Question special

A 56-year-old South American man presents with a 1-week history of tender lesions on his fingertips and toes. This is the first occurrence for the patient. He believes the inciting event was playing outside in wet and snowy conditions with his grandchildren in Minnesota. The next day he noticed itchy bumps that progressed to tender lesions, as seen in the image. He does not report any tobacco use, other associated skin symptoms, systemic complaints, or recent sick contacts. Testing for COVID is negative.

What is the most likely diagnosis?
A. Acrocyanosis
B. Dyshidrotic eczema
C. Chilblains
D. Sarcoidosis
E. Thromboangiitis obliterans

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