Cold Urticaria Images
May 05, 2022
Source: Cainiu Health
Dr. Liu Wan
Introduction
Contact with cold water or other cold substances causes pruritic edema and urticarial wheals at the exposed site, which typically resolve within approximately 30 minutes to 1 hour.
Lesions commonly occur on exposed areas such as the face and hands; in severe cases, other body regions may also be affected.
Cold beverages may induce edema of mucosal sites—including the mouth, tongue, and pharynx—and even cause abdominal pain.
Associated symptoms frequently include headache and syncope; immersion in cold water (e.g., cold-water swimming or cold showers) may precipitate shock and even death.
Urticaria is a common condition in daily life and can significantly impair patients’ quality of life. Cold urticaria is a specific subtype of urticaria—so what do cold urticaria lesions look like?
Images of Cold Urticaria
Exposure to cold water or other cold substances triggers pruritic edema and wheals at the affected site, which typically resolve spontaneously within approximately 30 minutes to one hour. Lesions most commonly occur on exposed areas such as the face and hands; in severe cases, they may involve additional body regions. Cold beverages may induce swelling of mucosal surfaces—including the mouth, tongue, and pharynx—and even cause abdominal pain. Headache is frequently reported; severe cases may present with hypotension, syncope, or even shock-induced death following cold-water swimming or cold showers. A diagnostic ice-cube test—placing an ice cube on the volar forearm for two minutes—typically elicits a characteristic wheal at the application site.
Cold urticaria is generally classified into hereditary and acquired forms. The hereditary form is rare in clinical practice, whereas the acquired form is far more common and typically manifests upon exposure to cold wind, cold water, or other cold stimuli. Treatment options include second-generation non-sedating antihistamines such as cetirizine, loratadine, and fexofenadine; sedating antihistamines such as hydroxyzine and ketotifen; or tricyclic antidepressants like doxepin, which demonstrate efficacy in selected patients. In addition to pharmacotherapy, patients must avoid known triggers—particularly by maintaining warmth and protecting exposed skin from cold exposure. If standard antihistamine therapy proves ineffective, clinicians should consider underlying systemic disorders associated with cold-induced urticaria, including paroxysmal nocturnal hemoglobinuria and cryoglobulinemia, and pursue comprehensive diagnostic evaluation to prevent disease progression or misdiagnosis.
Patients should also prioritize skin care and balanced nutrition to reduce susceptibility to bacterial or viral infections that may precipitate dermatological conditions—thereby severely impacting daily life. We hope this information proves helpful!
