Author Affiliations: Department of Dermatology, University of Cincinnati, Cincinnati, Ohio (Drs King, Plotner, and Adams); Section of Dermatology, Veterans Affairs Medical Center, Cincinnati (Dr Adams).
Perniosis is characterized by erythematous and violaceous smooth papules, plaques, and nodules, which are usually symmetrically distributed on the distal aspects of the fingers and toes and less commonly on the heels, nose, and ears. These lesions likely result from persistent or prolonged cold-induced vasoconstriction causing hypoxemia along with a subsequent inflammatory response.1
King JM, Plotner AN, Adams BB. Perniosis Induced by a Cold-Therapy System. Arch Dermatol. 2012;148(9):1101-1102. doi:10.1001/archdermatol.2012.1429