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J Dermatol 2019 Jan 31. Epub 2019 Jan 31.

Department of Dermatology, Juntendo University Urayasu Hospital, Chiba, Japan.

Zhonghua Shao Shang Za Zhi 2019 Jan;35(1):74-76

Department of Interventional Radiology, General Hospital of PLA, Beijing 100853, China.

Severe frostbite (grade Ⅲ to Ⅳ) is a common disease accompanied with high disability rate in cold regions, especially for military training and disaster events in cold regions. The treatment of severe frostbite mainly includes rapid rewarming in the early stage and amputation in the later stage; while the damage of vascular endothelial cells, microvascular thrombosis, and decreased tissue perfusion secondary to severe frostbite are important factors affecting prognosis. Transcatheter arterial thrombolysis is a new technique for the treatment of severe frostbite. Read More

Pediatr Emerg Care 2019 Jan 21. Epub 2019 Jan 21.

Background: We report a case of geometrical skin lesions in a teenage patient.

Case: A previously healthy 14-year-old boy presented in our pediatric emergency department with unusual skin lesions on his left forearm. The patient said the lesions started 2 weeks earlier following a spider bite. Read More

High Alt Med Biol 2019 Jan 7. Epub 2019 Jan 7.

1 IFREMMONT (Institut de Formation et de Recherche en Médecine de Montagne) Hôpital de Chamonix, Hôpital de Chamonix, Chamonix, France.

Savina, Yann, Sandra Leal, Pascal Zellner, François Becker, Monica Piris, and Emmanuel Cauchy. The effect of a 300 mbar increase in barometric pressure on digital microcirculation in healthy subjects exposed to high altitude: Is the use of a portable hyperbaric chamber to treat frostbite and/or hypothermia in the field indicated? (Flow_Pulse Study). High Alt Med Biol. Read More

Pediatr Emerg Med Pract 2019 Jan 1;16(Suppl 1):1-2. Epub 2019 Jan 1.

Pediatric Emergency Medicine Ultrasound Fellow, Department of Emergency Medicine, Stanford University School of Medicine, Lucile Packard Children’s Hospital, Palo Alto, CA

Hypothermia occurs when the core body temperature falls below 35ºC (95ºF) due to primary exposure (eg, environmental exposure) or secondary to other pathologies. Infants, children, and adolescents are at higher risk for primary cold injuries due to a combination of physiologic and cognitive factors, but quick rewarming and appropriate disposition can result in survival and improved neurological outcomes. Treatment for cold injuries is guided by severity and can include passive or active measures. Read More

Wilderness Environ Med 2018 Dec 24. Epub 2018 Dec 24.

Department of Vascular Surgery, University Hospital Coventry and Warwickshire, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK.

Extremities are the area of the body most commonly affected by frostbite, which can also affect the face, ears, perineum, or genitals. Optimum management has moved away from early amputation and debridement toward maximizing tissue preservation and delaying surgical intervention. Increasing length of digit amputation increases morbidity, in terms of loss of hand function, experienced by patients. Read More

Pediatr Emerg Med Pract 2019 Jan 1;16(1):1-16. Epub 2019 Jan 1.

Pediatric Emergency Medicine Attending Physician, Children's Minnesota, Minneapolis, MN.

Hypothermia occurs when the core body temperature falls below 35ºC (95ºF) due to primary exposure (eg, environmental exposure) or secondary to other pathologies. Infants, children, and adolescents are at higher risk for primary cold injuries due to a combination of physiologic and cognitive factors, but quick rewarming and appropriate disposition can result in survival and improved neurological outcomes. Treatment for cold injuries is guided by severity and can include passive or active measures. Read More

Aesthetic Plast Surg 2018 Dec 10. Epub 2018 Dec 10.

Institut de Biologie Paris-Seine (IBPS), CNRS, UMR 8256, Inserm ERL U1164, Biological Adaptation and Ageing, Sorbonne Université, 75005, Paris, France.

