Lancet. 1990; 335:555-7. Guillevin L, Lhote F. Điều trị polyarteritis nodosa và polyangiitis kính hiển vi. Viêm khớp nước mui. 1998; 41:2100-5. BF Haynes, Kaiser-Kupfer MI, Mason P, et al. Hội chứng Cogan: Các nghiên cứu ở những bệnh nhân mười ba, lâu dài theo dõi, và xem xét của văn học. Y học (Baltimore). 1980; 59:426-41. Hellmann DB. | CHAPTER 10 Unusual Vascular Diseases debrided and covered with a topical antibiotic. Rubbing affected areas is not advised and patients should receive tetanus toxoid and analgesics. Treatment of Frostbite Proper rewarming is essential Remove wet clothing if it is non-adherent Administer tetanus toxoid and proper amounts of analgesics Trench Foot Trench foot a condition that clinically resembles frostbite is usually associated with damp and cold settings and is also known as immersion foot sea-boat foot or foxhole foot. It was first described in the Napoleonic Wars but was commonly seen in soldiers of World War I who stood for days wearing tight boots in wet and cold trenches. It is caused by prolonged exposure of the foot to a non-freezing moist environment and is made worse by high altitude prolonged immobility and dependency of the limbs. Smoking and underlying vascular problems can aggravate this condition. A warm-water variety was described during the Vietnam War and more recently this condition has been recognized in elderly patients and homeless persons who have prolonged exposure to cold damp conditions. Acrocyanosis Acrocyanosis is a bluish discoloration and coolness of the hands and less commonly the feet that persists in both cool and warm environments. The forehead nose cheeks earlobes elbows and knees are rarely involved. It is more prevalent in those aged 20 to 50 years and affects men and women equally. Although acrocyanosis is rare two types have been described primary seen in young women and reported in patients with anorexia nervosa malignancies infectious mononucleosis and spinal cord injuries and secondary associated with connective tissue disorders . Acrocyanosis must be distinguished from peripheral cyanosis Raynaud syndrome and erythromelalgia. Acrocyanosis Characteristics Affects hands most commonly but occasionally the feet Persistent bluish discoloration Primary and secondary forms Several theories exist for the cause of acrocyanosis .