Overview of Cold Lipomatitis
Cold sebaceous meningitis is caused by direct action of cold and poor blood flow to adipose tissue injury, resulting in subcutaneous sebaceous meningitis, which manifests as subcutaneous nodules or plaques. In 1941, Haxthausen reported five patients and described the characteristics of its occurrence.
Etiology
Associated with excessive saturated fatty acid content in the subcutaneous adipose tissue and increased melting point. In adults, it is most often seen in frostbite or poor circulation due to tight clothing and pants, and in those with partial fibrinolytic activity and cold fibrinogen hyperplasia.
Symptoms
It most commonly develops in infants. The disease is mainly characterized by well-demarcated subcutaneous nodules or plaques with reduced surface temperature, greenish-red or greenish-purple color, hard texture, and tenderness. It occurs mainly on the cheeks, and can also develop on the lateral thighs, buttocks, and lower abdomen. It has also been reported to occur in the scrotum after swimming in cold water in winter. If the cold factor is removed immediately after the onset of the disease, the nodules will gradually soften and subside within 2 weeks, leaving no scar or trace.
Examination
1. General examination
No abnormal findings.
2. Histopathologic examination
It shows fat necrosis, with infiltration of neutrophils, lymphocytes and histiocytes around the blood vessels and in the local area, and later the fat cells rupture and merge into a cystic structure.
Diagnosis
Diagnosis can be made on the basis of history and clinical features combined with histopathology.
Treatment
Warmth and avoidance of cold are important, especially in infants and children, and multiple layers of loose clothing should be worn when riding, and no specific treatment is usually required.Aroni (1998) reported that treatment with tetracycline in an adult female patient had significant efficacy and prevented recurrence, but was contraindicated in patients under 14 years of age.The treatment of tetracycline in an adult female patient was reported to be effective in preventing recurrence.