Introduction: Formation of less periorbital ecchymosis in post-operative period of rhinoplasty is a popular trend. We present the use of instantly crystallizing supercooled serum physiologic solution for periorbital cooling.

Physics Of Supercooling: There are circumstances in which water temperature drops below its freezing point, but no phase transition happens while water remains in the liquid phase. Read More

MSMR 2018 Nov;25(11):10-17

From July 2017 through June 2018, a total of 478 members of the active (n=402) and reserve (n=76) components had at least one medical encounter with a primary diagnosis of cold injury. The crude overall incidence rate of cold injury for all active component service members in 2017-2018 was 19.6% higher than the rate for the 2016-2017 cold season and was the highest rate since the 2013-2014 season. Read More

Int J Circumpolar Health 2018 12;77(1):1536250

e Medical Imaging Group, Department of Clinical Medicine , UiT The Arctic University of Norway , Tromsø , Norway.

Exposure to cold climate is an inevitable consequence of military training in Norway. Adequate peripheral microcirculation in the extremities is important to maintain temperature, and to protect against freezing cold injuries. The aim of this study was to investigate the variability in skin rewarming ability. Read More

JAMA Dermatol 2018 Dec;154(12):1465-1472

The George Washington University School of Medicine and Health Sciences, Washington, DC.

Importance: Chemotherapy-induced alopecia as well as nail and cutaneous changes occur in up to 89% of patients receiving taxane-based chemotherapy and are associated with cosmetic concerns, psychosocial distress, and overall morbidity.

Objective: To review the efficacy and safety of interventions to prevent taxane-induced dermatologic adverse events.

Evidence Review: PubMed and Scopus databases were systematically reviewed for studies published in the English language from January 1, 1980, to August 13, 2018. Read More

Br J Radiol 2019 Feb 1;92(1094):20180545. Epub 2018 Nov 1.

1 Departments of Radiology/Nuclear Medicine, University of Michigan Hospital , Ann Arbor, MI , USA.

Objective:: Frostbite is a localized cold-thermal injury resulting from prolonged exposure of flesh to freezing and near freezing temperatures. The depth and extent of frostbite injuries are not easily assessed, from a clinical standpoint, at the time of injury making it challenging to plan appropriate management and treatment.

Methods:: A review of the literature of management of cold-related injuries and retrospective case review of the imaging and clinical course of frostbite injury. Read More

Scott Med J 2019 Feb 25;64(1):30-34. Epub 2018 Oct 25.

4 Consultant Eye Surgeon, Cardiff Eye Unit, University Hospital of Wales, UK.

The effects of high altitude on the human vascular system are well described. This case demonstrates an interesting combination of vascular complications at high altitude which were both life- and sight-threatening. In May 2017, during an attempt on Mount Everest, a 58-year-old man was forced to descend from 8000 m because of adverse weather. Read More

Eur J Appl Physiol 2019 Jan 16;119(1):171-180. Epub 2018 Oct 16.

Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands.

Purpose: The risk for local cold injuries has been linked to poor cold-induced vasodilation (CIVD) during cold exposure and to poor rewarming after cold exposure. The purpose of this study is to establish the relation between CIVD and rewarming speed.

Methods: Twelve participants immersed one hand in ice water for 30 min to evoke CIVD and the other hand in ice water for 10 min to investigate the rewarming profile. Read More

Res Vet Sci 2018 Dec 2;121:12-17. Epub 2018 Oct 2.

Baker Institute, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, United States. Electronic address:

Digital cryotherapy (DC) is frequently used as laminitis prophylaxis for horses. While DC with ice-water slurries is reported to be safe for up to 48 h, the safety of sleeve-style digital cryotherapy (SSDC) with ice in direct contact with the distal limb has not been evaluated. Our objective was to determine the incidence of distal limb pathologic conditions (DLPC) among horses treated with SSDC. Read More

Wilderness Environ Med 2018 Dec 3;29(4):431-436. Epub 2018 Oct 3.

