CP results from a cold injury to adipose tissue. Many patients classified as having CP or equestrian cold panniculitis have forms of perniosis that represent dermal vascular injury rather than true panniculitis. In CP, localized cold damage leads to inflammation of the subcutaneous adipose tissue and is particularly likely to occur in patients with chilblains or in paralyzed limbs affected by poliomyelitis. Localized chilling of the tissues of the thigh, buttocks, and lower abdomen is more likely to occur in women who are obese during the winter months because of increased cold exposure. In infants, the cheeks and forehead are areas that may be affected.
Granulomas are absent.
These changes also may occur in those infants classified as being sickly in whom minimal exposure to the cold has occurred. Other cold injuries are relatively frequent. No racial predilection is known. During childhood and infancy, an equal incidence exists for the sexes. The patient may have a history of a febrile illness or other illness without dermatologic findings.