Treatment of Perniosis with Oral Nifedipine in Comparison with Topical 5% Minoxidil Solution in Iraqi Patients. Single Blind Comparative Study


Background: Perniosis (chilblains) is a common dermatological problem. The condition results from abnormal reaction to cold, it is seen during the cold months of winter. Many treatment modalities have been tried with variable results.
Objective: To evaluate the effectiveness and safety of nifidipine in comparison with topical 5% minoxidil solution.
Methods: This was a single blind comparative therapeutic trial conducted in the Department of Dermatology and Venerology, Ramadi Teaching Hospital, Anbar, Iraq between December 2008 and March 2009. Sixty-two patients with perniosis were enrolled in this study, they were divided randomly into 2 groups, depending on the type of treatment. Group A: 42 patients received an oral sustained release preparation of nifedipine 20 mg once daily for one week then twice a day for another week. Group B: 20 patients received topical 5 % minoxidil solution applied twice daily for two weeks. Detailed history and full clinical examination were carried out for each case, regarding all relevant points related to the disease.
Results: The ages ranged from 9-68 years with a mean¬±SD of 21±10.2 years. They comprised 37 females and 25 males, with a female to male ratio of 1.5:1. All patients did not receive any medical remedies before the start of the study. In group A: 35 patients completed the 2 weeks treatment course. Twenty (57%) patients showed good improvement and 9(26%) showed very good improvement and complete cure after 2 weeks, which was statistically significant p<0.05. In group B: 17 patients completed the regime. Six (35%) patients showed good improvement and 1(6%) patient showed very good improvement, when signs and symptoms disappeared after 2 weeks.
Conclusion: Oral nifedipine was shown to be an effective and safe drug for treatment of perniosis, and can be used in smaller dosage, and it is superior to topical 5 % minoxidil solution. The last one showed early rapid action.

Keywords: Perniosis, Iraqi patients, nifidipine, topical 5 % minoxidil