Description, Causes and Risk Factors:
A condition seen in girls and young women in which exposure of the limbs to cold causes them to become swollen and dusky red; it results from direct exposure to cold, but not freezing, temperatures.
Erythrocyanosis is a common, sometimes familial condition. It is characterised by cutaneous lesions that often occur after exposure to cold and high humidity (dampness) during cold months of the year. It is an abnormal reaction to cold that occurs most frequently in women, children, and the elderly. Lesions tend to become worse in the elderly, and improve spontaneously in younger patients. The disease seems to be more common in environments where heating is inadequate for a few months of the year and is less common in localities characterised by harsh frigid winters where adequate home heating is the norm. Exposure to cold water sometimes seems to play a role.
The pathogenesis of erythrocyanosis is not well-understood. Cold is a requirement for the development of symptoms. Erythrocyanosis are caused by a combination of arteriolar and venular constriction, the latter predominating on rewarming with exudation of fluid into the tissues. Erythrocyanosis can be induced in susceptible individuals by prolonged exposure to temperatures above freezing point in humid climates. Tight clothing and in some cases, particularly during childhood, dysproteinaemia may play a part.
Erythrocyanosis mainly occurs in obese, often young, women. Purple-red mottled discoloration is seen on the buttocks, thighs and lower legs. Cold provokes the condition and causes an unpleasant burning sensation.
Erythrocyanosis usually last for about 7-14 days, and then gradually resolve during the following week. Treatment is not typically needed, but there is a wide range of soothing creams and lotions available to relieve the pain.
The symptoms and signs of erythrocyanosis may include:
Reddish appearance which may change to purple in color.
Pain and tenderness.
Skin over the erythrocyanosis may form a blister.
Skin breaks down and becomes an ulcer, causing a skin infection to develop.
Itching, burning sensation.
The diagnosis of erythrocyanosis is usually based on clinical grounds. A skin biopsy may be helpful in cases where the diagnosis is in doubt. The four characteristic findings are scattered necrosis of individual keratinocytes, marked subepidermal edema, perivascular lymphocytes and lymphocytic vasculitis. Erythrocyanosis may be difficult to distinguish from lupus erythematosus, spongiosis and Peri-eccrine lymphocytes are more common in erythrocyanosis. In lupus erythematosus vacuolation of the basal layer is more common, mucin is usually increased in the dermis and the lupus band test (that is IgG at the dermo-epidermal junction) is positive. The presence of antinuclear antibodies favors a diagnosis of lupus erythematosus.
The therapeutic strategy comprises avoiding chronic exposure to cold temperatures and employing therapeutic agents that increase peripheral circulation.
Keeping both the affected extremities and the core body dry and warm are essential in preventing erythrocyanosis. Patients should wear thick socks and shoes. For erythrocyanosis of the hands, gloves are recommended. Clothing should be loose-fitting. The ambient temperature should be warm. These environmental changes are most critical in preventing recurrences. Feet should always be kept dry as moisture enhances cold injury.
Avoid direct heat (that is do not expose the feet to a heater), but keep the feet warm by the use of woolen socks and footwear.
Use soothing lotions (eg calamine lotion).
If the skin is broken, use an antiseptic dressing to prevent the chilblains becoming infected.
Those with diabetes or poor circulation should see a Podiatrist. The risk of further complications from the erythrocyanosis in those with a foot that is 'at risk' is too high to delay seeking professional help.
Thermal or insulating insoles can help keep the foot warm to prevent chilblains.
Lanolin or a similar lotion that is rubbed into the feet will help stimulate the circulation.
There are a number of natural or homeopathic remedies that are recommended for the treatment of erythrocyanosis. Some of these do appear to help some people.
Do not rub or scratch erythrocyanosis.
NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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