# Equestrian cold panniculitis



## egrogan

Alright ladies, as though we all needed just one more body image issue to worry about...I present you with my recent diagnosis of "equestrian cold panniculitis," discovered after several weeks of having apparent bruising up and down the outside of my legs for no discernible reason. 

As described in the _Archives of Dermatology_ (1980):


> We describe four patients with panniculitis attributable to a combination of cold exposure and equestrian activities. All were young, healthy women who rode horses for at least two consecutive hours per day throughout the winter. Initially, several small, erythematosus, pruritic papules appeared on the superior-lateral portions of one or both thighs. During one week, the lesions progressed to indurated, red-to-violaceous,tender plaques and nodules. Studies for cryofibrinogens and cryoglobulins were negative. The histologic picture was that of a panniculitis with prominent inflammation of veins most notable at the dermal-subcutaneus fat junction. Cold panniculitis is not limited to infancy and childhood. The distribution of lesions in our patients may have been caused, in part, by the use of tight-fitting, uninsulated riding pants. Such attire may have slowed blood flow through the skin, thereby further reducing tissue temperature.


 and _JAMA Dermatology _(2013)_:_


> Cold panniculitis typically occurs in infants and young children, appearing as indurated erythematous plaques or nodules approximately 48 hours after exposure to cold weather or ice that resolve spontaneously in 2 weeks. Cold-induced panniculitis was first described by Hochsinger1 in 1902 as submental plaques in children after cold exposure. The higher ratio of saturated to unsaturated fats in infants results in a higher freezing point of fat and has been postulated to predispose infants to this disease. More recently, a variant involving the thighs of equestrians who ride for prolonged periods in cold temperature has become known as _equestrian cold panniculitis_ or _horse rider’s pernio_, but outside of this setting, cold panniculitis in adults is exceedingly rare.


Put another way- it's when the combination of being out in the cold while wearing riding tights freezes your fat layer and leads to bruising and inflamation! :eek_color: Apparently it will simply go away once it's warm again (ha! when will that be?!). 

In all seriousness though, I was biopsied and tested for a few autoimmune disorders, as this presents like a form of lupus, so I'm glad I can laugh about my frozen fat rather than have to confront something more serious. And maybe this will be useful to someone else if you develop a weird rashy bruise that freaks your doctor out (the first family medicine doctor I saw physically recoiled when she saw my legs and immediately went to get an infectious disease specialist! )


----------



## Acadianartist

Bahahaha... sorry, had to laugh about that last part. Yeah, some doctors aren't very good at hiding their reactions. 

Seriously though, this sucks, but it could be worse. You need a riding skirt! My daughter and I were out riding today in -17C and it was lovely. My toes were frozen, but my thighs were toasty warm! 

Thanks for sharing. Good to know this can happen!


----------



## AnitaAnne

Equestrians have their own sport specific syndrome that unique and not found in any other population subset! How crazy yet cool is that? We all knew we were different, but frozen fat is seriously weird! I thought only our speech and spending habits were special :rofl: 

The southern gals have medial thigh rashes :rofl: 

TG you don't have Lupus :smile:


----------



## Dreamcatcher Arabians

ROFL, another really good reason not to live north of the MasonDixon! Glad it isn't Lupus, but good grief who'd have ever thought of such?


----------



## jaydee

Weird that you should post this as similar 'marks' across and around my nose had me worried that 'my' lupus had come out of remission but like you it was just caused by the cold air on my unprotected face.
I don't think I've ever had it before though when its been much colder here


----------



## Wild Heart

This thread was created at the perfect time. 

I noticed I had bruises around my thighs....and the rear end. 
I am very clumsy so I figured that I ran into something and tried to remember any recent falls but nothing came to mind.

However, I haven't been riding but I do wear fairly thin pants when I am out doing farm work. My legs are pretty much frozen when I come back in but I'm too lazy to put on warmer pants. I wonder if just freezing my fat caused the bruising?


----------



## SilverMaple

Hmmmm.... I had weird big bruises on my thighs periodically when I was a teen and rode English. Nobody could figure it out and it went away after a few weeks. Come to think of it, I bet it was winter....


----------



## greentree

Why oh why doesn’t the fat die when it freezes?? And how does this bode for the cryogenic liposuction? I am glad that it was not lupus!


