Vasospasm Is a Consistent Finding in Pernio (Chilblains) and a Possible Clue to Pathogenesis

Dermatology. 2015;231(3):274-9. doi: 10.1159/000437224. Epub 2015 Aug 12.


Background/aims: 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.

Conclusion: 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.

MeSH terms

  • Adolescent
  • Adult
  • Biopsy
  • Chilblains / diagnosis
  • Chilblains / etiology
  • Chilblains / physiopathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Microscopy, Fluorescence
  • Middle Aged
  • Regional Blood Flow
  • Retrospective Studies
  • Skin / blood supply*
  • Ultrasonography, Doppler
  • Vascular Diseases / complications*
  • Vascular Diseases / diagnostic imaging
  • Vascular Diseases / physiopathology
  • Vasoconstriction / physiology*
  • Young Adult