Pernio, or chilblain, is a localized inflammatory disease of the skin resulting from an abnormal response to cold. Pernio presents as tender, erythematous-to-violaceous papules, nodules, or plaques that are usually located on the dorsal aspect of the fingers and toes and the lesions are less commonly found on the ears, nose, and lateral region of the thighs and buttocks. Differential diagnosis include such as Raynaud phenomenon, erythema nodosum, lupus erythematosus. A 32-year-old man was presented with painful papular lesions on his hands for the last 11 years. The lesions worsened with exposure to the cold and improved when his hands were warmed. A punch biopsy sample was taken from papule on the hands. Histopathological examination revealed perivascular infiltrate of lymphocytes in the dermis. The patient was diagnosed with pernio via these findings. Herein we reported a case with pernio. We discussed clinical and histopathological features of pernio and reviewed of differential diagnosis.
Keywords: chilblain, erythema nodosum, lupus erythematosus, raynaud phenomenon