Clinical features:
(1) erythematous, indurated plaques or nodules
(2) develop 1-3 days after exposure to cold or a prolonged application of ice
(3) tends to occur on the face (especially the cheeks) or lower extremities
(4) usually resolves spontaneously
Histologic features:
(1) The inflammatory cell infiltrate consists of histiocytes, lymphocytes and neutrophils (mixed).
(2) The inflammation tends to be more superficial, with maximum intensity at the interface between the reticular dermis and the subcutaneous fat. It involves both septa and lobules.
(3) Fat necrosis may appear after several days.
(4) Needle-shaped clefts in subcutaneous fat are absent
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Variant Forms
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Situation
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popsickle panniculitis
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child eating ice or popsickle
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equestrian panniculitis
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horseback rider in cold weather, often with tight fitting clothes
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Differential diagnosis:
(1) frostbite
(2) cold agglutinin disease
(3) Raynaud's phenomenon
(4) sclerema neonatorum (needle-shaped clefts in subcutaneous fat present)
(5) subcutaneous fat necrosis of the newborn (needle-shaped clefts in subcutaneous fat present)
(6) traumatic panniculitis
