Cold Urticaria

Cold urticaria is a type of skin condition characterized by the appearance of itchy, red, and swollen hives or wheals after exposure to cold temperatures or cold objects. It is a rare condition that affects approximately 3% of the population.

Causes and Triggers

The exact cause of cold urticaria is not fully understood, but it is believed to be an autoimmune disorder in which the body's immune system overreacts to cold temperatures. The condition can be triggered by a variety of factors, including:

• Exposure to cold air or water
• Swimming in cold water
• Drinking cold beverages
• Eating cold foods
• Using cold compresses or ice packs

Symptoms

The symptoms of cold urticaria typically appear within minutes to hours after exposure to a cold trigger and can include:

• Itchy, red, and swollen hives or wheals on the skin
• Hives that can range in size from small, pinpoint lesions to large, confluent areas of swelling
• Lesions that may appear anywhere on the body, but are most commonly found on the face, neck, arms, and legs
• In severe cases, anaphylaxis, a life-threatening allergic reaction that can cause difficulty breathing, rapid heartbeat, and a drop in blood pressure

Diagnosis

Cold urticaria is typically diagnosed based on a physical examination and a thorough medical history. A doctor may perform the following tests to confirm the diagnosis:

• Ice cube test: an ice cube is placed on the skin for 5-10 minutes to see if a hive or wheal forms
• Cold water immersion test: the affected area is immersed in cold water to see if symptoms develop
• Blood tests: to rule out other conditions that may be causing the symptoms

Treatment and Management

Treatment for cold urticaria typically involves avoiding exposure to cold triggers and using medications to relieve symptoms. The following treatments may be recommended:

• Antihistamines: to relieve itching, redness, and swelling
• Corticosteroids: to reduce inflammation and swelling
• Epinephrine injections: in severe cases of anaphylaxis
• Avoiding cold triggers: such as taking warm showers, wearing warm clothing, and avoiding cold foods and drinks

Complications and Prognosis

Cold urticaria can increase the risk of developing other conditions, such as:

• Anaphylaxis: a life-threatening allergic reaction that requires immediate medical attention
• Asthma: cold urticaria may be associated with an increased risk of developing asthma
• Other autoimmune disorders: such as lupus or rheumatoid arthritis

The prognosis for cold urticaria is generally good, and most people are able to manage their symptoms with treatment and lifestyle modifications. However, in severe cases, the condition can be debilitating and may require ongoing medical attention.