Perniosis in Association With Anorexia Nervosa

White, Kathleen Pogue; Rothe, Marti Jill; Milanese, and Ann; Grant‐Kels, Jane M.

doi:10.1111/j.1525-1470.1994.tb00063.x

Cited by 46 publications

(32 citation statements)

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“…19 A chilblain in cases of anorexia nervosa also explains the same. 6 38 (35.18%) patients had pigmentation along with erythema and oedema. This can be explained by the texture of the Asian skin where purpuric macules are visible as hyperpigmented macules.…”

Section: Discussionmentioning

confidence: 99%

Pattern of chilblains in a high altitude region of Ladakh, India

Singh

Datta²,

Grewal³

et al. 2015

Medical Journal Armed Forces India

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Section: Discussionmentioning

confidence: 99%

Pattern of chilblains in a high altitude region of Ladakh, India

Singh

Datta²,

Grewal³

et al. 2015

Medical Journal Armed Forces India

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“…Among adolescents, pernio has been seen in association with anorexia nervosa. 15 Among adults, pernio has been reported in association with systemic lupus erythematosus, 7 lupus anticoagulant, anticardiolipin, and antiphospholipid antibodies, 14 chronic myelocytic leukemia, 16 metastases from carcinoma of the breast, 17 and reaction to medication. 18 It is important, therefore, to consider these conditions when evaluating a patient with pernio, both to exclude an underlying diagnosis and to determine whether additional testing is necessary.…”

Section: Discussionmentioning

confidence: 99%

Pernio in Pediatrics

2005

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ABSTRACT. Pernio, or chilblains, is a localized inflammatory lesion of the skin resulting from an abnormal response to cold. Five cases were seen among adolescent female patients who presented to our rheumatology service in a pediatric tertiary care center in the winter of 2003 to 2004. All 5 patients were thin (BMI of <25th percentile) and had either toes or fingers that were affected. For each, laboratory evaluation results were unremarkable, including negative antinuclear antibody profile results. Symptomatic treatment, with or without medication, was recommended. Pernio most commonly occurs among young women but may occur among older individuals or among children. Because pernio develops among susceptible individuals who are exposed to nonfreezing cold, the lesions usually begin in the fall or winter and disappear in the spring or early summer. Acute pernio may develop 12 to 24 hours after exposure to the cold. Single or multiple erythematous, purplish, edematous lesions appear, accompanied by intense pain, itching, or burning. Chronic pernio occurs with repeated exposure to the cold and the persistence of lesions. In an acute exacerbation, the major differential diagnosis alternative would be Raynaud's phenomenon, which consists of sharply demarcated cutaneous pallor and cyanosis, followed by erythema, of far shorter duration (hours rather than days). Frostbite is freezing of tissue, with resultant tissue necrosis. Several conditions have been described as predisposing subjects to pernio, including the presence of cryoproteins, excessive cold exposure, and anorexia nervosa among children and systemic lupus erythematosus and antiphospholipid antibodies among adults. It is important, therefore, when evaluating a patient with pernio, both to exclude an underlying diagnosis and to determine whether additional testing is necessary. The lesions of acute pernio are usually self-limited but may lead to recurrent disease. The involved limb should be cleaned and dried, and rewarming should occur. Prevention is the best form of therapy, and cold exposure should be minimized after an initial insult. The prognosis for properly treated pernio is excellent. Nifedipine, which produces vasodilation, has been demonstrated to be effective in reducing pain, facilitating healing, and preventing new lesions of pernio. We think that the 5 cases seen in our rheumatology clinic represent an increase, compared with prior years; the dermatology clinic at the University of Colorado reported a series of 8 children treated during a 10-year period. The reasons for the possible increase are likely multifactorial, with cold climate, a vulnerable population with thin body habitus, and cold exposure all being contributing causes. Of note, the quality of cold in Colorado is quite dry; however, the winter of 2003 to 2004 was not particularly colder or drier than prior years. All patients were very thin, and thin body habitus may be associated with increased cutaneous vasoreactivity. It is also unclear how these cases of pernio may reflect that...

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“…In one dermatologic case report, perniotic skin lesions due to chronic cold exposure are described in a seven-p sequence as “purple patches, papules or plaques present on the proximal phalanges.”71 The complications of a Meckel's diverticulum can be remembered as the “seven p's”: peptic ulceration of adjacent mucosa with melaena; perforation and general peritonitis; pain which is colicky with intussusception; pink, raspberry tumour at umbilicus; patent vitellointestinal duct; persisting band with strangulations or cysts along the track; and persistent umbilical discharge 40…”

Section: Methodsmentioning

confidence: 99%

Alliteration in medicine: a puzzling profusion of p's

Hayden

1999

BMJ

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Perhaps the author should examine what criteria are used when cover art is selected by JAMA and make specific recommendations for evaluation. The statistics would have much more credibility if a larger base of examples (perhaps starting with the 1960s) was used, particularly if some type of trend was noticed.The terminology of the paper could be better defined-what specifically are "stereotyped sex images"? What would be a good or healthy ratio of such stereotyped images? (The paper cites 74% of the cover art depicting humans as presenting stereotyped sex images.) I would also recommend using pejorative adjectives only when each one conveys something significant and different and can be specifically evidenced. AbstractProblem Puzzling, progressive profusion of alliterative "p's" in published papers.

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Perniosis in Association With Anorexia Nervosa

Cited by 46 publications

References 24 publications

Pattern of chilblains in a high altitude region of Ladakh, India

Pattern of chilblains in a high altitude region of Ladakh, India

Pernio in Pediatrics

Alliteration in medicine: a puzzling profusion of p's

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