Cold urticaria (basically means "cold hives") is a disorder in which the hives (urticaria) or the formation of large reds on the skin after a cold stimulus. Acne scars are usually itchy and often the hands and feet will become itchy and swollen as well. The hives size varies from about 7mm in diameter to about 27mm in diameter or larger. The disease is classified as chronic when hives appear for more than 6 weeks; they can survive, although their travels are often unpredictable. This disorder, or perhaps two disorders with similar clinical manifestations, may be inherited (familially cold urticaria) or acquired (primary acquired cold urticaria). The shape obtained is most likely between the ages of 18-25, although it can occur as early as 5 years in some cases.
Video Cold urticaria
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Cold urticaria can be divided into the following types:
primary cold contact urticaria
Primary urticaria primary contact is a skin condition characterized by patches, and occurs in rainy, windy weather, and after swimming in cold water and after contact with cold objects, including ice cubes.
Secondary cold contact urticaria
Secondary cold urticaria contact is a skin condition characterized by a whip, since serum abnormalities such as cryoglobulinemia or cryofibrinogenemia are very rare, and then associated with other manifestations such as Raynaud or purpura phenomena.
Reflex cold urticaria
Reflex cold urticaria is a skin condition in which the general cooling of the body induces extensive sweeping.
familial cold urticaria
Familial cold urticaria (also known as cold family autoinflammatory syndrome , FCAS ) is an autosomal dominant condition characterized by rash, conjunctivitis, fever/chills and arthralgia caused by cold exposure - sometimes temperatures below 22Ã, Â ° C (72Ã, Â ° F).
It has been mapped to CIAS1 and is a slightly milder member of the illness family including Muckle-Wells syndrome and NOMID. Very rare and estimated to have a prevalence of 1 per million people and mainly affect Americans and Europeans.
FCAS is one of the cryopyrin-related periodic syndromes (CAPS) caused by mutations in the CIAS1/NALP3 gene (aka NLRP3) at 1q44 sites. The disease is described in The Lancet Volume 364 by Hoffman H.M. et al.
The influence of FCAS on patient quality of life is very far away. A survey of patients in the United States in 2008 found, "To overcome the underlying illness and to try to avoid symptomatic symptomatic patients, reporting restricted their work, school, family, and social activities." Seventy-eight percent of survey participants described the impact of illness on their work, including the absence and disruption of work progress, often, they quit their jobs as a consequence of their illness ".
Treatment using the kidneys (Kineret) has proven to be effective for FCAS, although this means daily immunosuppressant injections into areas such as the lower abdomen. The monoclonal canakinumab antibody (Ilaris) is also used.
Maps Cold urticaria
Symptoms
When the body is exposed to cold in the individual suffering from the condition, itching appears and the skin in the affected area usually becomes itchy. Hives results from the widening of the capillaries allowing the fluid to flow out into the surrounding tissues that are the epidermis. They finish when the body absorbs this fluid. The nest border is described as polycyclic, or consists of many circles, and changes when the liquid leaks out and is then absorbed. Pressing the nest causes the pale skin to distinguish it from bruises or papules. Hives can last for several minutes or several days, and vary from person to person. Also, a burning sensation occurs. During severe reactions, low blood pressure, which can be life-threatening, can occur. Serious reactions are most likely to occur if the itching occurs with less than 3 minutes of exposure (during a cold test).
Cause
The nest is a histamine reaction in response to cold stimuli, including drastic temperature drop, cold air, and cold water. There are many causes for cold itching, mostly idiopathic (meaning they have no known cause). Some rare conditions can cause cold hives, and can be useful to test this condition if cold hives are in any way unusual.
Scientists from the US National Institutes of Health have identified genetic mutations in three unrelated families that cause rare immune disorders characterized by excessive and impaired immune function: immune deficiency, autoimmunity, inflammatory skin disorders and cold induced itching (urticaria cold).
"Mutations found to occur in the gene for phospholipase C-gamma2 (PLCG2), an enzyme involved in the activation of immune cells, have identified the condition of antibody deficiency associated with PLCG2 and immune dysregulation, or PLAID."
Risk factors
- Cold weather/Snow : Exposure to cold or cold air for more than a few minutes may trigger a reaction.
- Sweat : A reaction can even occur on a warm day when there is sweat on the skin. If there is a wind it will quickly cool the skin and make itching.
- Cold/Cool IV Lines : When in hospital, inserting cold or cold drip lines to an individual allergic to cold temperatures can cause pain in the IV branch to be placed and the nest line may appears within a 6-8 inch radius of the IV site in a rising line pattern on the limb.
- Swimming : Swimming can be very dangerous because fast heart rate combined with itching attacks can cause hypotension.
- Air Conditioning : Entering a cool building during summer days can cause allergic reactions to exposed areas of the skin, congestion due to cold air and may feel tired.
- Cold Food/Drink : Eating or drinking cold or cold substances such as ice cream or even ice tea can cause the individual tongue and surrounding tissue to swell.
- Cold/Cold Surfaces : Sitting on a cool pavement, leaning against or holding a cold pole will produce a hive that forms in an area in contact with a cold surface.
- Blood Blood Restrictions : Typing or other activities that strain the muscles and reduce the blood flow can cool the body parts sufficiently to cause itching and itching.
- Blood Flow : Placing the hands or feet in the hot water nail turns purple/white until the body gets used to the temperature.
Diagnosis
Diagnosis is usually obtained by an allergist or other licensed practitioner who performs a cold test. During a cold test, a piece of ice is held against the forearm, usually for 3-4 minutes. A positive result is a specific-looking sign of an increased red nest. Hives may be ice shapes, or may radiate from the ice contact area.
"However, while this technique helps in diagnosis, they do not provide information about the temperature and time limits of stimulation in which patients will start developing symptoms."
which is important because it can shape the severity of the disease and monitor the effectiveness of the treatment.
Treatment
First-line therapy at ColdU, as recommended by EAACI/GA2 LEN/EDF/WAO guidelines, is symptomatic with second-generation H1-antihistamines. if the standard dosage is not effective it increases up to 4-fold is recommended for symptom control.
Second-generation H1-antihistamine, rupatadine, was found to significantly reduce the development of chronic cold urticaria symptoms without an increase in adverse events using 20 and 40 mg.
Allergy medicines containing antihistamines such as diphenhydramine (Benadryl), cetirizine (Zyrtec), loratidine (Claritin), cyproheptadine (Periactin), and fexofenadine (Allegra) can be taken orally to prevent and reduce some itching (depending on severity allergy). For those who have severe anaphylactic reactions, prescribed drugs such as doxepin, taken daily, should help prevent and/or reduce the likelihood of reaction and thus, anaphylaxis. There is also a topical antihistamine cream used to help relieve itching under other conditions, but no documentation says it will free the nest caused by cold temperatures.
Cold hives can produce potentially serious, or even fatal (systemic) anaphylactic reactions. People with cold itching may have to carry injectable epinephrine forms (such as Epi-pen or Twinject) to use in case of serious reactions. The best treatment for this allergy is to avoid exposure to cold temperatures.
Research has found that Omalizumab (Xolair) may be an effective and safe treatment for cold urticaria for patients who do not adequately respond to standard care.
Ebastine has been proposed as an approach to prevent cold urticaria acquired.
See also
- Amyloidosis
- Cholinergic urine, same itching reaction in response to heat
- Diascopy
- Eritema
- Goose goose, normal response unrelated to cold temperature
- List of skin conditions
- Skin lesions
- Plaid syndrome
References
External links
Source of the article : Wikipedia
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