Frostbites are purplish, purplish spots on the extremities, preferentially on the feet, with edema and itching, occurring during exposure to cold or moisture.
Frostbite occurs in most cases in young adults or during adolescence.
There is a clear predominance of women.
They occur only during wet and cold weather and the demonstrations disappear after the beautiful days
There is often a context of Raynaud’s syndrome (bleaching of certain cold fingers) or acrocyanosis (easily violated hands) in 80% of cases.
Causes and treatments of frostbite
If frostbite stops during the hot season and meets the entire classic criteria (occurred in a young person, most often a woman, in a context of acrocyanosis, on the feet …), it is considered that it’s just a benign vascular problem in the cold.
If the table is not typical, for example frostbite on the hands or occurring all year, the doctor will look for associated signs (joint pain, arterial disease …).
Indeed, atypical frostbite-like manifestations may be indicative of underlying diseases:
- Lupus– localized bruising especially on the dorsal side of the hands and persistent in summer
- Myeloproliferative disorder
- Buerger’s diseasein young smoker
- Cholesterol embolismon a field of cardiovascular pathology often from the fifties…
Medical treatment of frostbite
1 / Prevention
Preventive treatment is essential:
- Wearing warm, comfortable, warm shoes
- Making insoles or toe protection orthoseswhen frostbite still recurs on a toe or on an area of the plant
- Avoid vasoconstrictor drugssuch as oral or topical beta-blockers (eye drops prescribed for glaucoma for example), ergot derivatives, and oral or nasal ENT vasoconstrictors (treatment of colds).
If these measures are not enough, the doctor can prescribe vasodilators such as calcium channel blockers (nifedipine, diltiazem, verapamil …) from autumn to spring off-label.
2 / Treatment of frostbite
2.1 / mild chilblains
The doctor may prescribe the application of compresses and healing dressings, sometimes with cortison creams underneath.
2.2 / Ulcerated Frostbite
Drug treatment is also based on calcium channel blockers (nifedipine) in higher doses than in prevention.