Cold Panniculitis

Abstract

Cold panniculitis has been described in children and young women following cold exposure. Histopathologically, cold panniculitis shows a mostly lobular panniculitis, which consists of an infiltrate of lymphocytes and histiocytes in the fat lobules. Usually, the dermis shows a superficial and deep perivascular infiltrate mostly composed of lymphocytes, with no vasculitis. Inflammation is most intense at the dermal-subcutaneous junction. Differential diagnosis of cold panniculitis should be established with subcutaneous fat necrosis of the newborn, sclerema neonatorum, poststeroid panniculitis, chilblains, and frostbites.

Cold-Associated Perniosis of the Thighs (“Equestrian-Type” Chilblain): A Reappraisal Based on a Clinicopathologic and Immunohistochemical Study of 6 Cases

“…Thus, we think that the designation "cold-associated perniosis of the thighs" is best fitting with the clinicopathological features of this entity. This is different from acute cold-induced panniculitides 11 (Haxthausen's adiponecrosis e frigore 12 and ice popsicle panniculitis 13 ), in which fat necrosis is the primary cold-induced damage. In fact, shortly after the seminal article by Beacham et al, 1 the occurrence of a self-healing "cold-induced panniculitis" on the upper lateral thighs was found to be not restricted to young overweight women wearing tight-fitting pants during equestrian activities: men 9 and women 4 riding open vehicles/motorbikes, hikers wading across cold rivers, 4 and teenage girls wearing tight-fitting jeans with low waistband 7 were found to be also prone to develop an "equestrian-like, panniculitis-like" disease.…”

Firm Erythematous Nodules in a Hospitalized Infant

“…In adults it occurs most commonly in female equestrians on the thighs and buttocks and in individuals who use ice pack therapy for chronic pain . Cold panniculitis was first described over a century ago in children exposed to cold temperatures and is commonly recognized on the cheeks of children with a history of eating popsicles, due to direct contact with the buccal mucosa (popsicle panniculitis) . More recently, this entity has been reported in neonates and infants who undergo treatments with medically induced hypothermia for cardiac conditions and neonatal asphyxia .…”

Cold‐associated perniosis of the thighs histopathologically mimicking lupus. Six observations

“…In some cases, the presence of cold agglutinins was reported . More generally speaking, cold‐induced dermatoses appear in a variety of settings, either during outdoor activities in cold or humid environment, especially if chronic pressure due to tight‐fitting clothes or shoes, or following the application of ice packs or cryotherapy systems …”