Special Locations
Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes in Atlas of Dermoscopy, 2023
A structureless purple to blue spot observed through the nail plate is associated with one of two conditions: The presence of a blue nevus of the nail unit or a glomus cell tumor. In the latter, the pressure of the dermo scope on the nail plate can trigger the characteristic “electric” pain associated with this neoplasm. There are three well-described clinical tests that can help diagnose glomus tumors:Love's test: This test is considered suggestive of the presence of a glomus tumor if the pressure applied using the head of a pin or the tip of a paperclip reproduces pain on the affected fingertip. This test can also help locate the tumor.Hildreth's test: This test is considered suggestive of the presence of a glomus tumor if the tenderness observed during the Love's test disappears when the physician applies a tourniquet to the digit involved.The cold sensitivity test requires that the physician expose the finger to cold by, say, placing the finger in an ice bath. This exposure will elicit increased pain in a patient who has a glomus tumor.
The Crucial Role of Craniofacial Growth on Airway, Sleep, and the Temporomandibular Joint
Aruna Bakhru in Nutrition and Integrative Medicine, 2018
Dental infections are common; these must always be included in the differential diagnosis for orofacial pain. Hot or cold sensitivity that quickly resolves when the stimulus is removed is characteristic of reversible pulpal inflammation. Spontaneous, pounding pain often occurs once the pulp has become severely inflamed or necrotic. Formation of a periapical abscess may cause pain with chewing and when the tooth is percussed (tapped gently with a dental instrument).
Chromonychia
Archana Singal, Shekhar Neema, Piyush Kumar in Nail Disorders, 2019
Glomus tumor is an uncommon tumor of the neuromyoarterial glomus bodies located in the nail bed dermis. It is a painful benign nail tumor, occurring most commonly in the subungual area of the first and second fingernails. The classic triad of symptoms that typically exceed clinical signs includes intense, paroxysmal pain, pinpoint tenderness; cold sensitivity; and irradiation of pain along the same arm.7
Interdependent self-construal modulates the adrenocortical stress response in the socially evaluated cold-pressor test
Published in Stress, 2019
A few limitations of the current study need to be acknowledged. First, the present study did not include an appropriate control group, e.g. a CPT group. As social evaluative threat is a key component that induces stress responses on the SECPT among individuals with high InterSC, the inclusion of a control group may help us verify the experimental results. Second, participants’ cold sensitivity may vary. Thus, individuals with high InterSC may have shown a stronger cortisol stress response as compared to those with low InterSC because the former were more sensitive to cold. However, the lack of an accurate measurement of cold sensitivity makes it difficult to draw conclusions on this possibility. Future studies should take individual differences in cold sensitivity of the participants into account. Third, the intra-individual variability in cortisol diurnal rhythm may reflect either the amount of day-to-day fluctuation, or other systematic changes, in the HPA axis (Almeida, Piazza, & Stawski, 2009). Therefore, future studies should measure cortisol either by averaging the CAR across multiple days or by assessing the same variable using hair samples from the forehead, because the latter provides an index of cortisol production over multiple days (McEwen et al., 2017).
Extradigital glomus tumor of the anterior knee
Published in Case Reports in Plastic Surgery and Hand Surgery, 2020
Patients with glomus tumors classically present with a triad of pinpoint tenderness, paroxysmal pain, and cold hypersensitivity. Localization of the lesion can be performed with Love’s test by applying pressure to the suspected area with the head of a pin or paperclip, eliciting intense pain. Love’s pin test has a sensitivity of 100% and accuracy of 78% [6]. If a tourniquet or blood pressure cuff is utilized proximal to the lesion in Hildreth’s test, the tenderness is abolished. Hildreth’s test has a sensitivity of 71% and specificity of 100% with 78% accuracy [6]. Cold sensitivity was found to be 100% sensitive, specific, and accurate [6]. Subjective symptoms typically exceed clinical signs and it is not uncommon for patients to see multiple providers, sometimes over multiple years, prior to obtaining the correct diagnosis. Patients have been wrongly referred to psychiatrists due to misdiagnosed glomus tumor where no nail or skin alteration was visible, and no proper workup performed. Clinically, glomus tumors can be confused with neuromas, arthritis, gout, eccrine spiradenomas, and leiomyomas which can all be readily distinguished from glomus tumors histologically and immunohistochemically [4].
Cold hypersensitivity after hand injuries. A prospective 7-year follow-up
Published in Journal of Plastic Surgery and Hand Surgery, 2018
T. Vaksvik, M. Røkkum, I. Holm
For a more comprehensive overview of studies examining changes in cold sensitivity, including studies were patients are not followed prospectively, we refer to Carlsson and Dahlin [1]. Currently, along with the present results, the two previously mentioned Scandinavian studies [1,2] constitute the best available evidence for longitudinal changes in cold sensitivity after the first postoperative year following severe hand injuries. Strength of the present study was the evaluation of changes occurring after several years, including patients followed for many time points since the time of injury. A weakness of the study is the limited study sample of 71 patients of whom five were no longer cold hypersensitive at the 3-year follow-up. Furthermore, five of the patients were cold hypersensitive in their injured hand before the current injury [2], which may limit their possibilities of improvement. Thus, the power to detect statistically significant changes was low. Another study limitation is the lack of information about characteristics of the non-participants. We can, therefore, not generalize the results to the total eligible population of patients.
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