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Nifedipine: a new treatment for perniosis
Author(s) -
Rustin M.H.A.,
Newton J.A.,
Dowd P.M.
Publication year - 1987
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.1987.tb12003.x
Subject(s) - nifedipine , medicine , etiology , anorexia nervosa , surgery , gastroenterology , calcium , psychiatry , eating disorders
Perniosis consists of inflammatory cutaneous lesions, usually arising on acral sites as a result of an abnormal reaction to cold. Spontaneous resolution occurs, but some patients have chronic, recalcitrant and ulcerating lesions which persist into the summer. Although the aetiology is unknown, there are features suggesting a vasospastic component and since nifedipine is an effective treatment of Raynaud's phenomenon, we wondered whether it might also be beneficial in another cold‐related disorder, perniosis. Twenty‐five patients (23 female, two male) with severe recalcitrant perniosis were enrolled into an open study; 22 had idiopathic perniosis, three had associated anorexia nervosa. 1 Nifedipine retard 20 mg was prescribed after onset of lesions and the dose was increased by increments of 20 mg every 3 days until a therapeutic dose was achieved or side‐effects developed. Seventeen patients experienced rapid symptomatic relief on a modal dose of 60 mg daily with clearing of lesions after a mean of 14 days. A comparison of pre‐ and post‐treatment biopsies showed resolution of the dermal oedema and diminution of the perivascular cellular infiltrate. Six patients who derived no benefit only achieved a dose of 30 mg daily because of side‐effects and two patients were lost to follow‐up. There was no correlation between the aetiology, clinical and histological features and response to treatment.