Chilblains to choroba znana również jako pernio lub perniosis. w języku polskim można ją określać jako „obmrożenie” lub „pernioza”, choć nie jest to t
Etiologia i przyczyny

Chilblains (pernio) to zapalna reakcja małych naczyń krwionośnych skóry na ekspozycję na zimno, szczególnie w warunkach wilgotnych i przy temperaturach powyżej punktu zamarzania. Patofizjologia obejmuje początkową wazokonstrykcję tętniczek i żyłek, prowadzącą do hipoksji tkanek, a następnie gwałtowną wazodilatację, która powoduje przeciek krwi do otaczających tkanek i stan zapalny. Objawy kliniczne to bolesne, swędzące, zapalne zmiany skórne. Czynniki ryzyka to m.in. płeć żeńska, niska masa ciała, wiek (młodzież i osoby starsze), zaburzenia krążenia, palenie tytoniu, siedzący tryb życia oraz ekspozycja zawodowa na zimno i wilgoć. Chilblains mogą występować jako pierwotne lub wtórne, związane z chorobami autoimmunologicznymi (np. toczeń rumieniowaty układowy, choroba Raynauda), hematologicznymi (białaczki, chłoniaki) oraz genetycznymi (mutacje TREX1, SAMHD1, TMEM173 w rodzinnej postaci chilblain lupus).

Chilblains (Pernio) – Etiologia, przyczyny i czynniki wywołujące

Chilblains to choroba znana również jako pernio lub perniosis. W języku polskim można ją określać jako „odmrożenie” lub „pernioza”, choć nie jest to typowe odmrożenie wynikające z zamarzania tkanek. Jest to reakcja zapalna małych naczyń krwionośnych w skórze, występująca w odpowiedzi na narażenie na zimno, szczególnie w warunkach wilgotnych, ale bez temperatur zamarzania12.

Mechanizm powstawania chilblains

Dokładny mechanizm powstawania chilblains nie jest w pełni poznany, jednak badania wskazują na nieprawidłową reakcję naczyniową na zimno. Proces ten można opisać następująco:12

  • Podczas ekspozycji na zimno małe naczynia krwionośne (tętniczki i żyłki) znajdujące się blisko powierzchni skóry ulegają zwężeniu (wazokonstrykcji)
  • Zwężenie powoduje ograniczenie przepływu krwi do obszarów skóry, co prowadzi do zmniejszonego natlenienia tkanek
  • Gdy skóra zostaje następnie nagrzana, naczynia krwionośne rozszerzają się (wazodilatacja)
  • Jeśli proces rozszerzania zachodzi zbyt szybko, małe naczynia krwionośne nie są w stanie poradzić sobie ze zwiększonym przepływem krwi
  • Dochodzi do wycieku krwi z naczyń do otaczających tkanek, co powoduje stan zapalny, obrzęk i typowe objawy chilblains

123

Ten proces można porównać do efektu „wąskiego gardła”, gdy mniejsze naczynia rozszerzają się szybciej niż większe naczynia mogą przyjąć zwiększony przepływ krwi12. Zjawisko to powoduje uszkodzenie naczyń włosowatych w skórze, manifestujące się jako bolesne, swędzące i zapalne zmiany1.

Główne czynniki wywołujące

Bezpośrednią przyczyną wystąpienia chilblains jest ekspozycja na zimno. Szczególnie istotne są:12

  • Narażenie na zimno i wilgoć – chilblains najczęściej występują w warunkach zimnych i wilgotnych, raczej niż w suchym mrozie
  • Szybka zmiana temperatury – nagłe przejście z zimna do ciepła, np. ogrzewanie zimnych stóp bezpośrednio przy ogniu lub kaloryferze
  • Długotrwała ekspozycja na umiarkowanie zimne (nie zamarzające) temperatury w połączeniu z wilgocią

12

Czynniki ryzyka i predyspozycje do rozwoju chilblains

Nie każda osoba narażona na zimno i wilgoć rozwinie chilblains. Istnieje wiele czynników ryzyka zwiększających podatność na tę chorobę:12

Czynniki indywidualne

  • Płeć – kobiety są znacznie bardziej podatne na chilblains niż mężczyźni12
  • Niska masa ciała – osoby z niskim BMI i niedożywione mają zwiększone ryzyko z powodu mniejszej izolacji termicznej12
  • Wiek – chilblains często dotykają osoby młode, szczególnie nastoletnie dziewczęta, ale również osoby starsze z gorszym krążeniem12
  • Genetyka – skłonność rodzinna do chilblains sugeruje komponent genetyczny12

Czynniki związane z krwioobiegiem

  • Słabe krążenie obwodowe – osoby z zaburzeniami krążenia są szczególnie narażone12
  • Palenie tytoniu – nikotyna zwęża naczynia krwionośne, co pogarsza krążenie i zwiększa ryzyko chilblains12
  • Siedzący tryb życia – brak aktywności fizycznej pogarsza ogólną cyrkulację12

Czynniki środowiskowe

  • Klimat – wilgotny i zimny klimat sprzyja rozwojowi chilblains; częstsze występowanie w regionach bez centralnego ogrzewania12
  • Ekspozycja zawodowa – osoby pracujące na zewnątrz (rolnicy, rybacy, specjaliści sportów zimowych) mają zwiększone ryzyko12
  • Ubranie – zbyt ciasne ubrania i buty mogą ograniczać krążenie krwi, zwiększając ryzyko12

Wtórne chilblains związane z chorobami współistniejącymi

Chilblains mogą występować jako pierwotne (idiopatyczne) lub wtórne, związane z innymi schorzeniami12. Wtórne chilblains są rzadsze, ale mogą być manifestacją poważnych chorób wymagających diagnostyki1.

