Vasospasm Is a Consistent Finding in Pernio (Chilblains) and a Possible Clue to Pathogenesis.
OBJECTIVE
Pernio (chilblains) is an inflammatory condition classically characterized by localized erythema and swelling of acral sites upon exposure to cool and damp conditions. We sought to determine whether cold-induced vasospasm has a role in the development of pernio.


METHODS
We retrospectively reviewed 5 patients with pernio who were seen at our institution between January 1, 2000 and December 31, 2011, and had undergone a noninvasive arterial vascular study of the upper extremities that corresponded to a site of clinical involvement of pernio and who had also undergone vasospastic testing and ice water immersion as part of the noninvasive arterial vascular study protocol.


RESULTS
Vascular testing in all patients (mean age 37.8 years; 4 women) demonstrated vasospasm with ice water immersion.


CONCLUSIONS
Our findings suggest that vasospasm likely has a role in the pathophysiology of pernio and may also provide a rationale for the pharmacological treatment of vasospasm in patients with pernio.
Department of Dermatology, Mayo Clinic, Rochester, Minn., USA.
Varun
V
Shahi
David A
DA
Wetter
Jonathan A
JA
Cappel
Mark D P
MD
Davis
Peter C
PC
Spittell
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002647:Chilblains / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D012039:Regional Blood Flow; D012189:Retrospective Studies; D012867:Skin / Q000098:blood supply*; D018608:Ultrasonography, Doppler; D014652:Vascular Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D014661:Vasoconstriction / Q000502:physiology*; D055815:Young Adult