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  1. I H Souwer, general practitioner1,
  2. A L M Lagro-Janssen, general practitioner2
  1. 1Middelie 91, 1472 GT Middelie, Netherlands
  2. 2Radboud University Nijmegen Medical Centre, Department of Primary and Community Care, Unit Women’s Studies Medicine, 6500 HB Nijmegen, Netherlands
  1. Correspondence to: IHSouweri.souwer{at}wxs.nl
  • Accepted 7 March 2011

A woman visited her general practitioner in mid December with pain and reddish discoloration of her toes. Her symptoms had recurred every winter, but resolved completely in the summer. In previous years, she had had similar symptoms in her fingers.

What you should cover

Chronic chilblains are cold induced, painful or itching, red-blue lesions on the fingers, feet, ears, or thighs (fig).1 The condition occurs throughout the world, more commonly in women than men. The average Dutch general practitioner reports four new cases a year (Continuous Morbidity Registration Nijmegen, The Netherlands; unpublished data). If patients consult a doctor at all, it will be their general practitioner.2

Symptoms usually start in early winter and vanish in spring, but often recur the next winter. Sometimes symptoms persist owing to continued exposure to cold, which is commonly associated with work conditions (cold storage work, for instance). Ulceration may also be …

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THIS WEEK'S POLL