Chilblains and microgeodic disease diagnosed concurrently in a child's toe

Microgeodic disease, similar to chilblains (pernio), is characterized by painful, erythematous swelling, as well as small, punched-out erosions found in affected phalanges. Although they share a similar appearance and proposed pathogenesis, chilblains has rarely been diagnosed in children with microgeodic disease, and in those cases has not been confirmed on skin biopsy. This article details a child in Connecticut diagnosed during the winter with chilblains and microgeodic disease of his toe, as supported by biopsy and imaging. These findings further indicate that the two diseases are interrelated, imply a similar pathogenesis, and lead us to suggest similar treatment for problematic forms of both diseases.