Cold Urticaria characteristics
Is the most common type of urticaria produced by cold, it represents from three percent to thirteen percent of the varieties of physical chronic urticaria. The pathophysiology for this condition remains unknown. However, between the thirty and fifty percent of the patients affected by this condition present tests of positive passive cutaneous transfer (PK). Besides it has been proven in these individuals the release of mast cell mediators (histamine) after the exposition to cold. All the evidence seems to suggest that these patients produce IgE antibodies against cutaneous antigens dependent of cold.
There is an immediate variant and another delayed of Cold Urticaria, another type is the common urticaria acquired for cold and it usually is idiopathic. Secondary types are associated to cryoglobulinemia and it usually emerges on exposed areas.
Clinical manifestations of Cold Urticaria
It usually affects to young and adult people. The precipitant factor is cold (windy and cold weather, washing and immersion on cold water, intake of cold drinks, contact of skin with cold objects). The patient presents itching, erythema and the emergence of hives in those cutaneous areas that have been exposed to low temperatures. Although lesions can emergence during the exposition to cold, what is usual is the emergence of lesions after ten to thirty minutes have passed after the exposition to cold (during the overheating of skin). In general lesions tend to disappear in a spontaneous way after a period of half an hour.
The edema of lips can take place by entering in contact with cold foods. In the case of prolonged expositions (for instance in the case of cold water bath, a bath on the pool or the sea) can be produced hypotension and a syncope caused by the massive release of mediators, becoming the cause for drowning.
Clinical types that are less frequent are the reflex cold urticaria, on which a disseminated eruption appears after a generalized exposition at very low temperatures, but not necessarily with the local application of cold.
Localized cold urticaria appears only those areas that have been exposed to cold. On the case of localized cold urticaria hives appear on the surroundings but not inside the area that has been exposed to cold. On delayed urticaria for cold, hives emerge after three to twenty four hours after the application of cold on skin has finished. The cold urticaria can be associated with cholinergic urticaria, and with less frequency to factitious urticaria. As regard to the evolution of this condition, an improvement can be expected in just less than fifty percent of the cases after five years, although in some cases have been reported spontaneous remissions.
In general cold urticaria is considered as one of the five most frequent causes for chronic urticaria, it is included in the group of physical urticaria, what is very frequent is the emergence of red hives in the zones exposed to cold or low temperatures, it can emerge at any age, but the most affected persons are the adults.