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The authors report two cases of patients presenting with chemical frostbite-like injuries to the hands and wrists after contact exposure to Freon liquid. Although the history and initial physical presentations were quite similar, the severity of these injuries varied widely from superficial bullae to deep tissue injuries, requiring skin grafting and amputation of several digits. Freon is a widely used coolant in refrigerators, air conditioners, freezers, and water coolers, with a boiling point of -41 degrees C. Although several cases of Freon-induced inhalational injury have been reported, few case reports of Freon-associated contact skin injury exist in the literature. The authors detail the broad diversity of injuries resulting from Freon contact as well as the first report of severe Freon injury necessitating skin grafting and amputation of multiple digits.
From the *Department of Medicine, Duke University Medical Center, Durham, North Carolina; and daggerDepartment of Surgery, The Ohio State University Center for Burn Care, The Ohio State University Medical Center, Columbus, Ohio.
This article was published in the following journal.
Name: Journal of burn care & research : official publication of the American Burn Association
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The phenomenon of immense variability characteristic of ANTIBODIES. It enables the IMMUNE SYSTEM to react specifically against the essentially unlimited kinds of ANTIGENS it encounters. Antibody diversity is accounted for by three main theories: (1) the Germ Line Theory, which holds that each antibody-producing cell has genes coding for all possible antibody specificities, but expresses only the one stimulated by antigen; (2) the Somatic Mutation Theory, which holds that antibody-producing cells contain only a few genes, which produce antibody diversity by mutation; and (3) the Gene Rearrangement Theory, which holds that antibody diversity is generated by the rearrangement of IMMUNOGLOBULIN VARIABLE REGION gene segments during the differentiation of the ANTIBODY-PRODUCING CELLS.
Class I-restricted activation of CD8-POSITIVE LYMPHOCYTES resulting from ANTIGEN PRESENTATION of exogenous ANTIGENS (cross-presentation). This is in contrast to normal activation of these lymphocytes (direct-priming) which results from presentation of endogenous antigens.
Damage to tissues as the result of low environmental temperatures.
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