Several dermatologic abnormalities have been described in anorexia ner
vosa, but only rare associations have been made with perniosis. We rec
ently saw two teenage girls and one woman with anorexia nervosa who ha
d symptoms of perniosis. We suggest that altered thermoregulation and
a hyperreactive peripheral vascular response to cold in anorexia nervo
sa may predispose these patients to perniosis.