At a Glance - Juvenile spring eruption vs perniosis

Juvenile spring eruption

Juvenille spring eruption

Clinical features

  • Localised polymorphic light eruption.
  • Usually presents in early spring.
  • More common in boys and young men with short hair, as their ears are exposed.
  • Presents within 24 hours of sun exposure.
  • Itchy papulo-vesicular rash on the auricle. May form blisters.
  • Enlarged cervical lymph glands.
  • Healing occurs spontaneously within two weeks.
  • Tends to remit in summer but may recur each year.


  • Treatment speeds healing.
  • Emollients.
  • Topical potent steroid.
  • Antihistamines for itching.
  • Recurrences reduced by growing hair, wearing hats and using sunscreens.

Perniosis of the ear

Perniosis may ulcerate

Clinical features

  • Most common in women and sometimes familial.
  • Induced by cold, damp situations.
  • Perniosis (chilblains) may also affect extremities, ie feet and hands, fingers, toes and nose.
  • May also occur in association with lupus erythematosus (LE), viral hepatitis, HIV, rheumatoid arthritis and chronic myelomonocytic leukaemia.
  • Recurrent, painful, tender erythematous/violaceous plaques on the auricle.
  • May complain of itchy and burning sensation.
  • May blister and ulcerate.
  • Usually occur during the winter months.
  • Perniosis is usually a clinical diagnosis but investigate if in doubt.
  • Skin biopsy.
  • Positive antinuclear antibodies would suggest LE.


  • Avoid exposure to cold.
  • Nifedipine 10mg three times daily or 20mg twice daily.
  • Nicotinamide 500mg three times daily.
  • Topical hexyl nicotinate.
  • Amlopidine 2.5-5mg daily.
  • UV light to affected areas at the start of the cold season.
  • Sympathectomy in severe cases.

Contributed by Dr Jean Watkins, a sessional GP in Hampshire.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Follow Us:

Just published

£20 notes spread out

VAT trap for PCNs could strip millions of pounds from general practice

Tens of millions of pounds could be stripped from general practice because work carried...

Talking General Practice logo

Podcast: Is the BMA representing GPs effectively, why GPs face a pension tax hit, and views on the workload crisis

In our regular news review the team discusses representation of GPs, a new survey...

Man sleeping

NICE guidance on insomnia backs app to replace sleeping pills

Hundreds of thousands of people with insomnia could be offered treatment via a mobile...

Health worker prepares a dose of COVID-19 vaccine

JCVI backs autumn COVID-19 booster campaign for high-risk adults and NHS staff

Frontline health and social care staff and adults at increased risk of severe illness...

GP consultation

Government accused of 'misleading' claims on general practice workforce

GP leaders have accused the government of making misleading claims about the general...

Consulting room door

LMC calls for enhanced access to be scrapped after abuse forces practice to close reception

A Midlands LMC has backed a practice forced to close its reception desk after abuse...