Zaburzenia autoimmunologiczne

  • Toczeń rumieniowaty układowy (SLE) – najczęstsza choroba autoimmunologiczna związana z chilblains; występuje jako chilblain lupus erythematosus (CHLE)12
  • Rodzinny toczeń odmrozinowy (FCL) – rzadka postać związana z mutacjami genów TREX1, SAMHD1 lub TMEM17312
  • Choroba Raynauda – zaburzenie, w którym występuje nadmierne zwężenie naczyń krwionośnych w odpowiedzi na zimno12

Zaburzenia hematologiczne i nowotwory

  • Przewlekła białaczka mielomonocytowa – chilblains mogą być objawem tej choroby1
  • Ostra białaczka limfoblastyczna – opisywano przypadki, gdy chilblains były pierwszym objawem przełomu blastycznego12
  • Chłoniak jelitowy – rzadki typ chłoniaka układu limfatycznego1

Inne schorzenia związane z chilblains

  • Anoreksja – niski wskaźnik masy ciała predysponuje do chilblains12
  • Dysprotidemie – zaburzenia białek krwi, takie jak makroglobulinemia, krioglobulinemia1
  • Choroba trzewna – może być powiązana z występowaniem chilblains1
  • Zespół antyfosfolipidowy – choroba autoimmunologiczna wpływająca na krzepnięcie krwi1

COVID-19 a chilblains

W czasie pandemii COVID-19 zaobserwowano zwiększoną częstość występowania zmian podobnych do chilblains, zwłaszcza u młodych osób12. Zjawisko to nazwano „COVID toes”. Związek przyczynowy między COVID-19 a chilblains pozostaje niejednoznaczny, szczególnie że w wielu przypadkach nie stwierdzono ekspozycji na zimno jako czynnika wywołującego1.

Patofizjologia chilblains

Patofizjologia chilblains opiera się na procesach naczyniowych i zapalnych, które prowadzą do charakterystycznych zmian skórnych1.

Zmiany naczyniowe

Kluczowym elementem w patogenezie chilblains jest reakcja naczyń krwionośnych na zimno:12

  • Zimno wywołuje skurcz małych tętnic i żył
  • Fizjologicznie powinien występować ochronny odruch okresowego rozszerzania naczyń, aby zapobiec niedokrwieniu skóry
  • W chilblains dochodzi do utrzymującej się lub przedłużonej wazokonstrykcji
  • Prowadzi to do hipoksemii (obniżonego poziomu tlenu we krwi) i zapalenia tkanek

12

W przypadku chilblain lupus (CHLE), patogeneza nie jest dobrze poznana, ale obejmuje zwężenie naczyń wywołane zimnem prowadzące do zamknięcia łożyska włośniczkowego i spowolnienia krążenia z obecnością agregatów czerwonych krwinek widocznych w kapilaroskopii1.

Reakcja zapalna

Naukowcy zgadzają się, że chilblains są wynikiem skrajnej i nieprawidłowej odpowiedzi zapalnej1. W niektórych przypadkach, gdy obszary skóry zostają odcięte od prawidłowego przepływu krwi, najbardziej powierzchowne naczynia krwionośne reagują nadmiernym stanem zapalnym, próbując zwiększyć przepływ krwi1. Paradoksalnie, ten proces zapalny może prowadzić do dalszego uszkodzenia naczyń krwionośnych i tkanek skóry1.

Czynniki genetyczne w patogenezie

W przypadku rodzinnej postaci chilblain lupus (FCL), zidentyfikowano konkretne mutacje genetyczne:12

  • Mutacje genu TREX1 – gen ten uczestniczy w naprawie DNA
  • Mutacje genu SAMHD1 – gen odgrywa rolę w odpowiedzi immunologicznej
  • Mutacje genu TMEM173 (kodującego stymulator genów interferonu, STING) – prowadzą do zwiększenia funkcji

Mutacje te dziedziczą się w sposób autosomalny dominujący i mogą być obecne u osób z rodzinną historią choroby lub u tych, którzy rozwijają ją w dzieciństwie12.

Kwestie wymagające dalszych badań

Mimo istniejącej wiedzy na temat etiologii chilblains, wiele aspektów pozostaje niejasnych i wymaga dalszych badań:12

  • Dlaczego niektóre osoby rozwijają chilblains przy ekspozycji na zimno, a inne nie
  • Dokładne mechanizmy molekularne odpowiedzialne za nieprawidłową reakcję naczyniową
  • Rola czynników hormonalnych – sugerowana przez większą częstość występowania u kobiet
  • Potencjalny związek z niedoborami witamin i składników odżywczych (np. badanie tureckie sugerujące potencjalny związek z niskim poziomem witaminy B12 i jej wpływem na rozszerzanie i zwężanie naczyń krwionośnych)1
  • Dokładny charakter predyspozycji genetycznych do rozwijania chilblains

Zrozumienie tych aspektów mogłoby prowadzić do lepszej profilaktyki i skuteczniejszych metod leczenia chilblains, szczególnie w przypadkach nawracających i opornych na standardową terapię1.

Podsumowanie etiologii chilblains

Chilblains (pernio) stanowią złożone schorzenie naczyniowe o wieloczynnikowej etiologii. Główną przyczyną ich powstawania jest nieprawidłowa reakcja naczyń krwionośnych na zimno, szczególnie w połączeniu z wilgocią, oraz na szybkie zmiany temperatury. Zwężenie naczyń w odpowiedzi na zimno i następcze zbyt szybkie rozszerzenie przy ogrzewaniu prowadzi do wycieku płynu i krwi do otaczających tkanek, wywołując stan zapalny12.

Zwiększone ryzyko występuje u osób z predyspozycjami indywidualnymi (płeć żeńska, niska masa ciała), zaburzeniami krążenia oraz chorobami autoimmunologicznymi, szczególnie toczniem rumieniowatym. Chilblains mogą być manifestacją poważniejszych schorzeń, w tym białaczek i innych chorób układu krwiotwórczego12.

