Face frostbite

Introduction Face frostbite is damage caused by cold skin irritation on the face. The disease has a high incidence in the early winter and when the weather suddenly changes. Frostbite can occur when the skin temperature drops to -2 °C, and the highest incidence of frostbite occurs when the temperature is between -25 °C and -30 °C. The main risk factors for frostbite are previous cold injuries. Other risk factors include alcohol, mental illness, drug abuse, car accident, vehicle mechanical failure, homelessness, fatigue, circulatory damage, smoking, inappropriate clothing, high altitude. The pathophysiological mechanisms of frostbite are a combination of freezing, vascular insufficiency (contraction and occlusion) and damage caused by inflammatory mediators.

Cause

Soft tissue is frozen and the damage formed when the local blood supply is reduced. Frostbite can occur when the skin temperature drops to -2 °C, and the highest incidence of frostbite occurs when the temperature is between -25 °C and -30 °C. The main risk factors for frostbite are previous cold injuries. Other risk factors include alcohol, mental illness, drug abuse, car accident, vehicle mechanical failure, homelessness, fatigue, circulatory damage, smoking, inappropriate clothing, high altitude. Superficial frostbite is the most common, accounting for 74% of the total number of cases, and the face (nose, ear) is the most common affected area. The pathophysiological mechanisms of frostbite are a combination of freezing, vascular insufficiency (contraction and occlusion) and damage caused by inflammatory mediators.

an examination

Related inspection

Skin elasticity check physical examination of skin diseases skin color

The skin of the affected face is pale, cold, painful and numb. After rewarming, the local manifestations and burns are similar, but local swelling is generally not obvious. It can be divided into four degrees according to its depth and severity of damage.

Once frostbite: frostbite on the skin. The local skin is pale at first, gradually turning blue-violet, followed by redness, itching, tingling and paresthesia, and no blister formation. After about 1 week, the symptoms disappeared and the epidermis gradually fell off, leaving scars behind.

Second degree frostbite: frostbite for full-thickness skin. Local skin redness, itching, burning pain, blistering can occur within 24 to 48 hours, if there is no secondary infection, after 2 to 3 weeks, the blister is dry, forming a black dry sputum, and the wound has a parakeratotic neoplastic epithelial coverage Local may have persistent stiffness and pain, but leave no scars and convulsions.

Third degree frostbite: frostbite in the whole skin and subcutaneous tissue. The skin gradually turns from pale to blue and then to black. The skin feels disappeared, and edema and blisters appear in the surrounding tissues with frostbite, accompanied by severe pain and itching. After the necrotic tissue falls off, there is a wound, which is easy to be infected. It heals slowly, leaving scars behind and affecting function.

Four degrees of frostbite: skin, subcutaneous tissue, muscles and even bones are frostbitten. The sensory and motor function of the wound completely disappeared. The affected area is dark gray, and edema and blisters may appear at the junction with healthy tissue. Within 2 to 3 weeks, there is a clear line of necrosis, usually dry gangrene, but sometimes due to venous thrombosis, surrounding tissue edema and secondary infection, the formation of wet gangrene. Often leave disability and dysfunction.

Differential diagnosis

Differential diagnosis of facial frostbite:

Facial pain: Facial pain refers to pain on one or both sides of the face, or pain at the forehead. This pain can be dull or fluctuating, or it can be a very strong sting. Facial pain or paralysis, generally no life-threatening threat, but the pain is very painful, even if it can hold back the pain, the expression is numb.

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