Severe Ulcerative Perniosis Treated With Abobotulium Toxin

Perniosis (also known as pernio or chilblains), is a condition characterized by the development of pruritic, painful erythrocyanotic skin lesions induced by exposure to cold temperatures.2 When perniosis occurs in conjunction with clinical or laboratory features of systemic lupus erythematosus, the condition is further classified as chilblain lupus erythematosus (CHLE). CHLE is a rare condition with limited treatment options especially in refractory cases.3 Here we discuss the utility of therapeutic botulinum toxin injections in the treatment of severe, ulcerative CHLE.