Cold Urticaria

Overview
Cold allergy or in medical terms called cold urticaria is the reaction of the skin to cold which causes itching to appear and the skin becomes reddish in color.

The severity of cold allergy symptoms that appear on each person is different. Some people can lose consciousness, experience very low blood pressure, and even the worst can cause death.
Ages are the age most often affected by cold allergies, but usually will disappear completely within a few years.

Symptoms
Usually cold allergy symptoms appear when the skin is exposed to cold water or cold weather (below 4 degrees Celsius). Cold allergies are also more at risk of appearing in conditions that are windy and damp. The following are some cold allergy symptoms that can occur.

• Hands feel swollen when holding cold objects.
• Itchy lesions appear on the area of ​​the skin exposed to cold air.
• The lips and throat feel swollen when eating cold food or drinks.
• Reddish skin.

Allergic reactions are usually most severe when the whole body is exposed to cold temperatures, such as when swimming in cold water. The reaction can potentially endanger lives, such as swelling of the throat and tongue so that breathing is difficult, blood pressure drops dramatically, heart palpitations, fainting, and swelling of the arms and legs.
In general, cold allergies will disappear by themselves after a few weeks or months, but some also last longer. If your throat or tongue feels swollen, feels dizzy, and has difficulty breathing, immediately see a doctor.

Cause
Cold allergic reactions occur when the release of histamine and other chemicals into the bloodstream is triggered by cold weather. Some things are thought to be the cause of cold allergies, including genetic factors that have too sensitive skin cells, certain viruses or diseases. But the exact cause of why the body reacts so to cold is unknown.
There are several factors that can increase the risk of getting cold allergies, namely:

• Children and adolescents. This age is most often affected by cold allergies and usually improves on its own in a few years.
• Certain basic diseases. There are several health problems or diseases, such as cancer or hepatitis that increase the risk of getting cold allergies.
• Those who have recently had infections such as pneumonia or pneumonia are more at risk of experiencing cold allergies.
• There are children who inherit this disease from their parents, but this is very rare.

Diagnosis
To diagnose cold allergies is very easy, just by placing ice cubes on the skin for five minutes. If after a while after removing the ice cube a red lump appears, then you suffer from cold allergies.
In some cases where cold urticaria is thought to be caused by another disease, the doctor may suggest additional tests in the form of blood tests or other supporting tests.

Care
There is no medicine that can cure cold allergies. Treatment is given to reduce the symptoms of this disease and prevent symptoms from appearing later. The treatment usually given by doctors is with antihistamine drugs. However, the use of antihistamines with ordinary doses is known to be ineffective, so that more helpful is a non-sedative antihistamine with high doses.
The drugs usually given are:

• This drug is usually used to treat asthma, but can also cure some sufferers of cold urticaria.
• Antihistamines (eg fexofenadine and desloratadine). This drug inhibits histamine substances in the body that produce allergic symptoms.
• Cyproheptadine, an anthistamine drug that works by inhibiting nerve reactions that lead to cold allergy symptoms.
• This drug is usually used to treat anxiety and depression and is known to relieve cold allergy symptoms.

Prevention
Prevention of cold allergies can be done with several things as below.

• Avoid eating cold foods and drinks to prevent swelling of the throat.
• Take medication as prescribed by a doctor.
• Tell your doctor or medical officer if you are going to undergo surgery to prevent cold allergy symptoms from occurring in the operating room.
• Before being exposed to cold weather, it is recommended to take antihistamines.
• Protect the skin from drastic temperatures or cold weather.
• Bring adrenaline injections wherever you go to anticipate if an anaphylactic reaction occurs.

• Mayo Clinic (2018). Diseases and Conditions. Cold Urticaria. • British Association of Dermatologists (2012). URTICARIA AND ANGIOEDEMA • Greaves MW. Chronic idiopathic urticaria, Curr Opin Allergy Clin Immunol 2003; 3:363-8. • Kaplan AP. Chronic urticaria, pathogenesis and treatment. (J. Allergy Clin Immunol 2004;) 114:465-74.