Perniosis Induced by a Cold-Therapy System

Ice-Pack Dermatosis

“…The changing of the name is interesting, since the histopathologic description of the originally reported cases closely mirrors the description of findings in the characterization of cold panniculitis in an infant by Duncan et al 4 The 2 cases in our present report have features of both perniosis and cold panniculitis, supporting the hypothesis that these diseases lie on a spectrum with variable histopathologic findings depending on the clinical scenario, including the age of the patient, site of involvement, and the amount and composition of the fat in the subcutis. King et al 12 reported 2 cases of perniosis after anterior cruciate ligament repair and postoperative treatment with cold-therapy systems.…”

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 …”

“…5 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. [14][15][16][17][18][19][20] There seems to be a nosological problem because of the diversity of the denominations used for this pathology (rider's pernio, equestrian perniosis, equestrian cold panniculitis, chilblains of the thigh, etc.). We agree with Ferrara and Cerroni and choose to use for this disease presentation the term 'cold-associated perniosis of the thighs' which seems more accurate, as a panniculitis is not always present and because it is now reported in other types of cold exposures.…”

“…21 Cold-related lesions may also show, comparably to perniosis, a superficial and deep dermal lymphocytic infiltrate around the vessels, adnexa and nerves. 4,18,19 Focal or diffuse dermal mucin deposits have been described in some cases. 9,19 Cases of cold-induced dermatoses clinically similar to cold panniculitis or chilblains, but histologically resembling lupus Figure 4 Increased diffuse dermal mucin deposition (a and b, alcian blue, 920 and 940); CD3 + T cells (c, 92,5); small cluster of CD123 + plasmacytoid dendritic cells (d, 940).…”

Ice‐pack Dermatosis: A Diagnositic Pitfall for Dermatopathologists that Mimics Lupus Erythematosus

“…). Adipose tissue was also reportedly not present in the biopsy of 2 cases of perniosis induced by cold‐therapy for post‐operative care after anterior cruciate ligament repair . In addition, West et al found small clusters of CD123+ plasmacytoid dendritic cells in specimens of ice‐pack dermatosis.…”