Dokładne mechanizmy patofizjologiczne i genetyczne predyspozycje do rozwoju chilblains wciąż wymagają dalszych badań. Zrozumienie tych mechanizmów jest kluczowe dla opracowania skutecznych strategii profilaktycznych i terapeutycznych12.

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Chilblains – Wikipedia
    https://en.wikipedia.org/wiki/Chilblains
    Chilblains, also known as pernio, is a medical condition in which damage occurs to capillary beds in the skin, most often in the hands or feet, when blood perfuses into the nearby tissue, resulting in redness, itching, inflammation, and possibly blisters. […] It occurs most frequently when predisposed individuals, predominantly women, are exposed to cold and humidity. […] Chilblains can be idiopathic (spontaneous and unrelated to another disease), but similar symptoms may also be a manifestation of another serious medical condition that must be investigated. […] It has been suggested that in the absence of exposure to cold and damp, COVID-19 should be considered as a possible cause of chilblains.
  • #1 Chilblains | NHS inform
    https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/chilblains/
    Chilblains are caused by an abnormal reaction to the cold. Theyre common in the UK because the weather is damp and cold in the winter. […] When the skin is cold, blood vessels near its surface get narrower. If the skin is then exposed to heat, the blood vessels become wider. If this happens too quickly, blood vessels near the surface of the skin cant always handle the increased blood flow. Blood can leak into the surrounding tissue, which may cause the swelling and itchiness of chilblains.
  • #1 Chilblains: Causes, Symptoms. and Treatment
    https://patient.info/foot-care/chilblains
    Chilblains are caused by an abnormal skin reaction to cold. […] The tiny blood vessels under the skin narrow (constrict) when the skin becomes cold. The blood supply to areas of skin may then become very slow. […] The speed (rate) of temperature change may play a part. Some people get chilblains if they warm up cold skin too quickly.
  • #1 Chilblains | Altru Health System
    https://www.altru.org/health-library/conditions/chilblains
    Chilblains (CHILL-blayns) is a condition that causes inflamed swollen patches and blistering on the hands and feet. It’s caused by exposure to damp air that’s cold but not freezing. […] The exact cause of chilblains is unknown. They may be an unusual reaction of your body to cold followed by rewarming. Rewarming of cold skin can cause small blood vessels under the skin to expand more quickly than nearby larger blood vessels can handle.
  • #1 Chilblains | Beacon Health System
    https://www.beaconhealthsystem.org/library/diseases-and-conditions/chilblains?content_id=CON-20155443
    Chilblains causes inflamed, swollen skin, which appears several hours after exposure to cold but not freezing air. […] The exact cause of chilblains is unknown. They may be an unusual reaction of your body to cold followed by rewarming. Rewarming of cold skin can cause small blood vessels under the skin to expand more quickly than nearby larger blood vessels can handle.
  • #1 Pernio: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/1087946-overview
    Pernio is due to an abnormal vascular response to cold exposure, and it is most frequent when damp or humid conditions coincide. […] The direct cause of pernio is cold exposure; specifically, exposure to both mild nonfreezing cold and humidity seems to be required. […] Chronic pernio may be secondary to various systemic diseases as follows: Chronic myelomonocytic leukemia, Anorexia nervosa: Low body mass index may predispose to pernio, Dysproteinemias, Macroglobulinemia, Cryoglobulinemia, cryofibrinogenemia, cold agglutinins, Antiphospholipid antibody syndrome, Raynaud disease, Celiac disease. […] Chilblain lupus erythematosus (CHLE): Violaceous „pernio” plaques appear prominent over dorsal interphalangeal joints, often with positive antinuclear antibody (ANA) or rheumatoid factor (RF). Histologic and immunofluorescent evidence of lupus is present in the skin lesions.
  • #1 Chilblains (Pernio)
    https://lakecountyin.gov/departments/health/nursing-clinic/diseases-and-conditions/enviro-health-conditions/chilblains-pernio
    Chilblains occur when the skin is exposed to cold and damp conditions, leading to an inflammatory response in the small blood vessels (capillaries) of the affected areas. […] Several factors contribute to the development of chilblains: […] Exposure to Cold: Prolonged exposure to cold and damp weather, particularly in the absence of adequate protective clothing, increases the risk of chilblains. […] Individuals with poor circulation or conditions that affect blood flow are more susceptible to chilblains. […] People with sensitive skin or a history of skin conditions may be more prone to developing chilblains. […] Wearing insufficient or inappropriate clothing in cold weather can increase the risk of chilblains.
  • #1 Chilblains (Pernio): Symptoms and Management — DermNet
    https://dermnetnz.org/topics/chilblains
    Chilblains are tender and/or itchy bumps on acral sites following exposure to damp, cold, non-freezing conditions causing a localised form of vasculitis. […] Risk factors predisposing to the development of chilblains include: Smoking, Low body mass index and poor nutrition, Occupational hazard for outdoor workers, such as fishermen and farmers, Participation in ice-skating sports, Underlying bone marrow disorders eg, chronic myelomonocytic leukaemia, Underlying connective tissue disorders, particularly systemic lupus erythematosus (when it is called chilblain lupus), Underlying acrocyanosis and primary or secondary Raynaud phenomenon, Familial tendency to developing chilblains. […] Cold causes constriction of small arteries and veins but a protective physiological reflex intermittently dilates the blood vessels to prevent skin ischaemia. Persistent or prolonged vasoconstriction due to an abnormal vascular reaction to cold may result in hypoxaemia and inflammation to produce chilblains.
  • #1 Pernio – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK549842/
