Corticosteroid therapy for pernio

Ganor, S.

doi:10.1016/s0190-9622(83)80309-0

Cited by 18 publications

(10 citation statements)

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“…23 Several treatments have been attempted in the past without success, including ultraviolet radiation, 24 vitamin D 2 administration, 25 and thymoxamine administration. 26 Topical fluorinated corticosteroids have yielded conflicting results 27,28 in the treatment of pernio.…”

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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“…A number of systemic and topical therapies are reported to be effective in treating this condition, including antimalarial medications, 2 calcium channel blockers, 3 mycophenolate mofetil, 4 and highpotency topical corticosteroids. 5 Our patient was treated successfully with intralesional triamcinolone acetonide.…”

Section: Discussionmentioning

confidence: 77%

“…The vast majority of cases reported are idiopathic, so systemic examination is not necessary unless dictated by an abnormal review of systems. A number of systemic and topical therapies are reported to be effective in treating this condition, including antimalarial medications, calcium channel blockers, mycophenolate mofetil, and high‐potency topical corticosteroids . Our patient was treated successfully with intralesional triamcinolone acetonide.…”

Section: Discussionmentioning

confidence: 82%

Chilblains in a Mohs Histotechnician

Ayli

Ingraffea

Weinman

et al. 2012

Dermatologic Surgery

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“…Topical corticosteroids would be beneficial for treatment of the fissuring related to contact dermatitis and have been used to treat pernio. 8 In general, treatment for pernio-like lesions of COVID-19 is similar to that of primary pernio and includes topical steroids, physical warming and calcium channel blockers. 9 The pathophysiology behind these findings is unclear, but theories exist regarding the different presentations of COVID-19 associated skin findings.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Manifestations of COVID-19: Case Report and Discussion

Russell¹,

Gross²,

Nobbee³

2020

HCA Healthcare Journal of Medicine

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Introduction Various cutaneous manifestations of COVID-19 have been described and awareness of these findings is beneficial for clinicians for an accurate diagnosis. Clinical Findings We present a case of skin findings consistent with acral microthrombi induced changes in an elderly gentleman who was positive for COVID-19. Outcomes The patient had a mild course of COVID-19. Cutaneous findings resolved after one week from presentation with supportive care. Conclusions This case highlights the importance of awareness of manifestations of COVID-19, which may assist in timely diagnosis and prevention of transmission.

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Corticosteroid therapy for pernio

Cited by 18 publications

References 0 publications

Pernio in Pediatrics

Pernio in Pediatrics

Chilblains in a Mohs Histotechnician

Cutaneous Manifestations of COVID-19: Case Report and Discussion

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