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Rheumatology (Oxford, England) Nov 2022Chilblains were first described over a hundred years ago as cutaneous inflammatory lesions, typically on the digits, occurring on cold exposure. Chilblains can be... (Review)
Review
Chilblains were first described over a hundred years ago as cutaneous inflammatory lesions, typically on the digits, occurring on cold exposure. Chilblains can be primary, or secondary to a number of conditions such as infections, including COVID-19, and immune-mediated inflammatory disorders (IMIDs) with SLE being the commonest. Chilblain lupus erythematosus (CHLE) was first described in 1888 as cold-induced erythematous lesions before the terms 'chilblains' or 'perniosis' were coined. Diagnostic criteria exist for both chilblains and CHLE. Histopathologically, CHLE lesions show interface dermatitis with perivascular lymphocytic infiltrate. Immunofluorescence demonstrates linear deposits of immunoglobulins and complement in the dermo-epidermal junction. This narrative review focuses on chilblains secondary to immune-mediated inflammatory disorders, primarily the epidemiology, pathogenesis and treatment of CHLE.
Topics: Humans; Chilblains; COVID-19; Lupus Erythematosus, Discoid; Dermatitis; Diagnosis, Differential; Lupus Erythematosus, Cutaneous
PubMed: 35412601
DOI: 10.1093/rheumatology/keac231 -
Rheumatology (Oxford, England) Feb 2019Janus kinase (JAK)/signal transducers and activators of transcription (STATs) are a group of molecules associated with one of the major pathways through which many... (Review)
Review
Janus kinase (JAK)/signal transducers and activators of transcription (STATs) are a group of molecules associated with one of the major pathways through which many cytokines exert and integrate their function, and as such they are increasingly recognized as playing critical role in the pathogenesis subserving various immune-mediated diseases, including RA, PsA, SpAs, IBD, skin disorders (e.g. alopecia areata, atopic dermatitis), single-gene disorders like interferonopathies, and others. JAKs are the key initiating players of the JAK/STAT pathway. Upon binding of their respective effector molecules (cytokines, IFNs, growth factors and others) to type I and type II receptors, JAKs are activated, and through phosphorylation of themselves and of other molecules (including STATs), they mediate signal transduction to the nucleus. A class of drugs-called JAK inhibitors or JAKinibs-that block one or more JAKs has been developed in the last decade, and now numbers >20 members. Although, so far, JAK inhibitors have been marketed only for RA and PsA, these drugs have been tested in phase 2 and phase 3 clinical trials for other inflammatory conditions and beyond. In this review, we summarize the clinical data, including efficacy and safety, available for JAK inhibitors used in some immune-mediated conditions other than RA.
Topics: Alopecia Areata; Aortic Diseases; Arthritis, Psoriatic; Arthritis, Rheumatoid; Autoimmune Diseases; Autoimmune Diseases of the Nervous System; Chilblains; Cytokines; Dental Enamel Hypoplasia; Dermatitis, Atopic; Giant Cell Arteritis; Humans; Immunologic Deficiency Syndromes; Inflammatory Bowel Diseases; Janus Kinase Inhibitors; Lupus Erythematosus, Cutaneous; Metacarpus; Muscular Diseases; Nervous System Malformations; Odontodysplasia; Osteoporosis; Psoriasis; Spondylarthropathies; Uveitis; Vascular Calcification
PubMed: 30806709
DOI: 10.1093/rheumatology/key276 -
Annals of Burns and Fire Disasters Dec 2021The recreational consumption of nitrous oxide has steadily increased in recent years. Before being inhaled, the nitrous oxide is contained in a gas cylinder held firmly...
The recreational consumption of nitrous oxide has steadily increased in recent years. Before being inhaled, the nitrous oxide is contained in a gas cylinder held firmly between the thighs and then the gas is transferred to a rubber balloon. During the deconditioning steps, the cylinder cools down and causes frostbite. We report the case of six third-degree burns on the inner side of the thighs. At first superficial, this burn will deepen and require surgical management.
PubMed: 35035324
DOI: No ID Found -
Sports Health 2016Hypothermia and frostbite injuries occur in cold weather activities and sporting events. (Review)
Review
CONTEXT
Hypothermia and frostbite injuries occur in cold weather activities and sporting events.
