Perniosis in association with anorexia nervosa

Several dermatologic abnormalities have been described in anorexia nervosa, but only rare associations have been made with perniosis. We recently saw two teenage girls and one woman with anorexia nervosa who had symptoms of perniosis. We suggest that altered thermoregulation and a hyperreactive peripheral vascular response to cold in anorexia nervosa may predispose these patients to perniosis.