Disease Information for Urticaria, cold/immersion

Cold Urticaria

Some persons have a familial or acquired hypersensitivity to cold and may develop urticaria upon even limited exposure to a cold (eg, wind, freezer compartments). The urticaria usually occurs only on exposed areas, but in markedly sensitive individuals the response can be generalized and fatal. Immersion in cold water may result in severe systemic reactions from histamine release, including shock. 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 and may be accompanied by itching. Cyproheptadine, 16–32 mg/d in divided doses, is the drug of choice.

---------------[Medical Access Website current DXRX 2006]----------

Urticaria, Cold

Disorder Subdivisions

Primary Idiopathic Cold Urticaria

Urticaria Idiopathic Cold (Familial or Acquired)

General Discussion

Cold rrticaria is a chronic, reactive skin disorder. It is probably the most common form of physical urticaria (hives). Major symptoms may include abnormal reddening of the skin (erythema), hives and itching after exposure of the skin to cold temperatures.

There are two forms of the disorder: essential (acquired) cold urticaria, and familial (hereditary) cold urticaria. The symptoms of the acquired form become obvious in two to five minutes after exposure to the triggering substance or situation, while it takes 24 to 48 hours for symptoms of familial cold urticaria to appear. Also, symptoms tend to last longer with the familial form, typically about 24 hours although they may remain for as long as 48 hours. With the acquired form, symptoms tend to last for one to two hours.

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