Pernio (aka chilblains) appears as erythematous/violaceous macules, papules, plaques, or nodules in sites of cold exposure, typically on the fingers and toes. Symptoms of pruritus, pain, or burning often accompany the skin lesions, and complications of blistering, ulceration, or secondary infection can occur. The most frequently reported and most studied relationship between pernio and another disease is the relationship between pernio and lupus. Patients with pernio should try to keep the affected area warm by wearing appropriately insulated clothing, gloves, and footwear, while avoiding unprotected exposure to cold conditions. Other treatment options include topical steroids and oral nifedipine, although evidence is limited.