    Pernio is mostly thought to be idiopathic; however, while several forms of secondary pernio exist, they are incredibly rare, and the direct association has not clinically correlated with extensive studies due to the rarity. The most common form of secondary pernio is the association with systemic lupus erythematosus and the subsequent development of chilblain lupus erythematosus (CHLE). […] Of note, research has found pernio as the presenting symptom of a blast crisis in patients diagnosed with acute lymphoblastic leukemia. […] Pernio has generally been found to affect women more often than men. The most significant risk factor appears to be exposure to cold, damp climates, and pernio is often prevalent in areas without central heating such as many parts of the UK and northern Europe. Due to pernio’s association with the cold and damp, the presentation can be found to be seasonal, with an increase in prevalence during the winter months and relapse occurring when the weather warms again in the spring.
  • #1 Chilblains: symptoms, causes and how to reduce your risk – Your Health
    https://www.yourhealth.net.au/articles/wellbeing/skin-health/chilblains-symptoms-causes-and-how-to-reduce-your-risk/
    Chilblains are itchy, swollen and painful lumps on the skin that form after exposure to the cold. They are caused by changes in the blood vessels in response to the cold. […] You are more likely to develop chilblains if you: are sensitive to the cold and changes in temperature, have poor circulation, are elderly, are sedentary, are a teenage girl, are underweight.
  • #1 Chilblains | Better Health Channel
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/chilblains
    Chilblains are patches of red, swollen and itchy skin, thought to be caused by a combination of cold weather and poor circulation. […] Although the exact cause of chilblains remains unknown, it is thought to be associated with the body’s reaction to cold weather. […] As not everyone exposed to cold and damp conditions will develop chilblains, it is believed that those who do are overly sensitive to changes in weather and temperature. […] The elderly, sedentary, children, teenagers and people with medical conditions (such as anaemia) are most susceptible. […] The symptoms of chilblains are made worse with sudden temperature changes for example, entering a warm house after being outside in the cold. […] If you develop chilblains without being exposed to cold weather, seek advice from your health professional as this may be a sign of another condition such COVID-19.
  • #1 Chilblains (Pernio): What Is It, Symptoms, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/21817-chilblains-pernio
    Chilblains form after on-and-off or prolonged exposure to cold or damp air. The cold air causes blood vessels near your skins surface to tighten or constrict. This leads to less oxygen and inflammation in the exposed areas. […] Researchers dont know exactly why this reaction happens. Some experts believe pernio develops because of: […] Genetics […] Hormonal changes […] Underlying conditions, like connective tissue diseases.
  • #1 Chilblains: Symptoms, complications, and treatment
    https://www.medicalnewstoday.com/articles/172191
    Chilblains, also known as chilblain, pernio, and perniosis are small, itchy swellings on the skin associated with exposure to the cold. […] We dont know exactly what chilblains are, some studies show a localized form of vasculopathy that occur when a predisposed individual is exposed to cold. […] Exposure to the cold and damp may damage tiny blood vessels (capillaries) in the skin, resulting in redness, blisters, itching, and inflammation. […] Our blood vessels narrow when exposed to cold. When returning to warmth, the blood vessels expand again. For some people, this change results in blood leaking out of the blood vessels, causing inflammation and chilblain symptoms, especially if the change from cold to warmth is abrupt. […] The following groups of people are more susceptible to getting chilblains when exposed to cold: individuals with close family members who have/had chilblains, patients with circulation problems, patients with lupus, people whose homes are draughty and cold (not well insulated), tobacco smokers, women are more susceptible than men, underweight individuals, people with Raynauds disease.
  • #1 Chilblains (Pernio) Causes, Symptoms, and Treatment
    https://www.verywellhealth.com/chilblains-5219587
    Chilblains is a rare inflammatory condition induced by the cold affecting accral skin (meaning the skin of hands, feet, nose, and ears). […] While most cases are idiopathic (of unknown origin), scientists generally agree that chilblains is the result of an extreme and inappropriate inflammatory response. […] However, in some people, the vasoconstriction may be excessive and prolonged, depriving tissues of oxygen. […] When this happens, the body will respond with extreme inflammation to force the blood vessels open. […] Why some people are affected by chilblains and others aren’t is poorly understood. […] However, certain factors are known to increase a person’s risk, including: Being female (males are far less vulnerable to chilblains), Low body weight (which may explain why women are more commonly affected), Residing in cold climates (particularly in homes without central heating), Having lupus (an autoimmune disease that can sometimes target blood vessels with inflammation), Having poor blood circulation, such as can occur with peripheral artery disease, Wearing tight-fitting clothes (which can significantly impair normal blood circulation), Smoking (as tobacco smoke promotes vasodilation). […] Chilblains also tends to be seasonal, occurring more frequently in winter and less frequently in summer.
  • #1 Chilblains in immune-mediated inflammatory diseases: a review
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9383735/
    Chilblains can be primary, or secondary to a number of conditions such as infections, including COVID-19, and immune-mediated inflammatory disorders (IMIDs) with SLE being the commonest. […] Chilblains can be primary or secondary. Secondary chilblains are associated with IMIDs, infections (including hepatitis), haematological disorders, malignancy and drug-related causes. By far, the most common association is with SLE […] The pathogenesis of CHLE is not well understood. Vasoconstriction provoked by exposure to cold leads to the occlusion of the capillary bed and a circulation slowdown with the presence of aggregates of red blood cells visible on capillaroscopy. […] Familial chilblain lupus (FCL) can arise due to loss-of-function mutations in TREX1, or less commonly SAMHD1, or gain-of-function mutations in TMEM173 (which encodes stimulator of interferon genes, STING).
  • #1 Chilblains | Symptoms, Treatments & Management | SRUK
    https://www.sruk.co.uk/raynauds/chilblains/
