Chilblains

Also known as pernio or perniosis, a chilblain is an abnormal skin reaction to cold or damp weather in humid climates. It is painful swelling that also has red, burning and itching feelings that are intensified when coming in from the cold. Chilblains is a medical condition that is often confused with frostbite and trench foot. 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, which in turn can cause redness, itching, blisters, and inflammation. The skin may also break down over the swelling which may become infected. The toes, fingers, nose and ears are most common areas for appearance. Chilblains are often idiopathic in origin but can be manifestations of serious medical conditions that need to be investigated. ETIOLOGY EXTERNAL CAUSE • Cold. PREDISPOSING CAUSES • Poor peripheral circulation. • Poor general health. • Vasomotor irritability. • Constitution: o Fat, phlegmatic subject. o Thin, highly strung, nervous subjects. WEATHER • Common in winters. SEX • Common in females. CLINICAL FEATURES of Chilblains ONSET • Acute. LOCATION • Toes, fingures, ears, tip of nose. Symptoms • Ulceration of the digits and toes. • Red nose. • Skin redness. • Toe skin inflammation. • Finger skin inflammation. • Earlobe inflammation. • Intense, distressing itching and burning pain. • Worse from sudden change from cold to hot atmosphere. LESION • Parts become dusky red, cold. • Bilaterally symmetrical. • Oedema of affected parts. • Heals with change of weather. • Mild desquamation occurs at site of lesion. • Brownish mark left on resolution. COMPLICATIONS • Ulceration. General management • Avoid exposure to cold. • Keep feet, hands warm by wearing warm shoes & gloves. • Improve general health. • Wash hands with warm water. • Thorough drying after washing. Prevention of Chilblains Exposure • Avoid rapid changes in temperature. • Wear gloves or socks. • Use warm footwear. • Keep area warm. • Avoid scratching. • Keep hands and feet warm. Dietary • Healthy diet. • Exercise. • High doses of vitamin K. • Avoid alcohol before going out in snow. HOMOEOPATHIC TREATMENT • Abrotanum. • Agaricus. • Borax. • Calendula. • Heper sulph. • Lachesis. • Petroleum. • Rhus-ven. • Sulphur. ABROTANUM The characteristic is sensation of itching in the lesion. Loose & flabby skin. Skin becomes purplish after suppression of eruptions. This is especially indicated in persons with tendency towards marasmus. In general worse by cold air, wet weather. Alternate constipation and diarrhoea: lienteria. Marasmus of children with marked emaciation, especially of legs; the skin is flabby and hangs loose in folds. AGARICUS Burning, itching, redness & swelling as if frozen. Itching change place on scratching. Pricking as from needles. Chilblains more painful during cold weather, freezing air. Worse after alcohol. Persons with light hair; skin and muscles lax. Old people, with weak, indolent circulation. Drunkards, especially for their headaches; bad effects after a debauch. Delirium: with constant raving; tries to get out of bed; in typhoid or typhus. Headache: of those who readily become delirious in fever or with pain; of persons subject to chorea, twitchings or grimaces; from spinal affections. Chilblains, that itch and burn intolerably; frostbite and all consequences of exposure to cold, especially in face. BORAX Extreme dryness of the skin. Withered, witted, wrinkled skin. Tendency to develop whitish pimples with red areola. Slightest injury suppurates. Dread of downward motion in nearly all complaints. CALENDULA Tendency to develop chilblains after an injury with formation of ulcers with excessive secretion of pus. The surrounding part is red. The pain in the chilblains tend to become worse at night. Traumatic affections: to secure union by first intention and prevent suppuration. In all cases of loss of soft parts when union cannot be effected by means of adhesive plaster. External wounds with or without loss of substance; torn and jagged looking wounds; post-surgical operations; to promote healthy granulation and prevent excessive suppuration and disfiguring scars. Traumatic and idiopathic neuroma; neuritis from lacerated wounds; exhausted from loss of blood and excessive pain. Rupture of muscles or tendons; lacerations during labor; wounds penetrating articulations with loss of synovial fluids. Wounds: with sudden pain during febrile heat; constitutional tendency to erysipelas; old, neglected, offensive, threatening gangrene. HEPER SULPH. The skin is extremely sensitive tocold air. Tendency to develop deep cracks with chilblains. Better by warm application, warm wraps & heat. Worse in cold air, winter & cold application. Easy suppuration developing in chilblains. For torpid lymphatic constitutions; persons with light hair and complexion, slow to act, muscles soft and flabby. The slightest injury causes suppuration. Diseases where the system has been injured by the abuse of Mercury. In diseases where suppuration seems inevitable, Hepar may open the abscess and hasten the cure. Oversensitive, physically and mentally; the slightest cause irritates him; quick, hasty speech and hasty drinking. Patient is peevish, angry at the least trifle; hypochondriacal; unreasonably anxious. Extremely sensitive to cold air, imagines he can feel the air if a door is opened in the next room; must be wrapped up to the face even in hot weather; cannot bear to be uncovered; takes cold from slightest exposure to fresh air. LACHESIS Chilblain with bluish-red or bluish-black discoloration round it. Chilblains tends to develop ulceration leading to gangrene. Severe burning sensation worse at night & during sleep. Chilblains are very sensitive to touch. Chilblains bleed easily & copiously. Severe excoriation of the affected part. Persons of a less melancholy temperament, dark eyes, and a disposition to low spirits and indolence. Women of choleric temperament, with freckles and red hair. Better adapted to thin and emaciated than to fleshy persons; to those who have been changed, both mentally and physically, by their illness. PETROLEUM Itching chilblains with chapped hands & feet. Slightest injury on the chilblains tends to suppurate. Severe excoriation of the affected part. Itching sensation & from it moist discharge comes out which is very acrid. In general there is aggravation of symptoms from warmth of bed. Adapted to persons with light hair and skin; irritable, quarrelsome disposition; easily offended at trifles; vexed at everything. Ailments: from riding in a carriage, railroad car, or in a ship. Ailments which are worse before and during a thunderstorm. Symptoms appear and disappear rapidly. During sleep or delirium: imagines that one leg is double; that another person lies along side of him in same bed; that there are two babies in the bed. Vertigo on rising; in occiput as if intoxicated; like seasickness. RHUS-VEN. Chilblains with severe burning sensation. The affected parts looks red, indurated & swollen. Formation of deep corroding, phagadenic ulcers with offensive discharge. Itching is worse by warmth & better by cold. SULPHUR Voluptuous itching sensation. Burning sensation sensitive to air & wind & washing. Chilblains alternate with various other bodily complaints. Skin is dry rough chapped. Offensive odour of skin, worse at night in bed, scratching & washing. Adapted to persons of a scrofulous diathesis, subject to venous congestion; especially of portal system. Persons of nervous temperament, quick motioned, quick tempered, plethoric, skin excessively sensitive to atmospheric changes. For lean, stoop-shouldered persons who walk and sit stooping like old men. Standing is the worst position for sulphur patients; they cannot stand; every standing position is uncomfortable. Dirty, filthy people, prone to skin affections. Aversion to being washed; always <. after a bath.