title: Primary acquired cold urticaria.
abstract: Primary acquired cold urticaria (ACU) is the most common type of cold urticaria characterized by rapid onset of pruritic hives, swelling, and possible severe systemic reactions including hypotension and shock after cold exposure. Primary ACU is diagnosed by history of such symptoms, a positive immediate cold-contact stimulation test, and negative laboratory evaluation for underlying systemic disorders. Clinicians should be aware that patients with ACU may be susceptible to life-threatening systemic reactions especially during aquatic activities and that proper patient education is extremely important. This article reviews the clinical presentation, pathogenesis, diagnosis, and management of primary ACU.
authors.affiliation: Harvard Medical School, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Chyh-Woei
authors.initials: CW
authors.lastname: Lee
authors.forename: Albert L
authors.initials: AL
authors.lastname: Sheffer
mesh_terms: D000328:Adult; D003080:Cold Temperature / Q000009:adverse effects*; D003877:Dermatitis, Contact / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D018876:Environmental Illness / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D004890:Erythema / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D011537:Pruritus / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D014581:Urticaria / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy