History: The patient is a 50 year old woman with a three week history of poruritic, painful nodules and plaques on her upper lateral thighs. She was referred on a “same-day” basis by an I.D. specialist for diagnostic biopsies. Six months ago, she realized her dream when she bought a stable and now cares for 38 horses. She rides 4 – six hours per day. No new meds, no significant past history.
O/E: The exam shows a 12 cm in diameter erythematous to violaceous plaque on the right thigh. There are some very superficial erosions. In addition, there are 1 – 1.5 cm in diameter erythematous nodules. The skin in the affected areas in noticeably cool to the touch.
Clinical Photo(s):
Lab: CBC, ANA, cryoglobulins and cryofibrinogens normal
Histopathology:
Diagnosis or DDx: Equestrian Cold Panniculitis
Questions:
Reason(s) Presented: Interest, cases may well be seen in Maine
References: ECP in Women
Follow-up Photo:
5 days after diagnosis made -- long underwear
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