Department of Health, Human Performance and Athletics, Linfield College, McMinnville, OR (Dr Peterson).

Introduction: Porters working at high altitude face a number of preventable health risks ranging from frostbite to potentially fatal high-altitude pulmonary and cerebral edema. Porters are often recruited from impoverished low-altitude areas, poorly equipped in terms of protective clothing, and tasked with carrying loads that equal or exceed their body mass to high elevations. Despite a large population of porters working throughout mountainous parts of the world, there is little documentation regarding knowledge levels, attitudes, and practices related to the prevention of altitude illness in this population. Read More

Ear Nose Throat J 2018 Sep;97(9):E13-E14

Department of Otolaryngology, University of Kentucky, 800 Rose St., C-236, Lexington, KY 40536, USA.

Nitrous oxide, a cryogenic gas, may be abused as an inhalant for its euphoric properties. If inhaled, nitrous oxide may cause frostbite to the oral cavity and upper aerodigestive tract, with possible airway compromise due to edema. In this article we describe what is, to the best of our knowledge, the first case of intentional inhalation of nitrous oxide from an automotive nitrous oxide canister and discuss the management and mechanism of the patient's injury. Read More

Tidsskr Nor Laegeforen 2018 09 17;138(14). Epub 2018 Sep 17.

Bakgrunn: Det finnes lite forskning på forekomst av frostskader, både sivilt og militært. Prognosen og tidsforløpet ved slike skader har ikke tidligere vært undersøkt i større kohorter.

Materiale Og Metode: Deltagerne var personer registrert i Forsvarets helseregister med kulde- og frostskade i tidsrommet 1. Read More

Hand (N Y) 2019 Jan 19;14(1):13-18. Epub 2018 Sep 19.

1 The University of Mississippi Medical Center, Jackson, USA.

Background: The use of tissue plasminogen activator (tPA) for the treatment of frostbite has been reported and advocated, but its efficacy has not been well established. We conducted a systematic review to guide physicians on the role of tPA in the treatment of frostbite. Our hypothesis was that the use of tPA improves clinical outcomes, as measured by amputation rate. Read More

Mil Med 2018 09;183(suppl_2):168-171

Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX.

Historically, cold injury, hypothermia, and frostbite have been severe problems for military units on the battlefield. Kenneth D. Orr and David C. Read More

High Alt Med Biol 2018 Dec 22;19(4):388-393. Epub 2018 Aug 22.

1 Warwick Medical School, University of Warwick , Coventry, United Kingdom .

Frostbite and other cold-related injuries commonly develop during prolonged exposure to the low environmental temperatures of polar and mountainous regions. Hypoxia is a potent sympathetic stimulus that causes vasoconstriction of the peripheral blood vessels, which may further compound the risk of developing a cold-related injury during high-altitude exposure. To investigate this, we utilized portable infrared thermographic technology to quantitatively measure changes in the surface temperature of the hands during exposure to increasing levels of normobaric hypoxia in a temperature-controlled high-altitude simulation. Read More

Rheumatol Int 2019 Feb 20;39(2):265-275. Epub 2018 Aug 20.

Occupational and Environmental Medicine, Umeå University, 901 87, Umeå, Sweden.

The aim of this study was to determine the association between individual and external exposure factors, and the reporting of Raynaud's phenomenon, with or without concomitant cold sensitivity. In a population-based nested case-control study, cases with Raynaud's phenomenon (N = 578), and matched controls (N = 1156), were asked to respond to a questionnaire focusing on different risk factors. Univariate and multiple conditional logistic regression were performed. Read More

High Alt Med Biol 2018 Dec 17;19(4):382-387. Epub 2018 Aug 17.

