| • | AKA perniosis or chilblains |
| • | common; symptomatic skin lesions, which are precipitated by exposure to a moderate degree of cold in a humid climate |
| • | itchy or painful; papules or plaques; may have overlying blisters or ulcers |
| • | often superimposed on a background of acrocyanosis or erythrocyanosis |
| • | ddx: secondary pernio of chilblain LE |
| • | superficial perniosis – bilaterally symmetrical and acral (digits, heels, nose, and ears) |
| • | deep perniosis – thighs and buttocks (histologically extends to the subcutis) |
| • | treatment: keeping feet dry; nifedipine |
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