Topical Nitroglycerine in Perniosis/Chilblains

The treatment of perniosis is largely inadequate. The success rate of 0.2% nitroglycerine ointment is demonstrated in the present series. Twenty-two patients clinically diagnosed with severe perniosis were prescribed the topical vasodilator nitroglycerine. Digital photography and patient self-report of the clinical appearance, degree of irritation, and pain and soreness of the lesions were assessed on a 3-point scale to assess therapeutic response. A total of 18 of the 22 patients had regression of the lesions within the first week of treatment and complete regression in 2 weeks. Of these patients, 2 who experienced a relapse were successfully treated with another course of topical nitroglycerine. Two of 22 patients had regression of the lesions during the second week and complete regression in another week. Response was delayed in patients with a longer duration of disease. Topical 0.2% nitroglycerine ointment may be a promising alternative treatment option in perniosis.