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Related Experiment Videos

Cold-induced cholinergic urticaria--case report.

M Geller1

  • 1Geller Allergy-Immunology Clinic, Rio de Janeiro, Brazil.

Annals of Allergy
|July 1, 1989
PubMed
Summary
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A child experienced cold-induced cholinergic urticaria, presenting with hives upon cold exposure. Effective treatment involved a combination of hydroxyzine and cyproheptadine.

Area of Science:

  • Dermatology
  • Allergy and Immunology

Background:

  • Cholinergic urticaria is typically triggered by heat and sweating.
  • Cold-induced urticaria is less common and can present with varied triggers.

Observation:

  • A 9-year-old child developed generalized urticaria (hives) when exposed to cold water or cold air.
  • Lesions appeared as punctate wheals with erythema, resembling typical cholinergic urticaria.
  • The patient did not react to an ice cube test or cold water immersion.
  • Urticaria was not triggered by exercise-induced sweating.

Findings:

  • A positive methacholine skin test indicated a cholinergic response.
  • The clinical presentation mimicked cholinergic urticaria despite a cold trigger.
  • Cold exposure, not heat or exercise, provoked the urticarial reaction.

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Implications:

  • This case highlights a rare presentation of cold-induced cholinergic urticaria.
  • It suggests a potential overlap or distinct subtype within cold urticarias.
  • Combination therapy with hydroxyzine and cyproheptadine proved effective for symptom control.