Case Number : Case 2014 - 23 Feb 2018 Posted By: Dr. Richard Carr

Pernio

Good Job Anil. You hit the nail in the head (if am not wrong?!). Nice lymphocytic vasculitis and perieccrine infiltrate. 

Thanks Vincenzo. Have only heard and read about this condition. Have not seen any case in this part of the world! :--)

Yes, perniosis

Lymphos around the vessels

Lymphos around the eccrines

Edema of the dermis

Friends, it's perniosis

I vote for pernio too. Chilblain lupus can have similar findings. If the clinical setting is not classic, I also thought about a drug eruption.

Another differential could be lichen striatus. Although, as you guys, on top of my list of differentials I put perniosis and childblain lupus due to the presence of papillary edema and the clinical setting

It was on the thigh.  I suggested equestrian perniosis but I guess in the UK young women's thighs can be rather exposed on cold nights out on the town!

Chilblains was my initial thoughts as well. While “Equestrian” is a useful reminder but probably slightly restrictive. This cold associated dermatosis is reported in a variety of other settings (other than horse riding) upon prolonged exposure to cold in one way or another, typically on lateral thighs of young women. Lately I have observed it in a lady who spend 2-3 hours each morning regularly in the chiller section of one of the UK supermarkets as part of her new job without any history of horse riding.