    A chilblain is a condition which results from defective blood circulation on exposure to cold. […] It is probably due to poor circulation in the extremities (toes, fingers, etc.). The tiny blood vessels under the skin narrow (constrict) when the skin becomes cold and the blood supply to areas of skin may then become very slow. […] Chilblains are common. It is thought that about 1 in 10 people in the UK get chilblains at some stage in their life. […] Older people more commonly suffer from chilblains but anyone can be affected. […] Having chilblains does not necessarily mean that you have Raynaud’s. However, as both conditions are related to the circulation many people with Raynaud’s also have chilblains. […] There is some evidence that Vitamin B (nicotinic acid) helps to prevent chilblains. Vasodilators which are recommended for improving the circulation in Raynaud’s phenomenon by opening up the blood vessels, can also be useful in the treatment and prevention of chilblains. […] Regular exercise, not smoking, and a healthy low-fat diet packed with fruit and vegetables, are essential to keep the circulation strong.
  • #1 Chilblain Lupus: What It Is, Causes, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/21980-chilblain-lupus
    Chilblain lupus causes painful red or purple sores and discolored patches (plaques) of skin. These small sores (chilblains) form or worsen after exposure to cold temperatures. […] Chilblain lupus can be inherited (genetic) or sporadic (random). Sporadic chilblain lupus means you develop the condition later in life, usually as an adult. Researchers dont know why it occurs. […] People with inherited chilblain lupus have a gene variant (change). A change in either the TREX1 or SAMHD1 gene can lead to chilblain lupus. The TREX1 gene helps with DNA repair. The SAMHD1 gene plays a role in your immune response. Both gene mutations can be found in people who have a biological family history of the disease or who develop it as children. […] Anyone can develop chilblain lupus, but its most common in adults. People who live in cold, wet climates may be more likely to have chilblain lupus. […] Some conditions can increase a persons chances of getting chilblain lupus, including: Anorexia nervosa, a life-threatening eating disorder; Intestinal lymphoma, a rare type of lymphoma (lymph system cancer) that starts in your small bowel; Pregnancy.
  • #1 Chilblains in immune-mediated inflammatory diseases: a review
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9383735/
    Chilblains or chilblain-type lesions have been described quite frequently following development of COVID-19. […] A causative link between chilblains and COVID-19 remains inconclusive, especially since cold exposure does not appear to be a precipitating factor. […] Chilblains can be secondary to a number of different IMIDs, with SLE being the commonest. Histologically, the skin in CHLE demonstrates lymphocytic vasculitis as well as other features of CLE such as deposition of immunoglobulins and complement in the dermo-epidermal junction.
  • #1 Chilblains – Windsor & Maidenhead
    https://www.fixmyfoot.co.uk/chilblains-windsor-maidenhead.html
    In chilblains, those distant shut-off areas begin to react abnormally to the lack of blood flow. The blood vessels closest to the skin surface, and with the least blood, wage a full inflammatory response asking the body to pay attention to them. Instead of helping the situation, the inflammation actually leads to the destruction of blood vessels and real damage to the skin above them. […] Pernio can be idiopathic but chronic pernio may be secondary to various systemic diseases. […] Some people are more at risk of chilblains than others. This includes people with poor circulation, a family history of chilblains, regular exposure to cold, damp or draughty conditions, a poor diet or low body weight, lupus, Raynaud’s phenomenon, and people who smoke as nicotine constricts blood vessels. […] Chilblains can also occur on areas of the feet that are exposed to pressure, such as a bunion or a toe that’s squeezed by tight shoes.
  • #1 Chilblains: Causes, Symptoms, Diagnosis, Treatment, and Prevention
    https://www.webmd.com/skin-problems-and-treatments/chilblains-causes-symptoms-diagnosis-treatment-and-prevention
    Chilblains can form when parts of your body are exposed for too long in damp, cold weather. […] The word „chilblains” is a blend of the two Old English words „chill” (meaning cold) and „blegen” (sore). Scientists consider them an abnormal response to the cold. […] Certain medical conditions might have a link to chilblains, though such connections are rare. […] A small Turkish study found a possible link between chilblains and how low levels of vitamin B12 can affect the widening or narrowing of blood vessels.
  • #1 Chilblains: Causes, Symptoms, and Treatment Options for Cold-Induced Skin Damage • Yesil Health
    https://yesilhealth.com/your-health/chilblains-causes-symptoms-and-treatment-options-for-cold-induced-skin-damage/
    The exact cause of chilblains is still not fully understood, but it is believed to be related to the body’s response to cold temperatures. When the skin is exposed to cold, the blood vessels constrict or narrow, reducing blood flow to the affected area. This can lead to inflammation and damage to the skin. […] Some research suggests that chilblains may be caused by a combination of genetic and environmental factors. For example, people who have a family history of chilblains may be more likely to develop the condition themselves. […] The exact cause of chilblains is not fully understood, but it is thought to be related to poor circulation and an abnormal response to cold temperatures. Other factors that may contribute to the development of chilblains include: Genetics, Raynaud’s disease, Lupus, Other autoimmune disorders.
  • #2 Chilblains (perniosis) – symptoms and treatment | healthdirect
    https://www.healthdirect.gov.au/chilblains
    Chilblains (perniosis) are caused by the small blood vessels below the skin’s surface constricting too much. You are more likely to develop chilblains if you are sensitive to the cold. […] They can also form due to poor circulation or sensitive skin. […] Other risk factors for getting chilblains are: being a child or teenager, being female, exposure to smoking, having a low body weight, exposure to damp, wind or cold.
  • #2 Chilblains
    https://www.nhs.uk/conditions/chilblains/
    Chilblains can get when it’s cold. The cold makes the tiny blood vessels in your fingers and toes get smaller. This stops blood moving around as easily. […] If you warm up too quickly, the blood vessels get bigger again and blood rushes to your fingers and toes. This can cause pain or swelling.
