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Hunting Reaction is defined as a condition wherein there is constriction of the blood vessels (vasoconstriction) and dilatation of the blood vessels (vasodilation) in the arms and legs on exposure to cold.

What are the other names for this Condition (Also known as/Synonyms)

  • Hunting Reaction of Lewis
  • Hunting Response
  • Lewis Reaction

What is Hunting Reaction? (Definition/Background Information)

  • Hunting Reaction is defined as a condition wherein there is constriction of the blood vessels (vasoconstriction) and dilatation of the blood vessels (vasodilation) in the arms and legs on exposure to cold
  • Hunting Reaction usually occurs due to longstanding exposure to non-freezing temperature; it affects people who work outdoors in cold conditions. The condition may also arise on contact with cold water
  • The signs and symptoms of Hunting Reaction may include pain, swelling, and redness of the extremities. In some individuals, the pain may be severe enough to affect the quality of life. However, no other complications are typically noted
  • In many, the condition does not require any treatment and it gets better on its own, with gradual rewarming of the affected region. The prognosis of Hunting Reaction is typically excellent in a majority of individuals

Who gets Hunting Reaction? (Age and Sex Distribution)

  • Hunting Reaction may be observed in children and adults, though most of the cases are reported in adults
  • Both males and females are affected
  • No racial or ethnic group predilection is observed and the condition is observed worldwide

What are the Risk Factors for Hunting Reaction? (Predisposing Factors)

The risk factors for Hunting Reaction may include:

  • Prolonged unprotected exposure to non-freezing weather/temperatures
  • Living or travelling in cold regions without wearing adequate protective clothing
  • Prolonged outdoor activity during winters
  • Contact with cold water for a long duration
  • Hunting Reaction can be an occupational risk, such as in fishermen, those handling frozen meat, and construction workers, who work in wintry weather

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Hunting Reaction? (Etiology)

Hunting Reaction may be described as a skin condition occurring due to prolonged exposure to non-freezing cold air or water.

  • Initially, there is vasoconstriction (abnormal narrowing of blood vessels) resulting in the cooling of the arms and legs
  • This is followed by sudden vasodilation (abnormal expansion of blood vessels) resulting in blood flow to the extremities about 5-10 minutes later
  • Then, the vasodilation increases the body temperature. This phase is followed by vasoconstriction again, resulting in cooling of the extremities, which leads to the symptoms of Hunting Reaction
  • The constriction and dilatation of the blood vessels is caused by the release of neurotransmitters from the nerves

It has been observed that rarely such a response occurs not only due to exposure to low temperatures, but also on exposure to changes in pressure. Many consider this to be an exaggerated response of the body to cold, or in rare cases, to pressure.

What are the Signs and Symptoms of Hunting Reaction?

The signs and symptoms of Hunting Reaction may include:

  • Redness of the hands and feet (extremities)
  • Pain on the affected region of the body; the pain may be severe
  • Swelling of the affected part
  • Burning sensation; swelling may be observed

How is Hunting Reaction Diagnosed?

Hunting Reaction may be diagnosed using the following tests and exams:

  • Complete physical examination with comprehensive evaluation of medical history
  • Assessment of the signs and symptoms
  • Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
  • Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
  • Skin biopsy, if necessary: A biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

In many cases, no skin biopsy is necessary and the condition may be diagnosed via the presenting symptoms by a healthcare provider.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Hunting Reaction?

In a majority of individuals, no significant complications due to Hunting Reaction are noted. However, in some cases, the following complications are observed:

  • Pain can be severe enough to impede one’s work and daily activity
  • Cosmetic issues resulting in emotional stress
  • Recurrence of the condition

How is Hunting Reaction Treated?

In many individuals, no treatment is necessary for Hunting Reaction, since the condition gets better spontaneously. If required, the following measures may be considered:

  • Moving from the area of cold exposure
  • Gradually warming the affected skin region can help in recovery
  • Symptomatic and supportive therapy
  • Use of topical creams
  • Vasodilator therapy, if needed

How can Hunting Reaction be Prevented?

Avoiding exposure to cold weather and cold temperatures can help prevent Hunting Reaction. Additionally, the following steps may be taken to prevent the condition:

  • Use of protective and warm clothing (including wearing gloves, shoes); especially, taking precautions when there is a sudden change in weather temperature (from cold to hot)
  • Avoid getting wet in cold rain or cold waters for a long period
  • Considering the possibility of relocating to a warmer area (if it is a chronic condition)
  • Stop activities triggering the condition
  • Change your work activities or occupation, if possible
  • Being aware of injuries that may arise from prolonged cold exposure

What is the Prognosis of Hunting Reaction? (Outcomes/Resolutions)

The prognosis of Hunting Reaction is typically excellent, since it is a self-limiting condition with no severe symptoms or complications being noted.

Additional and Relevant Useful Information for Hunting Reaction:

Cold panniculitis (CP) is an acute condition resulting in the inflammation of subcutaneous fat tissue just beneath the skin, on exposure to cold temperatures. The term ‘panniculitis’ indicates an inflammation of fat (adipose) tissue.

What are some Useful Resources for Additional Information?

American Academy of Dermatology
930 E. Woodfield Road Schaumburg, IL 60173
Phone: (866) 503-SKIN (7546)
Fax: (847) 240-1859
Website: http://www.aad.org

References and Information Sources used for the Article:

http://www.cet-cryotherapy.com/cryotherapy_physiologic_effect.html (accessed on 09/20/18)

https://jamanetwork.com/journals/jamadermatology/article-abstract/530922 (accessed on 09/20/18)

https://www.ncbi.nlm.nih.gov/pubmed/9404866 (accessed on 09/20/18)

https://www.tandfonline.com/doi/full/10.1080/23328940.2015.1008890 (accessed on 09/20/18)

Helpful Peer-Reviewed Medical Articles:

Daanen, H. A. M. (2003). Finger cold-induced vasodilation: a review. European journal of applied physiology, 89(5), 411-426.

Hunting, A. S., Nopp, A., Johansson, S. G. O., Andersen, F., Wilhelmsen, V., & Guttormsen, A. B. (2010). Anaphylaxis to patent blue VI Clinical aspects. Allergy, 65(1), 117-123.

Mekjavic, I. B., Dobnikar, U., & Kounalakis, S. N. (2012). Cold-induced vasodilatation response in the fingers at 4 different water temperatures. Applied physiology, nutrition, and metabolism, 38(999), 14-20.

Lee, J. Y., Bakri, I., Matsuo, A., & Tochihara, Y. (2013). Cold-induced vasodilation and vasoconstriction in the finger of tropical and temperate indigenes. Journal of Thermal Biology, 38(2), 70-78.

Sawada, S. I., Araki, S., & Yokoyama, K. (2000). Changes in cold-induced vasodilatation, pain and cold sensation in fingers caused by repeated finger cooling in a cool environment. Industrial Health, 38(1), 79-86.

Ruijs, A. C., Niehof, S. P., Hovius, S. E., & Selles, R. W. (2011). Cold-induced vasodilatation following traumatic median or ulnar nerve injury. The Journal of hand surgery, 36(6), 986-993.

Amalu, W. C. (2004, September). Nondestructive testing of the human breast: the validity of dynamic stress testing in medical infrared breast imaging. In Engineering in Medicine and Biology Society, 2004. IEMBS'04. 26th Annual International Conference of the IEEE (Vol. 1, pp. 1174-1177). IEEE.

Cheung, S. S., & Daanen, H. A. (2012). Dynamic adaptation of the peripheral circulation to cold exposure. Microcirculation, 19(1), 65-77.