It's winter again, its cold and wet outside again, and my toes have little purple blistery things on them... again. My podiatrist tells me they are chilblains (folk name), aka "pernoisis" in medical speak.
Chilblains are small areas of the skin (usually the on toes, but also sometimes on fingers, nose, and cheeks) that have suffered a cold injury. The most common way someone can get chilblains is when they are suddenly exposed to cold/wet weather and don't properly protect themselves from the cold and wet. Like when there's a sudden snowstorm, and you find yourself outside shoveling snow in your uninsulated cowboy boots because you can't find your warm, fuzzy, waterproof snow boots.
The cold injury happens as follows. First, the area of skin gets very cold, so the tiny blood vessels constrict. Then the area warms up, perhaps very rapidly (think of bringing your cold, wet feet inside and immediately holding your toes up to a heater). The constricted blood vessels can't open up fast enough in response to the sudden heat. And viola! You get small, red or purple swollen spots that may itch intensely and then hurt.
Chilblains are more common in people with poor circulation or Raynaud's phenomenon. I suspect mine are related to my Sjogren's Syndrome and the Raynaud's that goes with it. Chilblains can also be associated with a special kind of lupus called chilblains lupus. Once you get your first chilblain, you may get them every winter, no matter how carefully you care for your feet.
What can you do once you have a chilblain? See a foot doctor or your family doctor. He/she will probably tell you to simply soak the affected body part in warm (not hot) water for 15 minutes once or twice a day, then dry thoroughly, and repeat until the swelling goes down some and the color fades. You may also be able to use topical steroids or vasodilators to treat the chilblain. And if your chilblain opens and gets infected, you will of course need antibiotics for that.
The best way to prevent chilblains is to keep your hands and feet warm and dry. Buy insulated, waterproof boots and gloves. And wear them... not just when it snows, but when it's just biting cold outside. Once you have been outside and gotten cold or wet, be sure to dry off and gently warm up your hands and feet (don't jump in a hot tub or sit next to a fireplace; try tepid water or simply sit in your warm house and wait).
Learn more:
Chilblains, from ePodiatry.com.
Chilblain lupus, from Dermis.net
Chilblains (pernio), from DermNet New Zealand.
