A histologic and immunohistochemical study of chilblains

Cribier, B.; Djeridi, Nadia; Peltre, Bernard; Grosshans, É

doi:10.1067/mjd.2001.117861

Cited by 133 publications

(106 citation statements)

References 10 publications

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“…14 The primary pathologic changes include edema of the papillodermis and reticular dermis infiltrate in the perieccrine region. 19 Vasculitis characterized by a perivascular lymphocytic infiltration of the arterioles and venules of the dermis, thickening and edema of the blood vessel walls, fat necrosis, and chronic inflammatory reaction with giant cell formation have also been described. 20 The lesions of acute pernio are usually self-limited, although they may lead to recurrent disease, as seen for patient 5.…”

Section: Discussionmentioning

confidence: 99%

Pernio in Pediatrics

2005

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ABSTRACT. Pernio, or chilblains, is a localized inflammatory lesion of the skin resulting from an abnormal response to cold. Five cases were seen among adolescent female patients who presented to our rheumatology service in a pediatric tertiary care center in the winter of 2003 to 2004. All 5 patients were thin (BMI of <25th percentile) and had either toes or fingers that were affected. For each, laboratory evaluation results were unremarkable, including negative antinuclear antibody profile results. Symptomatic treatment, with or without medication, was recommended. Pernio most commonly occurs among young women but may occur among older individuals or among children. Because pernio develops among susceptible individuals who are exposed to nonfreezing cold, the lesions usually begin in the fall or winter and disappear in the spring or early summer. Acute pernio may develop 12 to 24 hours after exposure to the cold. Single or multiple erythematous, purplish, edematous lesions appear, accompanied by intense pain, itching, or burning. Chronic pernio occurs with repeated exposure to the cold and the persistence of lesions. In an acute exacerbation, the major differential diagnosis alternative would be Raynaud's phenomenon, which consists of sharply demarcated cutaneous pallor and cyanosis, followed by erythema, of far shorter duration (hours rather than days). Frostbite is freezing of tissue, with resultant tissue necrosis. Several conditions have been described as predisposing subjects to pernio, including the presence of cryoproteins, excessive cold exposure, and anorexia nervosa among children and systemic lupus erythematosus and antiphospholipid antibodies among adults. It is important, therefore, when evaluating a patient with pernio, both to exclude an underlying diagnosis and to determine whether additional testing is necessary. The lesions of acute pernio are usually self-limited but may lead to recurrent disease. The involved limb should be cleaned and dried, and rewarming should occur. Prevention is the best form of therapy, and cold exposure should be minimized after an initial insult. The prognosis for properly treated pernio is excellent. Nifedipine, which produces vasodilation, has been demonstrated to be effective in reducing pain, facilitating healing, and preventing new lesions of pernio. We think that the 5 cases seen in our rheumatology clinic represent an increase, compared with prior years; the dermatology clinic at the University of Colorado reported a series of 8 children treated during a 10-year period. The reasons for the possible increase are likely multifactorial, with cold climate, a vulnerable population with thin body habitus, and cold exposure all being contributing causes. Of note, the quality of cold in Colorado is quite dry; however, the winter of 2003 to 2004 was not particularly colder or drier than prior years. All patients were very thin, and thin body habitus may be associated with increased cutaneous vasoreactivity. It is also unclear how these cases of pernio may reflect that...

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Section: Discussionmentioning

confidence: 99%

Pernio in Pediatrics

2005

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“…Ancak lökositoklazi görülmez. Az sayıda olguda likenoid interface dermatiti özellik-leri görülebilir (10,14) . Bazı olgularda ekrin hidradenit ve ekrin kanal açıklıklarında lenfosit infiltrasyonu gö-rülür.…”

Section: Discussionunclassified

“…Yapı-lan bir karşılaştırmalı çalışmada perniyo ve lupuslu olguların histopatolojik örnekleri değerlendirilmiştir. Buna göre perniyoda daha fazla oranda spongioz, periekrin inflamasyon ve dermal ödem görüldüğü buna karşın lupusda ise daha fazla oranda bazal tabakada vakuoler değişiklik görüldüğü saptanmıştır (14) . Antifosfolipid antikor sendromu, kriyofibrinojenemide interface dermatiti özellikleri, damarlar ve ekrin bezler çevresinde lenfosit infiltrasyonu, vasküler genişleme ve dermal müsin birikimi vardır.…”

Section: Discussionunclassified

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Pernio: A case report and the review of the differantial diagnosis

Topal¹,

Güngör²,

Topal³

et al. 2016

Okmeydani Medical Journal

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ÖZ GİrİŞPerniyo soğuk maruziyetinden sonra kaşıntılı veya ağrılı viyolese akral lezyonlarla ortaya çıkan inflamatuvar bir deri hastalığıdır. İdyopatik olabileceği gibi altta yatan bir sistemik hastalığa bağlı da oluşabilir. Eritemli papüllerden vesiküler tarzda lezyonlara kadar çok çeşitli olabilen deri lezyonları, akral bölge-lerde yerleşir (1) . Burada perniyo tanısı alan bir olgu sunularak, perniyonun klinik ve histopatolojik özel-liklerine değinilmiş ve ayırıcı tanılar gözden geçiril-miştir. OLGUOtuz iki yaşında erkek hasta polikliniğimize 11 yıl-dır el ve ayaklarında, kış aylarında ortaya çıkan ağ-rılı papül ve plaklar nedeniyle başvurdu. Hasta iki yıl önce özel bir dermatoloji kliniğine başvurmuş ve ekzema tanısı ile topikal steroidler verilmişti. Ancak lezyonlarında herhangi bir gerileme olmamıştı. Hasta kış aylarında oluşan bu lezyonların kızarık bir şekilde başladığını, daha sonra sarımsı bir renk oluştuğunu ve son aşamada kabuklanarak kaybolduğunu ifade ediyordu. Eklem ağrıları ve eklem bölgelerinde şişlik olduğunu da söyleyen hastanın anamnezi sorgulandı-ğında herhangi bilinen bir hastalığının olmadığı öğ-

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“…Cold is a well recognized etiological factor of perniosis, a dermatitis upon cold exposure [114]. Also, cold may act through a frostbite [115].…”

Section: Causes Of Inflammationmentioning

confidence: 99%

Definition of Inflammation, Causes of Inflammation and Possible Anti-inflammatory Strategies

Stankov¹

2012

TOINFJ

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Current definition of inflammation by its cardinal signs is obsolete and unsuitable for guiding adequate therapeutic strategies. Furthermore, present theory of the inflammatory process regarding vascular phenomena as essential for generation of cardinal signs is invalid and unable to explain well established empirical facts, particularly the extent of the osmotic pressure and temperature variations within the inflamed tissue.

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A histologic and immunohistochemical study of chilblains

Cited by 133 publications

References 10 publications

Pernio in Pediatrics

Pernio in Pediatrics

Pernio: A case report and the review of the differantial diagnosis

Definition of Inflammation, Causes of Inflammation and Possible Anti-inflammatory Strategies

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