Cold Urticaria Following An Ice Application - A Case Study

Urticaria is a common condition described in dermatology. The signs and symptoms of physical urticaria are repeated occurrences of short-lived cutaneous wheals accompanied by redness and itching.(1) Types of physical urticarias include cold, aquagenic, heat, pressure, vibratory, and solar.(1,2) Cold urticaria is a distinct clinical entity characterized by redness, itching, wheals, and edema on cold-exposed skin.(3) In addition to the local reactions, there may be an associated systemic reaction. Systemic reactions can consist of headache, flushing, faintness, and, rarely, collapse.(2) In some cases, the reaction may be severe after extensive exposure, such as whole-body immersion in cold water.(4) Cold urticaria develops most often in young adults between the ages of 20 and 30 years, more often in women than men, and possibly following emotional stress, viral illness, or multiple insect bites. (1,2)Cryotherapy is widely used for treating musculoskeletal injuries, and patients should be screened for contraindications prior to cryotherapy application.(5) Contraindications for cryotherapy include previous allergic reactions to ice applications, Raynaud disease, cold hypersensitivity or hyposensitivity, circulatory insufficiency, or a previous cold injury. Patients with no previous history of cryotherapy exposure may not be aware of their condition, and even if they have had a prior cryotherapy treatment, they still are susceptible to a reaction, because cold urticaria has be shown to be area-specific.(3)Researcher's have examined the pathomechanics, physiology, and treatment of cold urticaria, and to our knowledge, no study to date has measured skin surface temperature of a patient with a cold urticaria reaction. Clinicians should be aware of the signs and symptoms of cold urticaria and the possible serious complications.