I know I’m coming a little late for this, but I want to thank Cecil for last week’s column, about chilblains. I’d never heard of this condition, and I had been wondering about the lesions that have appeared on my hands for the last two winters. But let’s see:
[ul]
[li]Chilblains are caused by circulation problems in small blood vessels. Well, I do believe that the blood circulation in my hands isn’t very good, since they sometimes get really cold in the winter, even when I’m inside and otherwise not cold.[/li][li]The symptoms are swelling, discolouration and sometimes blisters, sores and painful nodules under the skin. This sounds like what I get, except for blisters, and for the fact that if I remember correctly, the inflamed zones on my skin usually get redder, not discoloured. The nodules under the skin, I do get and it really caught my attention when I read it in the column.[/li][li]Topical steroids are used to fight itching and swelling. Up to now, this is the only thing I’ve found that seems to work. I used a lot of cortisone cream during last winter. While it does help with the itching and swelling, and it prevents the apparition of new nodules (the existing ones surface, breaking the skin, and then heal), it doesn’t help with the odd colouration of the skin, and I need to put cream at least once every day, preferably more, if I want the effect to persist. Still, it works.[/li][li]It’s more common about people who are excessively thin. Hmm, no, in this case, it just doesn’t fit. 
I don’t smoke either.[/li][/ul]
So it seems that these lesions are likely to be chilblains after all. It’s good to know, now I know that keeping my hands as warm as possible next winter might stop them from reappearing. Plus, if I ever need an excuse to drink, I can always use this. 
So again, my thanks to Cecil for tackling this subject.
Just got back after being away.
I’ve wondered what chilblains were for years, ever since reading Jean Anhouilh’s play Becket, where Henry II complains about his. Even after reading the column, I still don’t really know what they are, or look or feel like. Although now I know what causes them.
I was drawn in to comment by this sentence:
As one who enjoys the symptoms of gout which i wouldn’t wisdh on my worst enemy), I have to take issue with this description. It certainly conveys the sense well enough – gout does feel as if you’ve got a zillion tiny razor blades sloughing away at the tyender surv=faces inside your sac of synovial fluid – but biological systems don’t work that way. I challenged my doctor about it one day. Look, I said, all the descriptions of gout say that it’s caused by sharp yuric acid crystals abrading your joints. I don’t buy it. What’s really going on? What happens is that the uric acid triggers an inflammation response. Exactly how this happens he didn’t know. It is possible that mechanical action plays a part, but I doubt it. I do know that the hot and hurtin’ tissue extends well beyond the region of the joint proper, and that it’s not in pain because of tiny crystals being jabbed into it. Gout is painful because the body’s defences have been turned on.