Diagnosis of Cold Urticaria
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last updated on 24/12/2024
Triggering situations
The main situations triggering cold urticaria attacks are as follows:
➜ swimming, exposure to cold air, ingestion of cold products, working in a cold environment, sudden thermal differential, etc., but also injection of non-warmed products, operating room and limb cooling, extreme sports exposed to cold, cryotherapy cabins…
Ice cube test (systematic)
Place an ice cube (in a plastic bag) on the forearm for 5 minutes. Read the results 10 minutes after removing the ice cube. If negative, consider increasing the exposure time to 10 or even 20 minutes.
If erythematous papule (positive test):
Then perform a biological assessment: CBC, CRP.
Non-recommended tests
- TempTest® in routine practice
- Diagnostic immersion test
In case of clinical signs suggesting a cytopathy
Purpura, arthralgia, peripheral neuropathy…
In case of clinical signs suggesting an associated systemic disease (purpura, arthralgia, peripheral neuropathy, etc.), consider testing for cryoglobulins and cold agglutinins in the biological assessment.
The working group does not recommend routine measurement of baseline tryptase in the management of patients with cold urticaria.
However, in the case of generalized type III reactions, the working group recommends measuring tryptase in the acute phase (between 30 minutes and 4 hours after the first signs), followed by baseline tryptase measurement more than 24 hours after the event.
➜ Elementary lesions
