Chilblains or pernio is term to describe an abnormal inflammatory response in acral skin (fingers and toes) in response to cold exposure. It mainly occurs in areas that have a cold and damp weather.

What does it look like?

The lesions present on the fingers and toes with multiple red-blue papules, nodules and erosions. It is often initially painful then becomes very pruritic.

How is it treated?

Prevention is through avoidance of exposure to cool damp weather and wearing proper clothing. Treatment of active lesions is mid-high potency topical corticosteroids. Those who suffer recurrent episodes may be treated with calcium-channel blockers such as nifedipine.