  • #2 Chilblains: Causes, Symptoms, and Treatment Options for Cold-Induced Skin Damage • Yesil Health
    https://yesilhealth.com/your-health/chilblains-causes-symptoms-and-treatment-options-for-cold-induced-skin-damage/
    The exact cause of chilblains is still not fully understood, but it is believed to be related to the body’s response to cold temperatures. When the skin is exposed to cold, the blood vessels constrict or narrow, reducing blood flow to the affected area. This can lead to inflammation and damage to the skin. […] Some research suggests that chilblains may be caused by a combination of genetic and environmental factors. For example, people who have a family history of chilblains may be more likely to develop the condition themselves. […] The exact cause of chilblains is not fully understood, but it is thought to be related to poor circulation and an abnormal response to cold temperatures. Other factors that may contribute to the development of chilblains include: Genetics, Raynaud’s disease, Lupus, Other autoimmune disorders.
  • #2 Chilblains – Windsor & Maidenhead
    https://www.fixmyfoot.co.uk/chilblains-windsor-maidenhead.html
    Chilblains are a vasospastic inflammatory disorder that occurs several hours after of the skin of unprotected individuals has been exposed to a non-freezing cold in damp environment (temperate humid climates). […] The exact reason chilblains occur is not well-understood but cold (specifically, exposure to both mild nonfreezing cold and humidity), is the direct requirement for the development of symptoms. Chilblains are the result of an abnormal vascular reaction (arteliolar and venular constriction) to prolonged exposure to temperatures above freezing point when damp or humid conditions coincide, followed by too rapidly rewarming (e.g. warming cold hands in front of a fire or heater). […] When the skin is cold, the farthest blood vessels (small arteries and veins) (hands, feet, tip of the nose) near its surface get narrower (constriction). If the skin is then exposed to sudden warmth, in rewarming of cold skin, small blood vessels closest to the skin cannot handle their sudden expansion that occurs more quickly than nearby larger blood vessels can handle, resulting in a „bottleneck” effect and the blood leaking into nearby tissues causes inflammation, swelling and itching.
  • #2 Chilblains (cold feet) Podiatrist in Orlando, FL | Timothy Mason, DPM
    https://www.orlandofootandankleinstitute.org/articles/crc32/514200-chilblains-cold-feet/
    Chilblains, often colloquially known as „cold feet,” is a condition that affects the small blood vessels in the skin when exposed to cold and damp conditions. […] Exposure to cold and damp conditions is the primary trigger for chilblains. […] Individuals with heightened sensitivity to cold are more prone to developing chilblains. […] Poor circulation can exacerbate the risk of chilblains. […] Age and gender can influence susceptibility to chilblains. […] Proper attire in cold weather is a key preventive measure. […] Gradual warming is essential after exposure to cold conditions. […] Sudden shifts in temperature can trigger chilblains. […] Warm feet are crucial in preventing and managing chilblains. […] Topical creams and ointments can provide relief for chilblains symptoms.
  • #2 Chilblains: Causes, Symptoms, Risk Factors and Complications
    https://www.prepladder.com/neet-pg-study-material/dermatology-and-venereology/chilblains-causes-symptoms-risk-factors-diagnosis-treatment-prevention-and-complications
    What precisely causes chilblains is unknown. Your body may unusually react to cold and then warm up again in response to it. When cold skin is re-heated, smaller blood vessels beneath the skin may enlarge more quickly than the bigger blood vessels nearby can hold. […] The subsequent factors increase the risk of chilblains: Wearing shoes that are excessively tight or leave skin exposed to the environment. If you wear too-tight shoes or clothing in cold, damp weather, you may be more likely to have chilblains. Being a young woman. This sickness is more common in females between the ages of 15 and 30. Being underweight. This disease typically impacts people with low body mass. Living in a cold, humid climate. You have a higher chance of developing chilblains if you live in an area with high humidity and cool, but not freezing, weather. Having certain health issues. SARS-CoV-2, connective tissue disease, and Raynaud’s phenomenon are among them.
  • #2 Chilblains (Pernio) Causes, Symptoms, and Treatment
    https://www.verywellhealth.com/chilblains-5219587
    Chilblains is a rare inflammatory condition induced by the cold affecting accral skin (meaning the skin of hands, feet, nose, and ears). […] While most cases are idiopathic (of unknown origin), scientists generally agree that chilblains is the result of an extreme and inappropriate inflammatory response. […] However, in some people, the vasoconstriction may be excessive and prolonged, depriving tissues of oxygen. […] When this happens, the body will respond with extreme inflammation to force the blood vessels open. […] Why some people are affected by chilblains and others aren’t is poorly understood. […] However, certain factors are known to increase a person’s risk, including: Being female (males are far less vulnerable to chilblains), Low body weight (which may explain why women are more commonly affected), Residing in cold climates (particularly in homes without central heating), Having lupus (an autoimmune disease that can sometimes target blood vessels with inflammation), Having poor blood circulation, such as can occur with peripheral artery disease, Wearing tight-fitting clothes (which can significantly impair normal blood circulation), Smoking (as tobacco smoke promotes vasodilation). […] Chilblains also tends to be seasonal, occurring more frequently in winter and less frequently in summer.
  • #2 What are Chilblains? | Lindsey Ebbs Podiatry
    https://footcheck.co.uk/podiatry-insights/what-are-chilblains/
    Chilblains develop when the body is exposed to colder conditions. […] People who are prone to chilblains, have blood vessels that fail to return the blood back to the peripheral capillaries quickly enough after being exposed to the cold. […] Being in and out of a cold environment into a warm one is primarily the problem, this creates a challenge for the vascular system to react quickly and effectively enough to prevent chilblains from developing. […] Those who have peripheral arterial disease, are often caused by smoking. […] People who have Raynaud’s syndrome will have a predisposition to chilblains. […] Low body fat (low BMI) can also contribute to chilblains as the insulation layer for the body is missing. […] Genetics can be a factor too… parents are always at fault!