EVIDENCE ACQUISITION
A PubMed search was used to identify original research and review articles related to cold, frostbite, and hypothermia. Inclusion was based on their relevance to prevention and treatment of cold-related injuries in sports and outdoor activities. Dates of review articles were limited to those published after 2010. No date limit was set for the most recent consensus statements or original research.
STUDY DESIGN
Clinical review.
LEVEL OF EVIDENCE
Level 5.
RESULTS
Frostbite and hypothermia are well-documented entities with good prevention strategies and prehospital treatment recommendations that have changed very little with time. A layered approach to clothing is the best way to prevent injury and respond to weather changes. Each athlete, defined as a participant in a cold weather sport or activity, will respond to cold differently depending on anthropometric measurements and underlying medical risk factors. An understanding of wind-chill temperatures, wetness, and the weather forecast allows athletes and event coordinators to properly respond to changing weather conditions. At the first sign of a freezing cold injury, ensure warm, dry clothes and move to a protected environment.
CONCLUSION
Cold injuries can be prevented, and cold weather activities are safe with proper education, preparation, and response to changing weather conditions or injury.
Topics: Cold Temperature; Frostbite; Humans; Hypothermia; Risk Factors; Wind
PubMed: 26857732
DOI: 10.1177/1941738116630542 -
Ugeskrift For Laeger Jan 2022Thermal burns are by far the most frequent and account for approx. 90% of all burns, while frostbites, chemical and electrical burns (CB) cover the remaining approx.... (Review)
Review
Thermal burns are by far the most frequent and account for approx. 90% of all burns, while frostbites, chemical and electrical burns (CB) cover the remaining approx. 10%. This review gives an overview of the treatment of corrosions and frostbites. CB and frostbites are relatively rare and prompt initiation of proper treatment is essential for both. CB should be diluted as soon as possible, preferably with a neutralizing solution. Treatment of systemic hypothermia comes before management of peripheral frostbite. Frostbites involve thawing in warm water, followed by vasodilation, thrombolysis and amputation if indicated.
Topics: Amputation, Surgical; Burns; Corrosion; Frostbite; Humans; Hypothermia
PubMed: 35060476
DOI: No ID Found -
CMAJ : Canadian Medical Association... Nov 2021
Topics: Fluorescence; Frostbite; Humans; Iloprost
PubMed: 34810170
DOI: 10.1503/cmaj.202258-f -
Dermatology Online Journal Jan 2021The severe acute respiratory syndrome coronavirus two (SARS-CoV-2), which causes the 2019 coronavirus disease (COVID-19), has infected patients worldwide. Physicians... (Review)
Review
The severe acute respiratory syndrome coronavirus two (SARS-CoV-2), which causes the 2019 coronavirus disease (COVID-19), has infected patients worldwide. Physicians have increasingly identified cutaneous findings as a significant clinical manifestation of COVID-19. In this review, we describe the clinical presentation, onset, duration, associated symptoms, treatment, and outcome of cutaneous manifestations thus far reported to be related to COVID-19. We have included data from 63 studies and subdivided reported cutaneous manifestations into the categories of viral exanthem, urticarial, vesicular, chilblains/chilblains-like, non-chilblains vasculopathy-related, pityriasis rosea-like, erythema multiforme-like, Kawasaki/Kawasaki-like disease, and others. Physicians should be aware of the known common cutaneous manifestations of COVID-19 and future research is required to better understand the pathophysiology and prognosis of each COVID-19-related skin manifestation.
Topics: COVID-19; Chilblains; Erythema Multiforme; Exanthema; Humans; Mucocutaneous Lymph Node Syndrome; Pityriasis Rosea; SARS-CoV-2; Skin Diseases; Skin Diseases, Vascular; Skin Diseases, Vesiculobullous; Systemic Inflammatory Response Syndrome; Urticaria
PubMed: 33560783
DOI: No ID Found -
BMJ Case Reports May 2014
Topics: Adult; Chilblains; Cold Temperature; Cyanosis; Female; Fingers; Humans
PubMed: 24849644
DOI: 10.1136/bcr-2014-203732