Cold and Heat
The skin has a fundamental role in preserving human body homeostasis. This balance is influenced by cutaneous blood flow, basal metabolic rate, shivering, and sweating. The degree of cutaneous injury is also influenced by the type of heat or cold source, the duration of exposure, temperature, skin thickness, and individual predisposition. The skin has the capacity to adapt to some changes in temperature, but sometimes these changes can cause severe damage and induce skin diseases. The etiopathogenesis of many diseases caused by cold remains poorly understood, but research suggests that the disruption in the regulation of dermal blood flow has an important role. Burns are very common in our daily life and can be indubitably dangerous. It is crucial that doctors in general know how to manage burns, and it is also important that people in general know how to deal with this problem, because in many cases this knowledge can help to minimize damage in primary care. This chapter highlights the epidemiology, clinical presentation, and current therapeutic approach to the most important diseases associated with heat and cold, namely frostbite, acrocyanosis, chilblains, cold urticaria, cryoglobulinemia, cold panniculitis, burns, and erythema ab igne.
KeywordsFrostbite Acrocyanosis Chilblains Cold urticaria Cryoglobulinemia Cold panniculitis
A bacterial skin infection characterized by a swollen, red area of skin that feels hot and tender.
Also known as pernio or perniosis, these are skin lesions resulting from abnormal response to cold temperature and characterized by erythematous or purplish lesions localized on fingers, toes, ears, and nose.
Immunoglobulins that precipitate in vitro at temperatures below 4 °C, and dissolve after rewarming at 37 °C.
Defined by freezing, cold thermal injury, which occurs when tissues are exposed to temperatures below their freezing point for a sustained period of time.
An inflammation of the subcutaneous adipose tissue. Cold panniculitis is a form of traumatic panniculitis caused directly by cold exposure.
An intermittent ischemia of the fingers or toes characterized by severe pallor and often accompanied by paresthesia and pain, induced by cold and relieved by heat.
- 10.McIntosh SE, Opacic M, Freer L, Grissom CK, Auerbach PS, Rodway GW, Cochran A, Giesbrecht GG, McDevitt M, Imray CH, Johnson EL, Dow J, Hackett PH. Wilderness Medical Society practice guidelines for the prevention and treatment of frostbite: 2014 update. Wilderness Environ Med. 2014;25(4 Suppl):S43–54. doi: https://doi.org/10.1016/j.wem.2014.09.001.CrossRefPubMedGoogle Scholar
- 11.Woo EK, Lee JW, Hur GY, Koh JH, Seo DK, Choi JK, Jang YC. Proposed treatment protocol for frostbite: a retrospective analysis of 17 cases based on a 3-year single-institution experience. Arch Plast Surg. 2013;40(5):510–6. doi: https://doi.org/10.5999/aps.2013.40.5.510. Epub 2013 Sep 13CrossRefPubMedPubMedCentralGoogle Scholar
- 27.Magerl M, Pisarevskaja D, Staubach P, Martus P, Church MK, Maurer M. Critical temperature threshold measurement for cold urticaria: a randomized controlled trial of H(1) -antihistamine dose escalation. Br J Dermatol. 2012;166(5):1095–9. doi: https://doi.org/10.1111/j.1365-2133.2012.10822.x.CrossRefPubMedGoogle Scholar
- 33.Ghetie D, Mehraban N, Sibley CH. Cold hard facts of cryoglobulinemia: updates on clinical features and treatment advances. Rheum Dis Clin N Am. 2015;41(1):93–108, viii–ix. doi: https://doi.org/10.1016/j.rdc.2014.09.008.
- 36.Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ. Fitzpatrick’s dermatology in general medicine. 7th ed. McGraw-Hill; 2008.Google Scholar
- 37.Quesada-Cortés A, Campos-Muñoz L, Díaz-Díaz RM, Casado-Jiménez M. Cold panniculitis. Dermatol Clin 2008;26(4):485–9, vii. doi: https://doi.org/10.1016/j.det.2008.05.015.
- 41.Torrelo A, Hernández A. Panniculitis in children. Dermatol Clin 2008;26(4):491–500, vii. doi: https://doi.org/10.1016/j.det.2008.05.010.
- 47.Li H, Guo Y, Yang Z, Roy M, Guo Q. The efficacy and safety of oxandrolone treatment for patients with severe burns: a systematic review and meta-analysis. Burns. 2016;42(4):717–27. doi: https://doi.org/10.1016/j.burns.2015.08.023. Epub 2015 Oct 9
- 53.Gauglitz GG, Williams FN, Herndon DN, Jeschke MG. Burns: where are we standing with propranolol, oxandrolone, recombinant human growth hormone, and the new incretin analogs? Curr Opin Clin Nutr Metab Care. 2011;14(2):176–81. doi: https://doi.org/10.1097/MCO.0b013e3283428df1.CrossRefPubMedPubMedCentralGoogle Scholar