface of the skin may break and an infection may develop.

Treatment of Chilblains

Common Treatment of Chilblains

  • Heated home and workplace stop up all draughts
  • Warm clothing especially gloves, thick woollen socks and comfortable protective footwear.
  • Exercise vigourously.
  • Wear cotton-lined waterproof gloves for wet work.
  • Sunscreen to exposed skin even on dull days.
  • Take vasodilator medication such as nifedipine prescribed before the onset of cold weather and taken throughout winter. Side effects include flushing and headache.
  • A potent topical steroid applied accurately for a few days may relieve itch and swelling.
  • Antibiotic ointment( Nifedipine and Zambuk) or oral antibiotics(Staphylcoccus aureus,Streptococcus pyogenes ) may be necessary for secondary infection.
 
 

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