A random comparative therapeutic trial of oral nifedipine v/s topical 5% minoxidil gel in patients of perniosis at a tertiary care center of North-western India

Introduction: Perniosis (chilblain) is a highly common, prolonged cold induced skin disorder, a very common nuisance in general skin OPD of northern parts of India where winters are long and prolonged and temperatures dip to almost zero. Various treatment modalities have been tried for its treatment, on time and again but none of the treatments have given optimum fast results. We conducted a study on perniosis in peak winters at one of the tertiary care center of the western India. Aim and Objectives: To study and compare, the efficacy of oral nifedipine v/s topical 5% minoxidil Gel in perniosis. Method: The patients clinically fitting in to the diagnosis of perniosis were divided randomly in to two groups. Necessary clinical examination and investigations were carried out to find out any other associated ailment including pregnancy. Group A was given oral nifedipine 10 mg three times daily and Group B was given topical minoxidil 5% Gel applied twice daily, topically. Irrespective of the group, all the patients were given oral antihistaminics. Both clinical and subjective responses were noted on day 3, 7 and 14, respectively. Results: Out of 84 patients, 30 were males and 54 were females with male to female ratio of 1:1.8. The House wives were affected more among all female patients (51%). In group A and B, 42 cases were included in the study and they completed the follow up till 14th day. In group A, after second week of follow up, 25 cases noted good response, 10 cases explained it as very good and in 6 cases, satisfying response was seen which was statistically significant (p<0.05). In group B also, 42 cases which completed the study, after second week, 22 cases achieved satisfaction, 17 cases good and 3 cases very good response. Conclusion: Oral Nifedipine 10 mg three times a day was more effective in lower doses among Indian patients with least possible side effects as compared to Topical 5% Minoxidil Gel therapy in the management of perniosis.