Diltiazem vs. nifedipine in chilblains: a clinical trial.

BACKGROUND: The treatment of chilblains remains unsatisfactory. Nifedipine in higher doses remains the mainstay of treatment. AIMS: To compare the efficacy of diltiazem with that of nifedipine, and to determine the efficacy of nifedipine in lower doses, 36 chilblains cases were studied. MATERIAL AND METHODS: Group A (12 patients) was treated with diltiazem 60 mg thrice daily, and Group B (24 patients) with 10 mg nifedipine thrice daily till complete relief and then maintained on a sustained release preparation of nifedipine 20 mg twice daily. RESULTS: Two patients in Group A showed complete relief in 7 days, and 3 patients in about 21 days, but in 7 cases there was little or no response. In group B, 21 cases showed 80-90% relief by the fourteenth day. CONCLUSIONS: We conclude that nifedipine remains the drug of choice in chilblains but can be used in a smaller dosage in the Indian population. Diltiazem is less effective in the conventional dose, which may be optimized.