Ice cube test in children with cold urticaria

The ice cube test performed in 24 children (6 cold urticaria, 6 healthy, 6 allergic and 6 chronic urticaria) showed that a 3 and 5-minute ice cube test was the appropriate time for the diagnosis of cold urticaria without false positive results. If the test was prolonged to 10 and 20 minutes, 17% and 33% respectively showed false positive results in chronic urticaria other than cold urticaria patients. After four weeks of cyproheptadine therapy, the ice cube test showed only 17% positive at 3 minutes and 33% at 5 minutes. When the ice cube test was performed for 10 and 20 minutes, 67% showed positive results. In conclusion, the ice cube test should be performed for 3 to 5 minutes to diagnose cold urticaria in children. The time should be increased to 10 or 20 minutes if the test shows negative results at 3 to 5 minutes after antihistamine therapy.