Two Cases of a Cool Skin Condition (Erythrocyanosis, Pernio or Chilblains,  Anyone?)

BY HANS DUVEFELT A month ago an oncologist called and asked me to see one of my heart failure patients whose chronically swollen legs seemed unusually blue but not cold. Before I could get him in to see me, he ended up seeing a colleague, who called me up and said the man’s legs were cool and there was no Doppler in that office to check for pedal pulses. The man was sent for an urgent CT angiogram with runoff. The test was perfectly normal. He had clean arteries. When I saw him, the legs were less blue than they must have been and they felt OK but he had what looked like a shingles rash around his right elbow. There was some surrounding swelling and redness, so I prescribed an antiviral, an antibiotic and prednisone and arranged to see him back. My diagnosis was erythrocyanosis. I have never seen a case but my instinct when I saw him was that this was a peripheral thermal regulation problem. So, a little bit of searching on the Internet gave me the diagnosis. In follow up, the legs looked fine and the elbow rash was drying up nicely. None of my research suggested a reasonable treatment option for his condition. But he was getting better so I didn’t have to worry about it at that moment. A few weeks later I saw a young woman who spends her free time in a horse barn. She had a bluish discoloration of her outer thighs on both legs with some red spots scattered throughout the affected area. She told me she had had something similar a year or two ea...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Chillblains Cool Skin Condition Erythrocyanosis Hans Duvefelt Source Type: blogs