RT Book, Section
A1 Nemer, Jacqueline A.
A1 Juarez, Marianne A.
A2 Papadakis, Maxine A.
A2 McPhee, Stephen J.
A2 Rabow, Michael W.
A2 McQuaid, Kenneth R.
SR Print(0)
ID 1184175335
T1 Cold Urticaria
T2 Current Medical Diagnosis & Treatment 2022
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264269389
LK accessmedicine.mhmedical.com/content.aspx?aid=1184175335
RD 2024/04/25
AB Cold  urticaria  is  a  hypersensitivity  to  cold  exposure  (eg,  wind,  freezer  compartments,  cold  water)  resulting  in  histamine  release.  It  usually  presents  as  localized  redness,  burning,  pruritus,  and  urticaria  in  the  exposed  areas,  but  may  progress  to  a  generalized  systemic  reaction,  shock,  and  death.  This  condition  may  be  familial  or  acquired.  Familial  cold  urticaria  is  an  autosomal  dominant  inflammatory  disorder,  manifested  as  a  burning  sensation  of  the  skin  occurring  about  30  minutes  after  exposure  to  cold.  Acquired  cold  urticaria  may  be  associated  with  medication  (eg,  griseofulvin)  or  with  infection.  Cold  urticaria  may  occur  secondarily  to  cryoglobulinemia  or  as  a  complication  of  syphilis.  Most  cases  of  acquired  cold  urticaria  are  idiopathic.  For  diagnosis,  an  ice  cube  is  usually  applied  to  the  skin  of  the  forearm  for  4–5  minutes,  then  removed,  and  the  area  is  observed  for  10  minutes.  As  the  skin  rewarms,  an  urticarial  wheal  appears  at  the  site  that  may  be  accompanied  by  itching.  Second-generation  H1-antihistamines  have  been  used  as  first-line  treatment.  In  refractory  cases,  the  addition  of  anti-immunoglobulin  E  (IgE)  or  cyclosporine  may  be  considered.