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Medical Author:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Humans are tropical animals. We are adapted to a warm climate. When exposed to cold, the body tries to stay warm. If the body is cooling off, circulation decreases in the arms, legs, ears, and nose so that the rest of the core body can stay warm. When temperatures are below freezing, ice may form in these areas with less circulation.

• Nonfreezing cold injuries are also caused by cooling of the skin. In immersion injuries, the nerves and blood vessels are damaged after exposure to cold, wet conditions at or above freezing temperatures.
• Pernio is caused by exposure to cold for a long period of time without freezing or by very wet conditions.
• Raynaud's phenomenon is an abnormal narrowing of the blood vessels that constrict with cooling of the fingers or toes.
• Cryoglobulins are proteins, which are normally dissolved in the blood, that become solids or gels when cold. Cryoglobulinemia is the condition associated with cryoglobulins in the blood, whereby cold exposure leads to bluish discoloration of the fingers or toes.
• The formation of hives in response to cold exposure of the skin is called cold urticaria.

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