Purple, oval, nontender nodules on the toes in a child with pernio.
Purple nodule on the ear of toddler with pernio.
CLINICAL FEATURES
Asymptomatic red-purple to purple nodules that develop several days to weeks after cold exposure characterize pernio. The nodules are on the fingers, toes or ears and are accompanied by a livedo pattern on adjacent skin. Uncommonly, the nodules ulcerate and become painful (kibes). The amount of cold exposure may seem trivial and associated wetness is required to develop pernio. Adolescent girls with anorexia nervosa are susceptible to pernio. Cryoglobulins or other cryoproteins may be present.
TREATMENT
Avoidance of wet and cold may prevent new lesions but there is no effective treatment for established pernio.
