Clinical features suggestive of chilblains are that the lesions often may be very itchy at first and are sometimes painful on rewarming.
Chilblains characteristically occur during the colder months of the year and resolve completely during the warmer weather.
This seasonal variation may not be seen in advanced cases (1).
Single or multiple, usually symmetric, erythematous, brownish, yellowish, or violaceous papules, patches, or plques resting on a cool, edematous base (3).
Lesions appear in crops (or single) as red edematous papules, patches, or plaques on peripherally exposed areas such as fingers and toes (known as trenchfoot and kibes), nose and earlobes.
Other areas such as the thighs, hips, or abdomen may be affected occasionally (1,2).
Often there is associated tenderness, intense pruritus and burning sensation (2).
Lesions are generally symmetrical and bilateral – the thumbs are affected relatively infrequently.
Lesions become a deep purple or reddish-purple colour.
The swellings may increase in size - occasionally forming blisters; itchiness may be replaced by pain and soreness.
Usually self-limiting
If there is re-exposure to cold then tender blue nodules may occur and may persist for 10–14 days.
Severe complications: skin laceration, ulceration, permanent discoloration, and scarring (2).
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