Nifedipine: A New Treatment for Perniosis

In a study from 1987, nifedipine, a medication commonly used for treating Raynaud's phenomenon, was investigated as a potential treatment for perniosis, a condition characterized by inflammatory skin lesions due to abnormal reactions to cold. The open study included 25 patients with severe recalcitrant perniosis, 22 of whom had idiopathic perniosis and 3 had anorexia nervosa. Patients were prescribed nifedipine retard 20 mg, with the dose increased by 20 mg every 3 days until a therapeutic dose was reached or side-effects occurred. Seventeen patients reported rapid symptomatic relief and lesion clearing after a mean of 14 days on a modal dose of 60 mg daily. Biopsies showed resolution of dermal edema and a decrease in perivascular cellular infiltrate. Six patients did not benefit, mainly due to side-effects at a lower dose of 30 mg daily, and two patients were lost to follow-up. The study concluded that there was no correlation between the cause of perniosis and the clinical or histological response to nifedipine treatment.