Difference between revisions of "Cold injuries"

(Trench Foot)
(Pernio (Chilblains))
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==[[Trench Foot]]==
 
==[[Trench Foot]]==
  
==Pernio (Chilblains)==
+
==[[Pernio (Chilblains)]]==
===Background===
 
*Mild but uncomfortable inflammatory lesions of skin
 
**Caused by long-term intermittent exposure to damp, nonfreezing ambient temperatures
 
*Primarily a disease of women and children
 
 
 
===Clinical Features===
 
*Hands, ears, lower legs, feet most commonly affected
 
*Symptoms
 
**Tingling, numbness, pruritus, burning paresthesias
 
**Cutaneous manifestations appear up to 12hr after acute exposure:
 
**Localized edema, erythema, cyanosis, plaques, nodules
 
***May progress in rare cases to ulcerations, vesicles, and bullae
 
**Rewarming may result in formation of tender blue nodules which may persist for days
 
 
 
===Treatment===
 
*Affected skin should be rewarmed, gently bandaged, and elevated
 
*Nifedipine 20mg PO TID may be helpful as both prophylactic and therapeutic tx
 
*Topical corticosteroids and oral steroid burst have been shown to be useful
 
  
 
==Cold Panniculitis==
 
==Cold Panniculitis==

Revision as of 06:22, 3 December 2013

Background

  • Frostbite occurs only when ambient temperatures are well below freezing
  • Nonfreezing cold injuries occur due to exposure to wet conditions when temper >freezing

Trench Foot

Pernio (Chilblains)

Cold Panniculitis

  • Prolonged exposure to temp >freezing leads to mild necrosis of subcutaneous fat tissue
  • Seen in children (popsicles) and women involved in equestrian activities
  • Resolution may result in adipose fibrosis w/ cosmetic defects
    • There is no treatment

Cold Urticaria

  • Hypersensitivity to cold air or water which may lead to fatal anaphylaxis
  • Treat similarly to urticarial lesions from other causes (i.e. antihistamines)
  • Avoidance of cold is recommended

Source

Tintinalli