Celiac disease and chilblains

Chilblains (pernio) are not known to be a feature associated with Celiac disease, however, some cases have been reported. Other skin manifestations can occur in Celiac disease with dermatitis herpetiformis occurring in 25%.

A case of chilblains was reported in 2006 in Paediatric Dermatology being a presenting feature of Celiac disease in an adolescent girl:

Chilblains, or pernio, are cutaneous lesions that may accompany systemic illnesses including states of malnutrition and autoimmune diseases. We report an adolescent girl in whom chilblains were the chief presenting sign of celiac disease. A gluten‐free diet led to weight gain and resolution of the chilblains. We speculate that in this patient, weight loss due to celiac disease contributed to the development of chilblains.

Another case was reported in SAGE Open Medical Case Reports in 2020 of chilblains being the presenting feature in a case of Celiac disease.

We present the case of a 12-year-old girl with severe pernio as the sole clinical presentation of celiac disease (CD), without associated gastrointestinal symptoms. Lesions greatly improved once a gluten free diet was initiated. At 5-year follow-up, she remains in clinical remission throughout the year with no pharmacological treatment, without skin lesions flare-up in the winter months.

A further case was reported by Mašić et al(2022) with the suggestion that:

In the workup of chilblains (pernio) in children, an active case finding for coeliac disease should be conducted with coeliac-specific serology testing.

The mechanism by which Celiac disease could increase the risk for chilblains is not clear but it could be speculated that nutritional deficiency may be a predisposing factor. In these cases a gluten-free diet appeared to manage the chilblains.

Perhaps related to this is a case report of cold urticaria occurring in Celiac disease. The symptoms of the cold urticaria resolved following the diagnosis of Celiac disease and following a gluten free diet.

Other systemic conditions have also be linked to chilblains such as leukaemia, COVID-19 and lupus erythematosus.

External Links:
The lower limb in Coeliac’s Disease (Podiatry Arena)

Related Pages:
Chilblains and Leukaemia
Chilblains and ‘COVID Toes’
Chilblain Lupus Erythematosus
Chilblains and Urine Therapy

Page last updated: @ 3:29 am

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