Three cases of acute pernio or chilblains are described in children who wore shoe boots. This dermatosis occurred on the plantar surface of only one foot, about 24 hours after exposure to a cold and wet environment. The lesions consisted of painful, tender, bluish-red nodules that lasted about ten days to two weeks and then resolved. The histologic examination showed involvement of deep dermal blood vessels by an infiltrate of lymphocytes, neutrophils, and eosinophils. There was also thickening of the walls of the vessels and intimal proliferation leading to obliteration of the vascular lumina.
Coskey RJ, Mehregan AH. Shoe Boot Pernio. Arch Dermatol. 1974;109(1):56–57. doi:10.1001/archderm.1974.01630010036007
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