----------



## Kriva

Very interesting information. I wonder how riding in tights is different than someone that runs in the wintertime and only wears spandex pants? Is it the pants that make a difference, or the fact that when you're a runner, you're being athletic, but when you're riding you're "just sitting there while the horse does all the work"? :icon_rolleyes: LOL! 

And it also makes me wonder about the fat freezing/body sculpting that's happening these days. Does that cause bruising too?


----------



## Woodhaven

I have ridden in very cold weather during my 60 years of riding, some years I rode more in winter than summer because of work commitments and I have never worried about wearing proper riding clothes just wearing something that was loose and comfortable in winter. I wonder if it is tighter clothes that causes this problem? I wear for winter riding a loose pair of pants and good fleecy underwear and if it is really cold ( just above 0 F) I would wear chaps.

I have never heard of this panniculitis before, see what you can learn on Horse Forum?? There's always something new that I learn.


----------



## greentree

Maybe it is the polyester that is the problem.....our summer breeches were cotton, and winter ones were wool. They were not form fitting, either!


----------



## trailhorserider

I once had a gynecologist tell me riding was bad for vaginas. She didn't elaborate and I didn't ask....... Giving up riding is not an option so why bother? :icon_rolleyes:


I do get a lot of leg bruising but I also hit a lot of trees!


----------



## egrogan

Thanks everyone. Yes, I too am really happy it's not lupus and something that gave everyone a good laugh!



Acadianartist said:


> Bahahaha... sorry, had to laugh about that last part. Yeah, some doctors aren't very good at hiding their reactions.


Yeah, it is pretty embarassing to have a doctor look at you like you are an alien. Fortunately I got referred to a wonderful dermatologist and she took it seriously without making me feel awful. 



AnitaAnne said:


> Equestrians have their own sport specific syndrome that unique and not found in any other population subset! How crazy yet cool is that? We all knew we were different, but frozen fat is seriously weird! I thought only our speech and spending habits were special :rofl:





Dreamcatcher Arabians said:


> ROFL, another really good reason not to live north of the MasonDixon!


Yep, the problems from sweating in unfortunate places are a whole separate post...if I had to choose, I'd take unsightly bruising to chafing :rofl: But I am wimpy about being hot and sweaty.



jaydee said:


> Weird that you should post this as similar 'marks' across and around my nose had me worried that 'my' lupus had come out of remission but like you it was just caused by the cold air on my unprotected face.
> I don't think I've ever had it before though when its been much colder here


 From what I read, it often shows up on the face of children who have panniculitis, so could be! 



Wild Heart said:


> This thread was created at the perfect time.
> I noticed I had bruises around my thighs....and the rear end.
> I am very clumsy so I figured that I ran into something and tried to remember any recent falls but nothing came to mind.
> 
> However, I haven't been riding but I do wear fairly thin pants when I am out doing farm work. My legs are pretty much frozen when I come back in but I'm too lazy to put on warmer pants. I wonder if just freezing my fat caused the bruising?


 @*Wild Heart* - because I've learned that the bruising could be a form of lupus, it might be worth talking with a doctor or dermatologist. I don't want to scare you at all, as I am certainly not a doctor! But if it is unusual and it doesn't seem to be going away, maybe consider seeing someone? 

I haven't been riding a lot either, but I often will wear fleece lined riding pants or longjohns under jeans while I'm out doing chores. From what I understand, the combo of tighter pants and long exposure to cold temps (a couple of studies said spending 2+ hours in the cold seemed to be something affected women had in common) could be one factor in causing it.



Kriva said:


> Very interesting information. I wonder how riding in tights is different than someone that runs in the wintertime and only wears spandex pants? Is it the pants that make a difference, or the fact that when you're a runner, you're being athletic, but when you're riding you're "just sitting there while the horse does all the work"?
> 
> 
> 
> 
> 
> 
> 
> LOL!





Woodhaven said:


> I have ridden in very cold weather during my 60 years of riding, some years I rode more in winter than summer because of work commitments and I have never worried about wearing proper riding clothes just wearing something that was loose and comfortable in winter. I wonder if it is tighter clothes that causes this problem? I wear for winter riding a loose pair of pants and good fleecy underwear and if it is really cold ( just above 0 F) I would wear chaps.


Dr. said while the name is "Equestrian" cold panniculitis, it is sometimes seen in other winter athletes wearing tight clothing, so runners too. @*Woodhaven* , seems like for me, wearing the long johns under jeans was too tight, not just riding tights.



