No abstract available.
Chilblains*

OBJECTIVE: The typical clinical feature of chronic cutaneous lupus erythematosus (CCLE) is 'discoid erythema'; however, several different clinical variants exist such as hypertrophic LE, LE profundus, chilblain LE, tumid LE and so on. The heterogeneity-spectrum of the lesional morphology of the cutaneous lesions and the predilection sites of the lesions of twenty Korean patients with CCLE were examined and tried to compare to those of CCLE patients of Caucasian origin. METHODS: Clinical examinations of twenty patients with CCLE were carried out by dermatologists to define the morphologic characteristics of cutaneous lesions and the anatomic predilection sites of the lesions. RESULTS: The most common cutaneous lesion-morphology noted in Korean patients with CCLE was classic discoid erythema. Three cases had concurrent cutaneous lesions of other clinical variants of CCLE. The predilection sites of all lesions were the face (cheeks) and head (frontal area). These clinical findings observed among this group of patients are similar to those features seen in people of Caucasian origin. CONCLUSION: The most frequent clinical feature of CCLE was discoid erythema and the predilections sites of the lesions found were the face and the scalp; indicating that the morphological heterogeneity-spectrum of cutaneous lesions and the predilection sites observed in Korean patients of CCLE seem to have no remarkable differences when compared with Caucasian cases with the same diagnoses.
Chilblains ; Diagnosis ; Erythema ; Head ; Humans ; Lupus Erythematosus, Cutaneous* ; Scalp

We experienced four cases of perniosis successfully treated with bukuryoingohangekobokuto, or hangekobokuto. Swollen tongue, pulsation at the pit of the navel, and tympanitic abdominal sounds were taken as common objective findings in all four cases. In addition, decreased surface body temperature was diagnosed at the bilateral hands and feet, so as to be distal from the trunk in palpation. These four cases had both symptoms of an eminent Ki obstruction, and a disorder of body fluid metabolism. For the two cases administered bukuryoingohangekobokuto especially, a state of strong Ki deficiency was diagnosed. Efficacy in each case was prompt. Thus, we consider bukuryoingohangekobokuto and hangekobokuto to be prescriptions worth trying for perniosis that does not responding to the usual Western medicines, or Kampo treatment.
Obstruction ; Application, NOS ; Chilblains ; Medicine, Kampo ; Western Herbs and Botanicals

OBJECTIVETo compare therapeutic effects of acupuncture plus massage and medicine on chilblains.

METHODSTwo hundred and sixty-four cases of chilblains were randomly divided into an acupuncture group of 136 cases and a medicine group of 128 cases. The acupuncture group were treated by acupuncture at 9 acupoints such as Yamen (GV 15), Laogong (PC 8), Sanyinjiao (SP 6), etc. plus massage, and the medicine group by dong chuang Plaster.

RESULTSIn the acupuncture group, 111 cases were cured and 136 cases were effective, the effective rate being 100.0%; and in the medicine group, 55 cases were cured and 98 cases were effective, the effective rate being 76.6%, with a very significant difference between the two groups in the therapeutic effect (P < 0.01).

CONCLUSIONAcupuncture plus massage is superior to dong chuang plaster in therapeutic effect on chilblains.

Chilblain lupus erythematsus is a rare special subtype of chronic cutaneous lupus erythematosus characterized erythematous acral skin lesion induced by cold, damp climate. Approximately, only 20% of the patients presenting with chilblain lupus erythematosus later develop systemic lupus erythematosus(SLE). We present here a case of chilblain lupus erythematosus, associated with a development of SLE later. A 29-year-old female patient has had violaceous and erythematous papules on the ear, dorsal hands and finger tips for 10 years and these lesions have been aggravated by winter. She has been diagnosed as a suspicious SLE for 3 years and then was treated with oral prednisolone and hydroxychloroqine.
Adult ; Chilblains* ; Climate ; Ear ; Female ; Fingers ; Hand ; Humans ; Lupus Erythematosus, Cutaneous ; Lupus Erythematosus, Systemic ; Prednisolone ; Skin

Chilblain lupus erythematosus (LE) is a rare, chronic form of cutaneous LE (CLE), which presents mostly in women as erythematous to violaceous plaques on the acral areas and face, precipitated by cold and damp climates. It may be accompanied by discoid LE (DLE) lesions or other forms of CLE. Up to 20% of patients develop systemic LE (SLE). Although two missense mutations in TREX1, encoding the 3'-5' repair exonuclease 1, were described in familial chilblain LE, the pathogenesis of sporadic chilblain LE remains unknown. To our knowledge, there are a few reports of chilblain LE in the Korean dermatologic literature. Herein, we present a rare and interesting case of sporadic chilblain LE in 71-year-old man and review the Korean literatures.
Aged ; Chilblains ; Climate ; Cold Temperature ; Exodeoxyribonucleases ; Female ; Humans ; Lupus Erythematosus, Cutaneous ; Mutation, Missense

Chilblain lupus erythematosus(CLE) is a chronic unremitting from of LE seen predomin antly in women, The chilblain lesion occurs commonly on the digits, calves and heels. Chronic facial discoid LE usually appears before the chilblain form. A 23-year-old female had relatively well defined, erythematous discoid plaques on her both cheeks and scattered erythema multiforme-like ring lesions on her right hand and right wrist. There were also chilblain lesions showing multiple, purple colored macules on her knees, lower legs and periungual areas of fingers and toes. The skin lesions developed at November, 1982 and then the skin lesions remitted during the next summer. The skin lesions recurred at December, 1983.
Cheek ; Chilblains* ; Erythema ; Female ; Fingers ; Hand ; Heel ; Humans ; Knee ; Leg ; Skin ; Toes ; Wrist ; Young Adult

Adolescent ; Adult ; Aged ; Chilblains ; therapy ; Female ; Ginger ; Humans ; Male ; Middle Aged ; Moxibustion ; Seasons ; Young Adult

The human capacity for physiologic adaptation to cold is minimal. A cold environment can be a threat to the skin, leading to a subsequent fall in core body temperature. Many physiologic, behavioral, and environmental factors predispose to the global effects of cold injuries. Physical injuries caused by cold have two forms: systemic forms such as hypothermia and localized forms such as frostbite. Reduced temperature directly damages the tissue, as in frostbite and cold immersion foot. Vasospasm of vessels perfusing the skin induces chilblain, acrocyanosis, and frostbite. The degree of damage caused by cold is related to four factors: temperature, exposure time, wind intensity (temperature sensation), and high altitude.
Adaptation, Physiological ; Altitude ; Body Temperature ; Chilblains ; Cold Injury ; Frostbite ; Humans ; Hypothermia ; Immersion Foot ; Skin ; Wind

Chilblain lupus erythematosus (LE) is a chronic unremitting form of LE seen predominantly in women. Chronic facial discoid LE frequently appears before the chilblain form. It may progress to systemic LE more frequently than other forms of chronic cutaneous LE do. We reported a case of chilblain LE in a 28-year-old male. He has had 1-5mm sized scaly erythematous macules on the ear, face, finger and toe tips for 10 years and these lesions have been aggravated in winter. Histopathologic findings were consistent with chilblain LE. The laboratory findings showed antinuclear antibody and anti-ds DNA antibody were positive but cryoglobulin and cold agglutinin were negative. One year later, lupus nephritis developed with leukopenia and decreased C3, C4 levels. He was diagnosed as systemic LE.
Adult ; Antibodies, Antinuclear ; Chilblains* ; DNA ; Ear ; Female ; Fingers ; Humans ; Leukopenia ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Male ; Toes