Frostbite - Skin
Early symptoms of frostbite include loss of pain sensation or a burning/tingling sensation. Complete anesthesia may occur with continued exposure. Clinical features of frostbite include cellular tissue effects (eg, endothelial injury and membrane damage), a thermoregulatory response (eg, shivering), and a systemic response (eg, shock, neuromuscular dysfunction). There are two clinical presentations: superficial frostbite and deep frostbite. Deep frostbite involves subcutaneous tissue and most often leads to tissue loss.
Young, elderly, and intoxicated persons are most at risk for frostbite. Research has shown that African American men and women are slightly more prone to develop frostbite than whites. Other people who may be more predisposed to frostbite are those of Arabic descent and those who reside in warmer climates. Men develop frostbite more often than women, but this may reflect a greater participation in sports and outdoor activities and a higher number of men who are homeless; athletes in cold climates and homeless persons without adequate shelter or clothing are at-risk populations for frostbite. Diabetes, the use of beta blockers, Raynaud's phenomenon and peripheral neuropathy may also predispose to frostbite development .
Pediatric Patient Considerations:
Infants and children have an increased susceptibility to frostbite because they lose heat from their skin faster because of their increased surface-to-body mass ratio. Often times, children may not communicate their symptoms at early onset.
T33.90XA – Superficial frostbite of unspecified sites, initial encounter
370977006 – Frostbite
- Frostnip – A milder form of cold injury that only involves the superficial and subcutaneous tissue. Pain usually resolves in 2 to 4 weeks.
- Pernio – A form of cold injury associated with damp or humid environment. Look for recurrent painful and/or pruritic erythematous, violaceous papules on fingers and/or toes. Often seen with poor vascular circulation.
- Trench foot – A condition affecting the feet that is associated with damp and cold environments. Unlike frostbite, it does not require exposure to freezing temperatures.
- Bullous pemphigoid – Look for systemic, tense, and intensely pruritic blisters.
- Cocaine levamisole toxicity