  • #2 Chilblains: Causes, Symptoms, Treatment & Prevention
    https://www.footcentregroup.com.au/blog-chilblains/
    Chilblains (Pernio or Peniosis) are common in the cooler months of the year. […] The exact cause of Chilblains is unknown, however it is said to be due to a decrease in blood flow towards the foot through a method known as vasoconstriction (Blood vessels becoming narrower in size). […] External weather changes such as being exposed to cold air, damp and windy conditions can result in getting Chilblain lesions. […] There are also some genetic factors which may contribute to chilblain formations; these are when there is a family history of chilblains as well as genetic factors for vascular insufficiency. […] Other factors of chilblains include poor nutrition and a lower body weight.
  • #2 Chilblains (Pernio)
    https://lakecountyin.gov/departments/health/nursing-clinic/diseases-and-conditions/enviro-health-conditions/chilblains-pernio
    Chilblains occur when the skin is exposed to cold and damp conditions, leading to an inflammatory response in the small blood vessels (capillaries) of the affected areas. […] Several factors contribute to the development of chilblains: […] Exposure to Cold: Prolonged exposure to cold and damp weather, particularly in the absence of adequate protective clothing, increases the risk of chilblains. […] Individuals with poor circulation or conditions that affect blood flow are more susceptible to chilblains. […] People with sensitive skin or a history of skin conditions may be more prone to developing chilblains. […] Wearing insufficient or inappropriate clothing in cold weather can increase the risk of chilblains.
  • #2 Chilblains: Causes, Symptoms And Treatment
    https://www.netmeds.com/health-library/post/chilblains-causes-symptoms-and-treatment?srsltid=AfmBOop9Q6QD2i-qY3B1K8p2HdOYv3YOwjh5wtNp8OmN6Bix5GTi9DiD
    People having a poor blood circulation are more susceptible to temperature changes and have an increased risk of chilblains. […] People suffering from Raynauds disease or an auto-immune connective tissue disorder called Lupus are more susceptible to chilblains. […] Chilblains is less common in colder and drier areas because the people living in these places are already used to extreme cold weather and hence the clothing used in these areas are more protective against cold. The risk of chilblains is higher in people living in an area with high humidity and cold, but not freezing temperatures. […] People addicted to chain-smoking or tobacco are more at risk of getting chilblains.
  • #2 Chilblains: Symptoms, Causes & Prevention – footinjuryclinic
    https://www.footinjuryclinic.com/blog/chilblains-symptoms-causes-prevention/
    Chilblains are caused by a combination of cold weather and poor circulation. […] In the cold weather, our blood vessels constrict to conserve body heat. This constriction can starve your extremities (toes, fingers and earlobes) of blood and warmth, if your circulation is sluggish. […] The elderly, people who are sedentary, and underweight individuals are more at risk.
  • #2 Chilblains vs Raynaud’s: Differences, Symptoms, Causes, Treatment
    https://www.medicinenet.com/difference_between_chilblains_and_raynauds/article.htm
    Some of the factors that may increase the risk of chilblains are: Smoking, Poor nutrition, Wearing tight clothes, Certain occupations or professions that require exposure to frequent cold, damp conditions, such as farmers, mountaineers, and fishermen, Family history of chilblains, Certain underlying conditions, such as Raynauds and lupus. […] Depending on the underlying cause, Raynauds may be primary or secondary. […] Some of the causes of secondary Raynauds are: Certain diseases, such as rheumatoid arthritis, blood disorders, Buergers disease, and Sjogrens syndrome, Atherosclerosis (hardening of the arteries), Certain occupations or professions, such as those that involve the use of vibrating tools, repeated movements (such as typing or playing piano), or chemical exposure (such as plastic manufacturing), A history of surgery on the hands or feet, accidents, or frostbite, Certain medications, such as oral contraceptive pills, beta-blockers, certain migraine medications (containing ergotamine), over-the-counter cold or allergy medications, and some cancer medications, Repeated cold exposure.
  • #2 Chilblains – Wikipedia
    https://en.wikipedia.org/wiki/Chilblains
    Chilblains, also known as pernio, is a medical condition in which damage occurs to capillary beds in the skin, most often in the hands or feet, when blood perfuses into the nearby tissue, resulting in redness, itching, inflammation, and possibly blisters. […] It occurs most frequently when predisposed individuals, predominantly women, are exposed to cold and humidity. […] Chilblains can be idiopathic (spontaneous and unrelated to another disease), but similar symptoms may also be a manifestation of another serious medical condition that must be investigated. […] It has been suggested that in the absence of exposure to cold and damp, COVID-19 should be considered as a possible cause of chilblains.
  • #2 Pernio: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/1087946-overview
    Pernio is due to an abnormal vascular response to cold exposure, and it is most frequent when damp or humid conditions coincide. […] The direct cause of pernio is cold exposure; specifically, exposure to both mild nonfreezing cold and humidity seems to be required. […] Chronic pernio may be secondary to various systemic diseases as follows: Chronic myelomonocytic leukemia, Anorexia nervosa: Low body mass index may predispose to pernio, Dysproteinemias, Macroglobulinemia, Cryoglobulinemia, cryofibrinogenemia, cold agglutinins, Antiphospholipid antibody syndrome, Raynaud disease, Celiac disease. […] Chilblain lupus erythematosus (CHLE): Violaceous „pernio” plaques appear prominent over dorsal interphalangeal joints, often with positive antinuclear antibody (ANA) or rheumatoid factor (RF). Histologic and immunofluorescent evidence of lupus is present in the skin lesions.
  • #2 Chilblain Lupus: What It Is, Causes, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/21980-chilblain-lupus
