CHILBLAINS (PERNIOSIS): EXPERIENCE IN FIELD, TREATMENT STRATEGIES: A FIELD STUDY

Lt Col(Dr) Rajendra Pal Singh; Lt Col (Dr) Dheeraj Kumar; Lt Col (Dr) Binu Sekhar M; Lt Col(Dr) Sanjay Kumar Sharma; Lt Col (Dr)Dronacharya Routh; Col (Dr) BS Deswal

Volume : VII, Issue : II, February - 2018

CHILBLAINS (PERNIOSIS): EXPERIENCE IN FIELD, TREATMENT STRATEGIES: A FIELD STUDY

Lt Col Dr Rajendra Pal Singh, Lt Col Dr Dheeraj Kumar, Lt Col Dr Binu Sekhar M, Lt Col Dr Sanjay Kumar Sharma, Lt Col Dr Dronacharya Routh, Col Dr Bs Deswal

Abstract :

Introduction: Chilblains are common among helicopter aircrew and maintenance personnel operating at high altitude locations. As the recommended behavioural preventive measures were inadequate, a study was undertaken to see the effectiveness of available pharmacological measures. Methodology: 42 healthy males with chilblains participated. 6 subjects, who were doing recommended behaviour measures only, were taken as controls. Rest 36 subjects were equally divided into four groups with four different pharmacological regimens which were foot parade + Clopidogrel (treatment–I), foot parade + Clopidogrel + Pentoxifylline (treatment–II), foot parade + Clopidogrel + Nifedipine (treatment–III) and foot parade + Clopidogrel + Pentoxifylline + Nifedipine (treatment–IV). Results: Of the total 42 patients, 32(76.2%) were recovered and 10(23.8%) were not recovered during the study observation period of 10 days. Control and treatment–I groups had shown recovery rate of 16.7% and 44.4% respectively. Rest had 100% recovery. When treatment duration for clinical cure was analysed among different groups, the mean±SD in days for control, treatment I, II, III and IV were 9.0±0.0, 9.3±1.1, 4.4±0.5, 4.4±0.7 and 3.2±0.6 days respectively. The control and treatment–I groups took significantly longer time for recovery than other three treatment groups (p<0.001). Treatment groups II and III were not found to have any significant difference (p=1.0) between themselves, while treatment group–IV had shown further advantage (p=0.047). The mean±SD of pre–treatment and treatment duration in days were 3.8±1.5 and 5.9±2.7, respectively. They did not have any significant correlation (r=–0.05,p=0.78). Conclusion: Pharmacological strategies have shown added advantage both in cure rate and rapidity of recovery.