Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 37-08: Cold Urticaria + Key Features Download Section PDF Listen +++ ++ Can be familial (autosomal dominant) or acquired Urticaria may develop on even limited exposure to cold (eg, wind, freezer compartments, cold water) Most cases of acquired cold urticaria are idiopathic However, cases can be associated with Medication (eg, griseofulvin) Infection Cryoglobulinemia Syphilis + Clinical Findings Download Section PDF Listen +++ ++ Usually presents as localized redness, burning, pruritus, and urticaria in the exposed areas May progress to generalized systemic reaction, shock, and death Burning sensation of the skin occurring about 30 min after exposure to cold seen in familial cold urticaria + Diagnosis Download Section PDF Listen +++ ++ Apply ice cube to the forearm skin for 4–5 min, remove, and observe the area for 10 min As the skin rewarms, an urticarial wheal appears at the site and may be accompanied by itching + Treatment Download Section PDF Listen +++ ++ Second-generation antihistamines have been used as first-line treatment In refractory cases, the addition of anti-immunoglobulin E (IgE) or cyclosporine may be considered