1 Orthopaedics Surgery Department, School of Medicine, Pontificia Universidad Católica de Chile , Santiago, Chile .

Frostbite is a common injury in high altitude medicine. Intravenous vasodilators have a proven efficacy and, recently, have been proposed as a safe outpatient treatment. Nevertheless, the lack of availability and consequently delayed application of this treatment option can result in poor clinical outcomes for patients. Read More

J Burn Care Res 2018 Oct;39(6):858-862

Department of Surgery, University of Colorado School of Medicine, Aurora.

Technology and telehealth have the potential to optimize burn care in areas limited by lack of expertise and geographic distance from a Burn Center. This study reports a multicenter, multiregional experience using a mobile phone app to facilitate triage of patients by allowing referring providers to send encrypted photos, thus enhancing the telephone consultation process. A retrospective review was conducted on referrals from August 2016 to July 2017 at three regional Burn Centers that utilize the same mobile phone app. Read More

Burns 2018 Nov 30;44(7):1844-1850. Epub 2018 Jul 30.

Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Manitoba, Canada; Departments of Surgery and Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address:

Objective: To describe frostbite (freezing cold injured tissue) in children and intrinsic (psychological and behavioral) and extrinsic (meteorological and safety hazard) factors related to the injury.

Methods: Retrospective chart review of children <18 years old referred to a regional pediatric hospital for frostbite, to determine the demographics, environment, and risk factors related to injuries.

Results: 47 patients met the inclusion criteria. Read More

High Alt Med Biol 2018 Dec 1;19(4):316-320. Epub 2018 Aug 1.

5 Department of Anaesthesiology and Intensive Care Medicine, General Public Hospital of the Brothers of St. John of God Salzburg, Paracelsus Medical University, Salzburg, Austria.

Objectives: Frostbite is a cold injury mostly affecting the extremities. The objective of this study was to reveal the incidence of frostbite injuries in the Austrian Alps, to search for frostbite risk factors, and thereby optimize prevention and treatment.

Methods: Out-of-hospital data in the National Registry of Alpine Accidents from January 1, 2005, to December 31, 2015, were screened for frostbite injuries. Read More

Hinyokika Kiyo 2018 Jun;64(6):283-285

The Department of Urology, Sapporo Medical University School of Medicine.

We report a case diagnosed as both necrotizing fasciitis and frostbite of the male external genetalia. The patient was a 58-year-old man with diabetes mellitus. He was referred to our hospital with swelling of his penis and icing there for 3 weeks. Read More

Ann Transplant 2018 Jul 3;23:450-456. Epub 2018 Jul 3.

Division of Liver Transplantation Surgery, Department of Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China (mainland).

BACKGROUND Liver transplantation (LT) using extended criteria donor (ECD) grafts is frequently associated with a high flush fluid potassium concentration (FFK) and acute hyperkalemia after reperfusion, which puts patients at greater risk of postreperfusion cardiac arrest (PRCA). CASE REPORT Herein, we present a case with an extremely high FFK that was successfully pretreated to avoid the risk of PRCA. A 3-year-old boy with biliary atresia underwent LT from a 623-g donation after brain death liver graft with localized frostbite on the right lobe surface. Read More

Vet Clin North Am Food Anim Pract 2018 Jul;34(2):265-275

Department of Integrated Physiology and Neurosciences, Washington State University College of Veterinary Medicine, Veterinary and Biomedical Research Building, Room 205, Washington State University, Pullman, WA 99164-7620, USA.

Numerous factors contribute to the outcome and recovery for range cattle affected by blizzard. Consequences and impact on the producer depend on the timing of the storm relative to the herd's production cycle, access to shelter, duration and intensity of the storm, and post-storm emergency management. Critical planning efforts by the producer include clear animal identification methods, identification of sheltering options, and consideration of animal indemnity and insurance requirements. Read More

J Burn Care Res 2018 Aug;39(5):780-785

Hennepin County Medical Center, Minneapolis Medical Research Foundation, Minneapolis, Minnesota.