SilverMaple said:


> Hmmmm.... I had weird big bruises on my thighs periodically when I was a teen and rode English. Nobody could figure it out and it went away after a few weeks. Come to think of it, I bet it was winter....


 Could be! One study I read said upwards of 25% of women in Finland (apparently they studied this there) who ride in the winter reported symptoms...



greentree said:


> Why oh why doesn’t the fat die when it freezes?? And how does this bode for the cryogenic liposuction?


Hehe- the nurse who took out my stitches from the biopsy sites had never hear of this either, so when I was describing it to her, she was joking that maybe she might try riding to get the frozen fat benefit :rofl:



Kriva said:


> And it also makes me wonder about the fat freezing/body sculpting that's happening these days. Does that cause bruising too?


 I had NO idea this was a "thing" and had to look it up. I promise you all I was not trying to do any body sculpting!!!! :rofl:



trailhorserider said:


> I once had a gynecologist tell me riding was bad for vaginas. She didn't elaborate and I didn't ask....... Giving up riding is not an option so why bother? :icon_rolleyes:


This is just cracking me up. I think you get the last word on the thread!!!


----------



## phantomhorse13

Scary and funny all at the same time (and very glad you don't have lupus!!).


I guess my fat is thick enough to be self-insulating or else my pants aren't that tight.. or maybe I need to ride more hours? I certainly will think twice if I wind up with any weird bruising though - thanks for the info!!


----------



## 4horses

Never heard of that before. Around here all i need to worry about is heat stroke during the summer. And huge horse flies, mosquitoes, and ticks.

Would chaps and warmer pants prevent that? Assuming it is related to wind burn on a poorly protected area.


----------



## Celeste

If the fat freezes, it seems like it would die. I wonder if you ladies that ride up north are slimmer than your southern counterparts. Then again, you have to factor in sweet tea, fried chicken, and the fact that all vegetables are cooked in fat back (or bacon for the more modern cook).


----------



## Walkamile

@Celeste Seems like the gals I know that ride, me included, have _extra_ fat layers to help insulate our _inner _fat. If freezing fat from tight clothes and riding actually would reduce the fat, I'm pretty sure I would not only be riding every day, but would need to buy much tighter riding pants then I have purchased!


Why can't it be that simple? I'm ready to be thin!


----------



## SueC

I don't know how I missed this! Thank you for the education, @egrogan.  I'd never heard of panniculitis before. It sounds like an affliction dessert chefs might get, you know, "Oh no! I made pannacotta and got panniculitis!"

If you want to see something seriously graphic, look up "mesenteric panniculitis"... but don't do it while you're eating...


----------



## 3Horses2DogsandaCat

greentree said:


> Why oh why doesn’t the fat die when it freezes?? And how does this bode for the cryogenic liposuction?



That's what I was thinking. We could all get Cool Sculpting for free :smile:


----------



## SilverMaple

Celeste said:


> If the fat freezes, it seems like it would die. I wonder if you ladies that ride up north are slimmer than your southern counterparts. Then again, you have to factor in sweet tea, fried chicken, and the fact that all vegetables are cooked in fat back (or bacon for the more modern cook).



I have fat around my fat, so nope. Not thinner. I wish it worked that way!!


----------



## egrogan

Haha, just saw this conversation has revived. By way of updates, I still have some bruising even with applying topical ointment. It doesn't hurt, it's just unsightly. Definitely no body sculpting going on here :wink: 

I really don't know why this was the year this happened, but it hasn't really mattered what clothes I'm wearing- could be very thick fleece lined pants, jeans with thermal longjohns underneath, yoga pants with waterproof windpants over the top. The cold still seems to be affecting me, just on my legs. Who knows why!


----------



## SueC

I think sitting on a horse reduces the blood circulation to the outer thigh. Combined with that being the leading edge heading into wind and rain / cold air, this would result in vulnerable skin. You don't get it walking, as that keeps the circulation going nicely through the legs - I've tried that in wind and rain too. But when on a horse in that weather, the skin on my outer thighs will have erythema after a ride, and I shower quickly and get into warm dry clothes.


----------



## Celeste

Here in Georgia, we may complain about the cold, but I suspect we would have to ride naked in February to experience the frozen fat thing. Actually, February wasn't too bad this year.


----------



## egrogan

We have definitely coined a new phrase in our house this winter...there are "cold enough to freeze the fat" days when it's down around 0-10*F :hide:


----------

