Perniosis, or chilblain, is an uncommon condition of the acral skin. Presented herein is a case report of a 65-year-old otherwise healthy construction worker with perniosis. He had a 3-year history of lesions on the fingers and toes brought on by cold, damp weather. On initial presentation, a biopsy sample was taken of a hallux lesion, and the patient was given a trial course of nifedipine therapy. Follow-up at 3 weeks showed complete relief of symptoms with nifedipine use, and the biopsy results confirmed the diagnosis. The etiology and pathogenesis of perniosis are reviewed. Differential diagnoses and treatment options are reviewed and discussed. Nifedipine therapy has been shown to be effective and should be considered the standard of care in the treatment of perniosis along with avoidance of cold, damp environments, with protection using gloves and warm socks.
Pernio is an inflammatory condition of the skin associated with cold exposure. The dermatologic manifestations may vary, and this entity is frequently misdiagnosed. Its association with systemic disease underscores the importance of accurate diagnosis. The authors describe a case report in which a patient who, after initially presenting with a complaint of pain and an ingrown toenail, was eventually diagnosed with pernio as well.