Cold contact urticaria triggered by a permanent tattoo

Cold contact urticaria is an inducible urticaria triggered by exposure to cold air, liquids, or objects. Symptoms may range from mild, localized urticaria to genuine anaphylaxis particularly after extensive contact of large skin areas to cold. Treatment mainly requires a strict avoidance of cold exposure and the use of second-generation H1 antihistamine. In most cases, it is not associated with any specific etiology although in rare cases it can be secondary to various associated diseases or triggered by a number of external factors. We present the observation of a 38-year-old woman for whom cold contact urticaria began on a recent tattoo area.