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C Crawford Mechem, MD, FACEP
Section Editor
Daniel F Danzl, MD
Deputy Editor
Jonathan Grayzel, MD, FAAEM


Frostbite results from the freezing of tissue. It is a disease of morbidity, not mortality. It is most frequently encountered in mountaineers and other cold weather enthusiasts, soldiers, those who work in the cold, the homeless, and individuals stranded outdoors in the winter [1-3].

This topic review will discuss the classification, presentation, diagnosis, and management of frostbite. Severe hypothermia and related illnesses are discussed elsewhere. (See "Accidental hypothermia in adults".)


Frostbite is a severe, localized cold-induced injury due to freezing of tissue. Immersion foot (also referred to as Trench Foot) is a non-freezing cold injury (NFCI) that may also cause tissue loss and long-term sequelae. Milder forms of injury include frostnip and pernio:

Frostnip refers to cold-induced, localized paresthesias that resolve with rewarming. There is no permanent tissue damage.

Pernio, or chilblain, is characterized by localized inflammatory lesions that can result from acute or repetitive exposure to damp cold above the freezing point. Lesions are edematous, often reddish or purple, and may be very painful or pruritic (picture 1). Pernio is most common in young women, but both sexes and all age ranges may be affected [4].


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Literature review current through: Sep 2016. | This topic last updated: Apr 20, 2015.
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