title: Cold-Associated Perniosis of the Thighs ("Equestrian-Type" Chilblain): A Reappraisal Based on a Clinicopathologic and Immunohistochemical Study of 6 Cases.
abstract: Cold-associated perniosis of the thighs ("equestrian cold panniculitis") is an unusual and still enigmatic entity. The authors retrieved 6 cases for a re-evaluation of their clinicopathologic features and for an immunohistochemical assessment with antibodies anti-CD3, anti-CD20, and anti-CD123. All patients were women, aged 17-45 years. One of them had elevated antinuclear antibody titers. Available anamnestic data confirmed the triggering role of prolonged/intermittent exposure to cold (not necessarily for equestrian activities). The lesions affected the thighs, with a preferential, although not exclusive involvement of the upper lateral surface. The histopathological pattern was perivascular, superficial, and deep, extending toward the superficial fat lobules, with lymphocytic vasculitis and mucin deposition; clumps of CD123 cells were found in 4 of 6 cases. Cold-associated perniosis of the thighs cannot be considered as a panniculitis. The histopathological features considerably overlap with perniosis at other sites of the body and with chilblain lupus erythematosus.
authors.affiliation: *Research Unit Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria; and †Anatomic Pathology Unit, Gaetano Rummo Hospital, Benevento, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Ferrara
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cerroni
mesh_terms: D000273:Adipose Tissue / Q000737:chemistry / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D018951:Antigens, CD20 / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D001808:Blood Vessels / Q000473:pathology; D017252:CD3 Complex / Q000032:analysis; D002647:Chilblains / Q000145:classification / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D003080:Cold Temperature / Q000009:adverse effects*; D020405:Dermis / Q000098:blood supply / Q000737:chemistry / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053650:Interleukin-3 Receptor alpha Subunit / Q000032:analysis; D008178:Lupus Erythematosus, Cutaneous / Q000473:pathology; D008875:Middle Aged; D015434:Panniculitis / Q000145:classification / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology*; D011237:Predictive Value of Tests; D009626:Terminology as Topic; D013848:Thigh; D055815:Young Adult
chemical_list: D018951:Antigens, CD20; D015415:Biomarkers; D017252:CD3 Complex; C115022:IL3RA protein, human; D053650:Interleukin-3 Receptor alpha Subunit