Definition: “a recurrent localised erythema and doughy subcutaneous swelling cause by exposure to cold and accompanied by pruritus (itching) and a burning sensation”
(http://www.dva.gov.au)

Clinical Features:

• Itchy and tender red or purple swellings that occur on the peripheral of the body in response to cold.
• Commonly found on the nose, ear lobes, fingers and toes and over bunion swellings – can be found on the wrist of babies and on the heels of adults.
• Occur several hours after exposure to cold – can be aggravated by heat exposure yet less common in colder climates.
• More common in the young and the elderly and in those with peripheral circulatory deficits.

Etiology:

• Due to reduced circulation, especially mirco-circulation deficits.
• Arterioles (constantly moving) contract – stasis (still) occurs within vessel – blood leaks through and perfuses into local tissue – area deprived of oxygen and nutrients – pain and tissue damage occurs.
• Contributing factors include:
• Heredity
• Peripheral vascular disease
• Smoking
• Poor Nutrition
• Hormonal Changes
• Connective Tissue Disorders
• Bone Marrow Disorders

Treatment:

• Generally responding poorly to treatment
• Portent topical steroid application
• Hirudoid cream (Heparinoid 0.3% in an ointment base)
• Antibiotic Rx for broken or ulcerating chilblains with secondary infection ( elderly prone to ulceration)

Prevention:

• Do not allow area to become cold
• Insulate local areas around work and home
• Warm clothing ie: wool socks
• Increase exercise before going outside
• Gentle massage before exposure to cold or heat
• Vasodilator medication if extreme
• Do not smoke