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Cold panniculitis - Skin
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Cold panniculitis - Skin

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Contributors: Craig N. Burkhart MD, Dean Morrell MD, Lowell A. Goldsmith MD, MPH, Nancy Esterly MD
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Synopsis

Cold panniculitis is the crystallization of subcutaneous fat with subsequent inflammation in response to cold injury. The typical scenario is an infant or young child that has had prolonged cold exposure to the cheeks or limbs from low ambient temperatures, local therapeutic application of cold (eg, during cardiac surgery), or other cold exposure (eg, from a popsicle).

Codes

ICD10CM:
M79.3 – Panniculitis, unspecified

SNOMEDCT:
397768002 – Cold panniculitis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Infectious cellulitis or panniculitis may appear very similar to cold panniculitis. However, infants with infections are often febrile and appear ill.
  • Identical appearing nodules may form 1–2 weeks after abrupt cessation of systemic steroids; however, they usually affect more extensive areas of the body (face, trunk, and extremities).
  • In newborns, especially those with unusually large plaques (ie, those greater than 3 cm) or affected by perinatal complications (asphyxia, hypothermia, seizures, preeclampsia, or meconium aspiration), subcutaneous fat necrosis of the newborn should be highly considered.
  • Traumatic panniculitis (blunt trauma or injection) should be distinguished by history.
  • Sclerema neonatorum is characterized by diffuse bond down hardening of the skin that is cold rather than warm on palpation.
  • Metastatic neuroblastomas are firm bluish nodules rather than ill-defined and erythematous.

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 02/02/2016
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Cold panniculitis - Skin
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Cold panniculitis : Cheek, Cold exposure, Erythema, Blanching patch, Hardened skin
Clinical image of Cold panniculitis
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