Chilblains
are a medical condition that is often confused with frostbite

Frostbite

Frostbite is the medical condition where localized damage is caused to skin and other tissues due to extreme cold. Frostbite is most likely to happen in body parts farthest from the heart and those with large exposed areas...

 and trench foot

Trench foot

Trench foot is a medical condition caused by prolonged exposure of the feet to damp, unsanitary, and cold conditions. It is one of many immersion foot syndromes...

. Chilblains are acral ulcers (that is, ulcers affecting the extremities) that occur when a predisposed individual is exposed to cold and humidity. The cold exposure damages capillary beds in the skin

Skin

-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...

, which in turn can cause redness, itching, blisters, and inflammation

Inflammation

Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...

. Chilblains are often idiopathic

Idiopathic

Idiopathic is an adjective used primarily in medicine meaning arising spontaneously or from an obscure or unknown cause. From Greek ἴδιος, idios + πάθος, pathos , it means approximately "a disease of its own kind". It is technically a term from nosology, the classification of disease...

 in origin but can be manifestations of serious medical conditions that need to be investigated. Chilblains can be prevented by keeping the feet and hands warm in cold weather. A history of chilblains is suggestive of a connective tissue disease

Connective tissue disease

A connective tissue disease is any disease that has the connective tissues of the body as a target of pathology. Connective tissue is any type of biological tissue with an extensive extracellular matrix that supports, binds together, and protects organs...

.

Symptoms

The areas most affected are the ears

Ear

The ear is the organ that detects sound. It not only receives sound, but also aids in balance and body position. The ear is part of the auditory system....

, earlobes, nose

Human nose

The visible part of the human nose is the protruding part of the face that bears the nostrils. The shape of the nose is determined by the ethmoid bone and the nasal septum, which consists mostly of cartilage and which separates the nostrils...

, and extremities

Limb (anatomy)

A limb is a jointed, or prehensile , appendage of the human or other animal body....

; feet & toes

Toe

Toes are the digits of the foot of a tetrapod. Animal species such as cats that walk on their toes are described as being digitigrade. Humans, and other animals that walk on the soles of their feet, are described as being plantigrade; unguligrade animals are those that walk on hooves at the tips of...

, hands

Hand

A hand is a prehensile, multi-fingered extremity located at the end of an arm or forelimb of primates such as humans, chimpanzees, monkeys, and lemurs...

 & fingers

Finger

A finger is a limb of the human body and a type of digit, an organ of manipulation and sensation found in the hands of humans and other primates....

.

• Blistering
  Blister
  A blister is a small pocket of fluid within the upper layers of the skin, typically caused by forceful rubbing , burning, freezing, chemical exposure or infection. Most blisters are filled with a clear fluid called serum or plasma...
  
   of affected area
• Burning and itching sensation in extremities
• Dermatitis
  Dermatitis
  -Etymology:Dermatitis derives from Greek derma "skin" + -itis "inflammation" and genetic disorder.-Terminology:There are several different types of dermatitis. The different kinds usually have in common an allergic reaction to specific allergens. The term may describe eczema, which is also called...
  
   in extremities
• Digital
  Digit (anatomy)
  A digit is one of several most distal parts of a limb, such as fingers or toes, present in many vertebrates.- Names:Some languages have different names for hand and foot digits ....
  
   ulceration
• Erythema
  Erythema
  Erythema is redness of the skin, caused by hyperemia of the capillaries in the lower layers of the skin. It occurs with any skin injury, infection, or inflammation...
  
   (blanchable
  Blanch (medical)
  When skin is blanched, it takes on a whitish appearance as blood flow to the region is prevented. This occurs during and is the basis of the physiologic test known as diascopy....
  
   redness of the skin)
• Pain
  Pain
  Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
  
   in affected area
• Skin discoloration, red to dark blue
• Symptoms worsen when exposed to warmth

Treatments

• Keep area warm
• Nifedipine
  Nifedipine
  Nifedipine is a dihydropyridine calcium channel blocker...
  
   may be used in more severe or recurrent cases. Its vasodilation
  Vasodilation
  Vasodilation refers to the widening of blood vessels resulting from relaxation of smooth muscle cells within the vessel walls, particularly in the large arteries, smaller arterioles and large veins. The process is essentially the opposite of vasoconstriction, or the narrowing of blood vessels. When...
  
   helps reduce pain, facilitate healing and prevent recurrences.
• Diltiazem
  Diltiazem
  Diltiazem is a non-dihydropyridine member of the class of drugs known as calcium channel blockers, used in the treatment of hypertension, angina pectoris, and some types of arrhythmia....
  
   may also be used.

Exposure

• Avoid rapid changes in temperature.
• Wear gloves and socks.
• Use warm footwear.
• Keep hands and feet warm.
• Avoid tight fitting socks/shoes
• Place cotton wool between the toes to improve circulation

Dietary

• Healthy diet
• Exercise to improve circulation
• Avoid alcohol before going out in snow

History

The medieval Bald's Leechbook

Bald's Leechbook

The Leechbook of Bald is an Old English medical text probably compiled in the ninth-century, possibly under the influence of Alfred the Great's educational reforms....

 recommended that chilblains be treated with a mix of eggs, wine, and fennel

Fennel

Fennel is a plant species in the genus Foeniculum . It is a member of the family Apiaceae . It is a hardy, perennial, umbelliferous herb, with yellow flowers and feathery leaves...

 root.
An old Irish remedy was to place the affected digits in a bowl of water in which potatoes had been boiled.

See also

• Erythrocyanosis crurum
  Erythrocyanosis crurum
  Erythrocyanosis crurum is a skin condition, a variant of acrocyanosis caused by chronic exposure to cold....
  
  
• Equestrian perniosis
  Equestrian perniosis
  Equestrian perniosis is a skin condition that presents on the lateral thighs of women equestrians who ride on cold damp days....
  
  
• Trench foot
  Trench foot
  Trench foot is a medical condition caused by prolonged exposure of the feet to damp, unsanitary, and cold conditions. It is one of many immersion foot syndromes...
  
  
• Frostbite
  Frostbite
  Frostbite is the medical condition where localized damage is caused to skin and other tissues due to extreme cold. Frostbite is most likely to happen in body parts farthest from the heart and those with large exposed areas...
  
  

External links

• Cold stress, National Institute for Occupational Safety and Health