Cold urticaria is a rare condition that affects some individuals, causing an allergic reaction when exposed to cold temperatures. This immune system response can lead to symptoms such as hives, swelling, pain, and in severe cases, life-threatening anaphylaxis. First described in 1792, cold urticaria is more common in women, with onset typically occurring in the early twenties.
There are two forms of cold urticaria – primary and secondary. Primary cold urticaria, which accounts for 95% of cases, often has no known cause. Secondary cold urticaria is linked to underlying conditions or infections such as Epstein-Barr virus, lymphoma, HIV, and hepatitis C.
Symptoms of primary cold urticaria include rash, swelling, bumps, and hives, as well as fatigue, fever, and joint pain. Triggers can include exposure to cold weather, swimming, consuming frozen food or cold liquids, and handling cold objects. Mast cells play a role in the condition, releasing histamine when activated in response to cold exposure.
Testing for cold urticaria involves placing an ice cube on the skin to observe the reaction. Treatment options include antihistamines, corticosteroids, and in severe cases, the use of monoclonal antibodies like Omalizumab. Desensitization therapy may also be used to gradually expose the skin to cooler temperatures to reduce the immune response.
It’s important for individuals with cold urticaria to avoid triggers and understand their critical temperature threshold. Adrenaline may be necessary in cases of anaphylaxis, and precautions should be taken during surgical procedures where exposure to cold temperatures can pose a risk. By increasing awareness and understanding of cold urticaria, individuals can better manage and mitigate the potential dangers associated with this condition.
This article was republished from The Conversation under a Creative Commons license and written by Adam Taylor, Professor of Anatomy at Lancaster University.