Frostbite is a form of thermal injury that can have devastating consequences for patients, including digit amputations and sometimes more proximal amputations. To the best of the authors' knowledge, no one has determined national characteristics of frostbite patients, nor the prevalence of these diagnostic and therapeutic modalities. This is the first look at nationwide trends in the treatment of frostbite in the United States. Read More

J Burn Care Res 2018 Aug;39(5):676-679

Department of Surgery, Hennepin County Medical Center, Minneapolis, Minnesota.

Numerous demographic, socioeconomic, and injury factors influence a burn patient's hospital course. Compared to the typical burn patient, frostbite injury frequently impacts those with high rates of mental illness, substance abuse, and those suffering homelessness. Our aim was to examine differences in the hospital course of frostbite patients compared to those with burns limited to the hands and feet. Read More

Wilderness Environ Med 2018 09 12;29(3):392-400. Epub 2018 Jun 12.

Ilulissat Hospital, Avannaa Region, Ilulissat, Greenland. Electronic address:

Greenland is not only the largest island in the world, it is also the least densely populated country on the globe. The majority of Greenland's landmass lies within the Arctic Circle. Weather conditions in Arctic areas can be extreme, thus exposing locals and visitors to a high risk of acquiring frostbite injuries. Read More

JAMA Dermatol 2018 Jun;154(6):707

Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.

Wilderness Environ Med 2018 09 8;29(3):366-374. Epub 2018 Jun 8.

Altitude Research Center, University of Colorado School of Medicine, Aurora, CO; Institute for Altitude Medicine, Telluride, CO (Dr Hackett).

Severe frostbite occurs frequently at extreme altitude in the Himalayas, often resulting in amputations. Recent advances in treatment of frostbite injuries with either intravenous or intra-arterial tissue plasminogen activator, or with iloprost, have improved outcomes in frostbite injuries, but only if the patient has access to these within 24 to 48 h postinjury, and ideally even sooner. Frostbitten Himalayan climbers are seldom able to reach medical care in this time frame. Read More

Int Arch Occup Environ Health 2018 10 28;91(7):785-797. Epub 2018 May 28.

Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, 901 87, Umeå, Sweden.

Purpose: To identify factors associated with the reporting of cold sensitivity, by comparing cases to controls with regard to anthropometry, previous illnesses and injuries, as well as external exposures such as hand-arm vibration (HAV) and ambient cold.

Methods: Through a questionnaire responded to by the general population, ages 18-70, living in Northern Sweden (N = 12,627), cold sensitivity cases (N = 502) and matched controls (N = 1004) were identified, and asked to respond to a second questionnaire focusing on different aspects of cold sensitivity as well as individual and external exposure factors suggested to be related to the condition. Conditional logistic regression analyses were performed to determine statistical significance. Read More

Clin Exp Dermatol 2018 Jul 20;43(5):596-597. Epub 2018 May 20.

Dermatology Department, Norfolk and Norwich University Hospital, Norwich, UK.

Aust Dent J 2018 Apr 21. Epub 2018 Apr 21.

Conservative Dentistry and Endodontics, SRM Dental College, Ramapuram, Chennai, Tamil Nadu, India.

Current lifestyle trends encouraging the rise in use of liquid nitrogen in food and beverages may eventually increase the episodes of injuries reported as well. Here, we report the first case of intraoral frostbite as a result of direct injury to the tissues due to ingestion of liquid nitrogen. The mechanism of injury to the oral mucosa in the absence of any injury to the gastric mucosa is explained correlating it to the Leidenfrost phenomenon. Read More

High Alt Med Biol 2018 06 2;19(2):185-192. Epub 2018 Apr 2.

4 Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute , Ljubljana, Slovenia .

Gorjanc, Jurij, Shawnda A. Morrison, Rok Blagus, and Igor B. Mekjavic. Read More

Zhongguo Zhong Yao Za Zhi 2018 Jan;43(2):410-414

China Association of Traditional Chinese Medicine Pharmacology Specialized Committee, Henan University of Chinese Medicine, Zhengzhou 450046, China.

