Dermatologist, John Flynn Medical Centre, Tugun, Queensland,
Australia on Jan 1, 2008
The distribution of the rash in this condition is
due to the insulating properties of fat. The skin is cooled
excessively because heat cannot transfer easily through the
fat from the warmer underlying core. Lesions commonly occur
on the buttocks and over fat upper arms in horse riders. Jockeys
do not get it because they are not fat!
Henry Foong FRCP, Ipoh, Malaysia on
Jan 1, 2008
Thanks for presenting this interesting case. I have
not heard of this entity before and it is certainly a great
teaching case. The lobular panniculitis histology was very impressive.
Robert Rudolph MD, FACP, Clinical Professor
of Dermatology, University of Pennsylvania, Philadelphia, PA,
USA on Jan 1, 2008
Terrific and instructive case. Great way to start
the New Year!!
Joel Bamford M.D., Duluth, MN, USA
on Jan 2, 2008
Thanks for making me aware of Equestrian Cold Panniculitis
Arash Abtahian M.D. Shiraz, Iran on Jan 2,
ECP is a variant of perniosis being in proximal lower extremities.
It occurs in person riding horses and does not wear warm clothings.
Treatment is the same as perniosis
Khalifa Sharquie MD, Professor of Dermatology, College
of Medicine, University of Baghdad, Baghdad, Iraq on
Jan 3, 2008
Although it is an interesting case but perniosis and cold panniculitis
probably represent extremes of one spectrum that occur in cold
countries like Iraq which is now a common problem
and there should be no problem in diagnosis. It could be easly
prevented by avoidance of cold exposure with supportive therapy
like topical and systemic steroids
Bushan Kumar MD, Former Head of Dermatology, Postgraduate
Institute of Medical Education & Research, Chandigarh, India
on Jan 3, 2008
Lesions of perniosis or chilblains are known to occur on the
parts of the body like fingers, toes, nose and ears which cannot
be considered as having a lot of fat and normally there is good
amount of circulation in these parts either because of anatomical
location or because of their participation in normal activities.
The lesions tend to occur because of cold induced vasoconstriction.
I am not sure if the layer of fat facilitates the development
of lesions by obstructing the transmission of heat from the
circulation below or it acts as a insulation against damage
due to cold.