After numerous consultations with 7 doctors over the space of several months, dozens of blood tests, biopsies, and several prescriptions it turned out i didn't need, the verdict on my hands is finally in.
Pernio, also known as chilblains, is a minor condition caused by cold. When my hands get cold, which happens from morning until night, fall to spring, and i try to warm them back up, blood rushing back into the fingers causes the capillaries to burst. The skin over these areas becomes inflamed, sometimes resulting in open sores. The joints hurt, and the fingers become very tender.
Sometimes this condition is secondary to discoid or chronic subcutaneous lupus. In my case, it is primary pernio, no underlying immunological cause.
Every blood test came back normal or negative. The biopsies showed no infection of any type, bacterial, viral, or fungal. In all likelihood, the first time we thought i had a fingernail fungus, it was actually my first bout of pernio, more than a year ago.
The only treatment the rheumatologist can think might even remotely help would be blood pressure medication, and with my blood pressure usually being around 100/60, that doesn't seem to me to be a good option. It would not help to trade chilblains for passing out due to low blood pressure.
Other than that, all i will be able to do is try to keep my perpetually icy cold hands warm during the winter.
So all of the concern over this past winter has boiled down to a minor, untreatable, nuisance condition. It is mildly painful, not at all contagious, and very ugly to look at.
It could have turned out to be a lot worse, so no complaints. Just keep the gloves handy.
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