Frostbite is a common disease in winter, and systemic or local injury caused by low temperature invasion. Frostbite sites are commonly face, ears, nose, hands, feet and other peripheral blood circulation parts. The main symptoms are pale skin, cold, pain and numbness, skin itching in high temperature, and severe cases may suffer from skin erosions and ulcers. Read More

Case Rep Dermatol 2018 Jan-Apr;10(1):17-23. Epub 2018 Feb 1.

bDepartment of Biomedical Sciences, Nazarbayev University School of Medicine, Astana, Kazakhstan.

The association between ultraviolet radiation exposure and skin cancer is well established. Limited studies have reported an association between frostbite and the development of non-melanoma skin cancer but evidence for a proven link is insufficient and possible carcinogenic mechanisms have not been fully explored. In this report, 3 cases of non-melanoma skin cancer (1 case of basal cell carcinoma and 2 cases of squamous cell carcinoma of the skin) which developed at a site of previous frostbite caused by exposure to extremely cold temperatures in Astana, the capital city of Kazakhstan, are described. Read More

Hautarzt 2018 May;69(5):376-383

Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.

Physical and chemical emergencies are often caused by household or work accidents. Regardless of the medical field and outside specialized clinics, the physician may be confronted with the situation for first or secondary care. The identification of the causing agent and a rapid assessment of the extent and severity of the tissue damage are essential to initiate early transfer to a specialized burn clinic. Read More

J Foot Ankle Surg 2018 Mar - Apr;57(2):382-387

Director and Assistant Professor, Podiatric Medicine and Surgery Residency, University of Pittsburgh Medical Center Mercy, Department of Orthopedic Surgery, University Pittsburgh School of Medicine, Pittsburgh, PA.

Acute compartment syndrome of the foot and ankle is a relatively rare clinical finding. Lower extremity compartment syndrome is customarily due to vascular or orthopedic traumatic limb-threatening pathologic issues. Clinical correlation and measurement of intracompartmental pressure are paramount to efficient diagnosis and treatment. Read More

Indian J Med Res 2017 10;146(4):548-549

Department of Internal Medicine, Christian Medical College & Hospital, Vellore 632 004, Tamil Nadu, India.

Rev Infirm 2018 Feb;67(238):40-43

Service médical d'urgence, Brigade de Sapeurs-Pompiers de Paris, 3 rue Darmesteter, 75013 Paris, France. Electronic address:

Frostbites are cold-freezing injuries of the extremities due to the exposure to temperatures below 0°C. The risk, in the absence of treatment, is the amputation of frostbitten areas which become gangrenous. Victims of frostbite must be treated and evacuated urgently. Read More

Behav Brain Sci 2017 Jan;40:e279

Department of Psychology,Stanford University,Stanford,CA

Machines that learn and think like people must be able to learn from others. Social learning speeds up the learning process and - in combination with language - is a gateway to abstract and unobservable information. Social learning also facilitates the accumulation of knowledge across generations, helping people and artificial intelligences learn things that no individual could learn in a lifetime. Read More

Clin Exp Dermatol 2018 Jun 17;43(4):488-490. Epub 2018 Jan 17.

Department of Neuroradiology, All India Institute of Medical Sciences, New Delhi, India.

Nursing 2018 Feb;48(2):26-33

Linda Laskowski-Jones is editor-in-chief of Nursing2018 and Vice President of Emergency and Trauma Services at Christiana Care Health System in Newark, Del. She and Lawrence J. Jones are directors of the Appalachian Center for Wilderness Medicine in Morganton, N.C., and members of the Blue Mountain Ski Patrol in Palmerton, Pa.

Int J Dermatol 2018 May 10;57(5):596-598. Epub 2018 Jan 10.

Dipartimento di Fisiopatologia e dei Trapianti, University of Milan - Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Clin Exp Dermatol 2018 Jun 26;43(4):500-502. Epub 2017 Dec 26.

Department of Dermatology, Royal Derby Hospital, Derby, UK.