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Treament of open chilblians

Discussion in 'General Issues and Discussion Forum' started by Richie, May 27, 2010.

  1. Richie

    Richie Member

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    Hi guys have a PT with very painful open chilblains, PT has multiple pathologies including lupus. Is the old treatment of friars balsam and iodene recomended if so how is this done. Does any one have any other suggestions.

    Many thnaks

  2. Craig Payne

    Craig Payne Moderator

    - I assume they are on cortisone?
    - they probably also have raynouds and possibly some vasculitis
    - There is a variant of lupus called "Chilblain Lupus"! --- particularly nasty as the chilblains are a poor prognostic indicator and there is very high risk of going on to systemic lupus erythematousis - if she does not have it already.
    - the chilblains in these people persist much monger than ‘regular’ chilblains

    Your wound management in these people is going to need to be 'aggressive' and those old traditional recipes of friars balsam are likely to be inadequate. Apply all the typical wound management techniques and peraps use Opsite, Tegaderm, Biofilm, Hydrofilm - these are the brand in use in Australia and may be different elsewhere, so use a good film dressing

    (my wound management knowledge is NOT the best, so I will check the above with someone who knows more about it than me)
  3. Admin2

    Admin2 Administrator Staff Member

    Related threads:
    Other threads tagged with chilblains
  4. Pauline burrell-saward

    Pauline burrell-saward Active Member

    Have a Pt who had really bad chilblain last year which took all summer to heal. This winter it broke down again but not so bad.

    took ages to heal till Nractise Nurse used"silver" based dressings. almost instant healing
  5. medisrch

    medisrch Active Member

    Yes agree with Pauline here. Silver based dressings would be the best option.
  6. Graham

    Graham RIP

    I have used an ankle block in a few bad cases which appears to help.
  7. Craig Payne

    Craig Payne Moderator

    I just had this turn up in one of my alerts:
    Treatment of Chilblains by Paravertebral Sympathetic Block.
    I thought "that looks interesting" , so followed it up .... then I noticed the date on it:

  8. drfoot2

    drfoot2 Active Member

    Aside from local treatments of the chilblain, one could also treat the peripheral circulation. I advise either 10 mg Adalat or 25mg Glyceryl Trinitrata patches. (transiderm Nitrate) The patches locally vasodilate when placed over the Posterior Tibial artery. I advise patients to alternate on one ankle daily. Be mindful of the main side effect being headaches. Alternatively, Adalat for the headache sufferer or the patient with Raynauds disease. This gives a systemic vasodilatory effect, so good for multiple site invlovement like hands, feet, ear lobes etc.


    Hi richie .Came across your quote.Im here in Ireland,Adults and children with painful chilblains.The best I find is with Betadine Solution.It has a very good way of sealing the affected area without having to strap up the areas ,allowing the areas to form a crust formation.The patient can apply the solution with cotton bud.The solution seems to become "stickey" around the areas I find a pair of Plastazote insoles are also good.Mark
  10. Cameron

    Cameron Well-Known Member


    Certainly for UK, Australasia and South Africa the lingering spectre of Read's therapeutics and to a lesser extent Le Rossignol continues to influence much of day to day pharmaceutical practice. Open chilblains are the equiv. of mild frostbite and need the care and attention of modern wound management. (as has been suggested in discussion).

    Much of traditional chiropodial therapeutics was based on history and practice and the above text books make much reference to galenticals and pre-synthetic pharmacy. Ironically this approach enjoys curency because it offers 'alternative' natural cures, such a Compound Tincture of Benzoin ( Friars Balsam). In the care of an open chilblain even in the Read text however, it would be contraindicated because it forms a film over the wound.

    Feeling very old as I have just realised I have been practising for four decades.


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