title: Diltiazem vs. nifedipine in chilblains: a clinical trial.
abstract: BACKGROUND
  The treatment of chilblains remains unsatisfactory. Nifedipine in higher doses remains the mainstay of treatment.
  
  
  OBJECTIVE
  To compare the efficacy of diltiazem with that of nifedipine, and to determine the efficacy of nifedipine in lower doses, 36 chilblains cases were studied.
  
  
  METHODS
  Group A (12 patients) was treated with diltiazem 60 mg thrice daily, and Group B (24 patients) with 10 mg nifedipine thrice daily till complete relief and then maintained on a sustained release preparation of nifedipine 20 mg twice daily.
  
  
  RESULTS
  Two patients in Group A showed complete relief in 7 days, and 3 patients in about 21 days, but in 7 cases there was little or no response. In group B, 21 cases showed 80-90% relief by the fourteenth day.
  
  
  CONCLUSIONS
  We conclude that nifedipine remains the drug of choice in chilblains but can be used in a smaller dosage in the Indian population. Diltiazem is less effective in the conventional dose, which may be optimized.
authors.affiliation: Department of Dermatology, STD &Leprosy, Military Hospital, Agra, India, India.
authors.forename: A K
authors.initials: AK
authors.lastname: Patra
authors.forename: A L
authors.initials: AL
authors.lastname: Das
authors.forename: P
authors.initials: P
authors.lastname: Ramadasan