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Picture of the Month

Robert Giusti, MD; Walter W. Tunnessen Jr, MD
Arch Pediatr Adolesc Med. 1997;151(10):1055-1056. doi:10.1001/archpedi.1997.02170470089018.
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A 6-MONTH-OLD male infant had bluish purple discoloration of his cheeks for 7 days. There was no history of fever, popsicle ingestion, or trauma. The infant was not irritable and did not show signs of discomfort. The family lived in New York City and the onset of the lesions was in January.

On physical examination the infant's cheeks were bluish purple and nonblanching (Figure). A doughy induration of the subcutaneous tissue with distinct borders was noted. The buccal mucosa was unaffected and the skin temperature was normal.

Denouement and Discussion 

Chilblains (Pernio)  Chilblains, also known as pernio, was initially described by Corlett in 1894.1 The disorder is characterized by localized cyanosis and doughy subcutaneous swelling in areas exposed to cold. Nodules are frequently palpable in affected areas and symptoms may include itching, burning, or pain. The onset of changes in the skin occurs 12 to 24 hours after cold


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