Pure Cold-Induced Cholinergic Urticaria in a Pediatric Patient

Area of Science:

• Allergy and Immunology
• Dermatology
• Urticaria Pathophysiology

Background:

• Cold urticaria and cholinergic urticaria are recognized as distinct conditions.
• The co-occurrence or exclusive presentation of cold-induced cholinergic urticaria is exceptionally rare in medical literature.
• Urticaria triggered by environmental factors presents diagnostic challenges.

Purpose of the Study:

• To report a rare case of exclusive cold-induced cholinergic urticaria.
• To document the diagnostic process and management of this rare urticaria subtype.
• To contribute to the limited literature on cold-induced cholinergic urticaria, particularly in adults.

Main Methods:

• Clinical case presentation and detailed patient history.
• Diagnostic workup including laboratory and in-office urticarial testing.
• Therapeutic trial with oral antihistamine medication.

Main Results:

• The patient presented with urticaria exclusively during exercise in a cold environment.
• All standard urticarial diagnostic tests yielded negative results.
• Symptoms were successfully controlled with oral antihistamine therapy.

Conclusions:

• Exclusive cold-induced cholinergic urticaria is a rare clinical entity.
• Negative diagnostic testing can occur in specific urticaria presentations.
• Oral antihistamines are effective in managing this rare form of urticaria.