Raynauds and Perniosis

Raynaud’s Phenomenon

  • Is a vasospastic disease that affects the blood supply to the fingers and toes (rare but can affect the tip of the nose/earlobes.
  • Triggered by exposure to the cold, stress/psychological upsets
  • Pt will report one or more fingers turning white/numb, blue during rewarming and then bright red due to increased blood flow. Pt can report that it lasts minutes to hours.
  • Can be primary (not associated with any disease process) or secondary (due to another disease process)

Causes of Secondary Raynauds

  • Systemic Sclerosis (crest syndrome)
  • Systemic Lupus Erythematous
  • Dermatomyositis
  • Sjogren syndrome
  • Granulomatosis with polyangiitis
  • Drugs- B blocker, clonidine, bleomycin, bromocriptine, imipramine, OCPs
  • Atherosclerosis
  • CVA
  • Multiple Sclerosis
  • Polio
  • Occupational causes- using vibrating tools- pneumatic drill operators, lumberjacks

Chilblains (also known as Pernio or Perniosis)

  • It is a localized form of vasculitis. Red/purple patches that can be painful, pruritic, and may blister, scab or ulcerate. Affected areas may be swollen.
  • Occurs several hours after cold exposure and lasts between 7-14 days
  • Common locations: fingers/toes, heels, lower extremities, nose, ears (wrists in babies)
    • Peds: may recur each winter and then suddenly resolve
    • Elderly: tends to recur yearly and likely to worsen each year
  • Pt’s with poor peripheral circulation are more likely to develop chilblains

Adapted from:

DermNet NZ. (2016). Retrieved from http://www.dermnetnz.org

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