Cold Panniculitis

 

 

Cold panniculitis is also more frequent in infants following exposure to severe cold. This variant of panniculitis has been described in the cheeks of children sucking ice cubes, ice packs, or ice lollies (popsicles), and in the thighs and buttocks of women who ride horses wearing tight trousers during the cold months, resulting in obstruction of the blood supply to the subcutaneous fat (equestrian panniculitis). The involved areas show indurated erythematous plaques with ill-defined margins.

The panniculitis is mostly lobular with an inflammatory infiltrate of lymphocytes and histiocytes in the fat lobules. The papillary dermis may show marked edema as well as a superficial and deep perivascular lymphocytic infiltrate, closely resembling the histopathologic picture of perniosis.

If the involved area is kept warm, the plaques slowly soften and resolve in days without scarring. Looser trousers should be recommended for women who ride horses. Vasodilator drugs are not effective in preventing or treating cold panniculitis.