IN 1902, Carl Hochsinger described a hardening of tissue in the submental region in children, related to cold exposure.1 His patients were between 4 and 10 years old. After exposure to unusually cold weather, they developed a tender, slightly erythematous, well-demarcated induration of the submental subcutaneous tissue. Most of his patients had an abundance of subcutaneous fat in the area. The induration gradually resolved spontaneously in two to three weeks. Hochsinger compared the lesions to those of subcutaneous fat necrosis of the newborn, and observed a similar lesion after prolonged application of an ice bag to the thigh of an 8-year-old boy. In only one instance was the cheek involved.
In 1941, Haxthausen described five additional cases, four in children aged 6 months to 3 years, and one in a 17-year-old girl.2 His patients all had conspicuous involvement of the cheeks, and the oldest girl had evidence of