Diagnosis of Chilblains
Diagnosis of chilblains is typically clinical, meaning it is based on physical examination and symptom history rather than lab tests. While chilblains are relatively straightforward to recognise, it’s important to rule out other skin and circulatory conditions that may look similar.
1. Clinical Examination
A doctor will begin by examining the affected area. Hallmark signs that suggest chilblains include:
- Discoloured, inflamed patches on extremities
- Swelling and skin changes
- Reports of cold exposure prior to symptom onset
The presence of itchy or burning lesions that appear after cold weather and resolve with warmth is usually diagnostic.
2. Medical History | Diagnosis of Chilblains
Doctors will ask about:
- Frequency and pattern of symptoms
- Exposure to cold or damp environments
- Use of heating or rapid rewarming techniques
- Family or personal history of circulatory disorders
They may also ask whether symptoms reappear during specific seasons, particularly winter.
3. Rule Out Other Conditions
Other skin and vascular conditions may mimic chilblains, including:
- Frostbite: Typically more severe and associated with tissue death
- Raynaud’s phenomenon: Characterised by white or blue fingers triggered by cold or stress
- Erythromelalgia: Red, hot, and painful extremities, usually triggered by warmth rather than cold
- Vasculitis or lupus: If symptoms are chronic or systemic
If an autoimmune or connective tissue disorder is suspected, blood tests may be ordered.
4. Biopsy (Rare) | Diagnosis of Chilblains
A skin biopsy is rarely needed, but may be performed in atypical or unresponsive cases to confirm diagnosis or exclude other causes.
Timely and accurate diagnosis of chilblains ensures patients receive the appropriate care and don’t suffer unnecessarily from avoidable flare-ups or complications.
[Next: Treatment of Chilblains →]
