PERNIOSIS: AN ENIGMATIC DERMATOLOGICAL ENTITY- STUDY OF ITS DEMOGRAPHIC PROFILE AND NAIL CAPILLAROSCOPIC CHANGES

Abstract

BACKGROUND: Perniosis is a localised inammatory disorder affecting the unprotected skin regions of individuals exposed to damp, nonfreezing cold. The exact pathogenesis has not been elucidated, however, it is thought to be a microvascular disease. AIMS: To study the demographic prole of patients presenting with perniosis and examine the nailfold capillaroscopic (NFC) changes. MATERIAL AND METHODS: This was an observational, cross-sectional study conducted at a Tertiary care hospital of North India over a period of three months (November 2020- January 2021). Patients with idiopathic perniosis were included in the study. After detailed history and clinical examination, proximal nailfold (PNF) video capillaroscopy was performed in the affected digits. RESULTS: A total of 47 patients with idiopathic perniosis were recruited in the study consisting of 35 females and 12 males with female to male ratio of 2.9:1. A majority of individuals belonged to age group 21-35 years (38.29%). Lesions were localized to both hands and feet in 23 patients (48.9%), only hands in 19(40.4%) and only toes in rest 5 (10.6%) patients. Ten (21.2%) patients had family history of similar complaints and history of smoking was present in 2 (4%) patients. The mean BMI 2 recorded in 37 patients aged >20 years was 20.72+4.32kg/m . Finger nail videocapillaroscopy performed in 42 patients showed dilated capillaries in 42.8%, tortuosity in 40.4% and microhaemorrhages in 28.5% patients. CONCLUSION: In the present study, presence of nailfold capillaroscopic changes suggested that an organic damage to the microcirculation is present in perniosis. Low BMI is an important association for development of perniosis. LIMITATIONS: Long term follow up is required for patients with chilblains to assess permanency of nailfold capillaroscopic changes.