    Chilblain lupus causes painful red or purple sores and discolored patches (plaques) of skin. These small sores (chilblains) form or worsen after exposure to cold temperatures. […] Chilblain lupus can be inherited (genetic) or sporadic (random). Sporadic chilblain lupus means you develop the condition later in life, usually as an adult. Researchers dont know why it occurs. […] People with inherited chilblain lupus have a gene variant (change). A change in either the TREX1 or SAMHD1 gene can lead to chilblain lupus. The TREX1 gene helps with DNA repair. The SAMHD1 gene plays a role in your immune response. Both gene mutations can be found in people who have a biological family history of the disease or who develop it as children. […] Anyone can develop chilblain lupus, but its most common in adults. People who live in cold, wet climates may be more likely to have chilblain lupus. […] Some conditions can increase a persons chances of getting chilblain lupus, including: Anorexia nervosa, a life-threatening eating disorder; Intestinal lymphoma, a rare type of lymphoma (lymph system cancer) that starts in your small bowel; Pregnancy.
  • #2 Chilblains – Symptoms, Diagnosis And Treatment | 24-7Medcare
    https://24-7medcare.com.au/skin-conditions/chilblains/
    People who have Raynauds Disease also report experiencing chilblains. This is a common condition that is seen in up to 14-20% of the population. Its a condition characterised by discoloured hand digits, which arises from reduced blood supply to certain areas due to vasospasms of the blood vessels. Similar to chilblains, cold weather also exacerbates Raynauds Disease.
  • #2 Pernio (Chilblains) – MD Searchlight
    https://mdsearchlight.com/health/pernio-chilblains/
    Pernio, a condition that affects the skin usually due to exposure to cold, is mostly believed to occur without any identifiable cause. […] The most frequently seen version of this secondary pernio is associated with a disease called systemic lupus erythematosus, which can further lead to the development of chilblain lupus erythematosus (CHLE). […] Interestingly, research has discovered cases where pernio was the first noticeable symptom in patients who were later diagnosed with acute lymphoblastic leukemia, which is a type of blood cancer.
  • #2 Chilblains | Better Health Channel
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/chilblains
    Chilblains are patches of red, swollen and itchy skin, thought to be caused by a combination of cold weather and poor circulation. […] Although the exact cause of chilblains remains unknown, it is thought to be associated with the body’s reaction to cold weather. […] As not everyone exposed to cold and damp conditions will develop chilblains, it is believed that those who do are overly sensitive to changes in weather and temperature. […] The elderly, sedentary, children, teenagers and people with medical conditions (such as anaemia) are most susceptible. […] The symptoms of chilblains are made worse with sudden temperature changes for example, entering a warm house after being outside in the cold. […] If you develop chilblains without being exposed to cold weather, seek advice from your health professional as this may be a sign of another condition such COVID-19.
  • #2 Chilblains – Symptoms, Diagnosis And Treatment | 24-7Medcare
    https://24-7medcare.com.au/skin-conditions/chilblains/
    Chilblains or perniosis is an uncommon inflammatory skin condition that mainly occurs during colder temperatures. […] This condition is typically caused by an abnormal response from the blood vessels to cold and damp climates. […] Primary chilblains occur idiopathically. This means that there are no apparent causes. On the other hand, secondary chilblains can usually be traced back to an underlying health condition (e.g. bone disorders, inflammatory conditions, etc.) […] Cold climates and sudden temperature changes are the most common causes of chilblains. Scientists suspect that chilblains originate from vasospasm of the blood vessels when exposed to the cold. […] Vasospasms occur due to the sudden contraction of the arteries which carry the blood around the body. These vasospasms can affect the blood flow to the surrounding tissue, including the skin and muscles. Over time, these changes can lead to symptoms, such as inflammation and swelling around the skin (particularly to areas that are exposed to the cold).
  • #2 Chilblain lupus erythematosus
    https://dermnetnz.org/topics/chilblain-lupus-erythematosus
    Chilblain LE occurs as both a sporadic and inherited condition. Sporadic cases are the most common and occur predominantly in middle-aged women, while familial chilblain LE presents in early childhood. […] The pathogenesis of the sporadic form of chilblain LE remains unknown. […] It is believed a cold stimulus provokes vasoconstriction or microvascular injury with occlusion of the capillary bed and diminished circulation, leading to hyperviscosity and stasis of the skin, which is exacerbated by reduced blood temperature. […] In those with a family history or onset of chilblain LE in childhood, the condition may be a result of a mutation in the TREX1 or SAMHD1 genes. […] These mutations in TREX1 and SAMHD1 are inherited in an autosomal-dominant manner.
  • #2 Chilblains: Symptoms, Pictures, Causes, Treatment, More
    https://www.healthline.com/health/chilblains
    Chilblains are small lesions. Theyre caused by the inflammation of tiny blood vessels after the skin is exposed to cold air. […] Doctors arent sure why this reaction occurs, but it may be related to an unusual reaction to cold exposure and rewarming. […] Its unclear what exactly causes people to develop chilblains. But there are a few things that might increase your risk.
  • #2 “Chilblains (CHILL-blayns): Causes, Symptoms, Treatment, and Prevention”
    https://www.doctorshubnepal.com/diseases-conditions/chilblains
    Chilblains occur when small blood vessels near the skins surface constrict in response to cold exposure. The exact cause is not fully understood. […] Risk factors include: […] Certain Medical Conditions: Conditions affecting circulation or autoimmune disorders may play a role.
  • #3 Chilblains: Causes, Symptoms & Treatment | Apollo Hospitals
    http://www.apollohospitals.com/diseases-and-conditions/chilblains-causes-symptoms-treatment
    Chilblains refer to inflammation of the blood capillaries in your skin resulting from cold exposure. This condition commonly affects your feet or hands. […] Though a response to cold exposure, the exact mechanism of chilblains is not known yet. Due to cold, the blood vessels of your toes and fingers shrink or become small. It prevents blood circulation. […] And, when your body warms up quickly, the blood vessels tend to expand again, making blood rush to your toes and fingers. It leads to redness, pain, and inflammation.