Recurrent thermal lesions on acral skin after exposure to low temperatures. Case report

Abstract

Introduction. Erythema pernio is a condition that presents as an abnormal reaction to low temperatures, due to a prolonged vasoconstriction which leads to inflammation and hypoxemia of the vascular walls; it generally occurs in countries with very cold climates. The disease was first described by William Tomas in 1894 as "dermatitis hiemalis". The largest number of cases was reported during World War II. Objective. To know the main findings of the clinical evolution and diagnosis of chilblains, in order to serve as a contribution to the medical scientific community. Methodology.  A clinical case report was used in relation to chilblains, through the retrospective collection of information by accessing the clinical history by means of the patient's authorization through informed consent. A bibliographic review was included to corroborate the case information. Results. A 21-year-old female patient attended a Dermatology outpatient clinic where she reported recurrent dermatological manifestations on hands and feet for 5 years, after several treatments that she does not remember, she presented slight improvement and several episodes of remission and exacerbation. On physical examination she presents violaceous macules and erythematous papules of 1 mm over erythema, distributed bilaterally on distal phalanges of fingers and toes, while on the back of hands, palms and soles she presents scarce erythematous papules, some of them ulcerated.  Conclusion.  Being an infrequent disease in our environment, it is not usually diagnosed in a timely manner and therefore it is treated ineffectively, thus worsening the clinical pictures of patients and even putting their lives at risk. With the presentation of this case we hope to contribute to the scientific community to learn more about the management of pernio.