Frostbite Differential Diagnoses

Updated: Oct 13, 2020
  • Author: Bobak Zonnoor , MD, MMM; Chief Editor: Dirk M Elston, MD  more...
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Diagnostic Considerations

Other problems to be considered include frostnip, trench foot, and pernio. Frostnip appears as blanching of the skin with transient numbness and paresthesias that resolves with rewarming. It is characterized by lack of ice crystal formation in the tissues and absence of tissue loss.

Trench foot results from prolonged exposure to a wet nonfreezing cold environment that produces peripheral neurovascular damage without ice crystal formation. This neurovascular damage manifests as pain, paresthesia, pallor, pulselessness, and paralysis. Trench foot is a reversible condition if diagnosed and treated early. Patients with trench foot have a better prognosis than patients with frostbite.

Pernio (chilblains/cold sore) is less severe than trench foot and consists of painful inflammatory skin lesions caused by chronic repeated exposures to damp, nonfreezing cold temperatures. It is characterized by localized edema, erythema, plaques, nodules, vesicles, or bullae that appear as long as 12 hours after the injury. It is more common in young women.

Hypothermia, defined as core body temperature of less than 35°C, usually occurs as a concurrent disease.

Differential Diagnoses