title: Clinical features and natural history of acquired cold urticaria in a tertiary referral hospital: a 10-year prospective study.
abstract: BACKGROUND
  Acquired cold urticaria (ACU) represents a heterogeneous group of disorders that share a common clinical feature: the development of urticaria or angioedema after cold exposure. We present epidemiological and clinical data of subjects with ACU, natural progression and we examine possible parameters that could correlate with disease severity.
  
  
  METHODS
  During a 10-year period in all subjects with ACU, detailed record of personal history, laboratory testing, cold stimulation testing (CST), atopy assessment and disease severity took place. In a re-evaluation visit at the end of the surveillance period, ACU progression was assessed from patients in a subjective way.
  
  
  RESULTS
  Four thousand one hundred fifty-seven individuals with chronic urticaria were referred, and 352 (198 males, 154 females, 8.47% of patients with chronic urticaria) presented definite symptoms of physical urticarias, while 95 individuals (49 males, 46 females, 27% of patients with physical urticarias) were detected with ACU. Sixty-two participants were included in study analysis. Thirty-two patients (51.6%) were female; the mean age was 41.5 +/- 15.6 years, while the mean age at disease onset was 32.5 +/- 15.6 years; half were < or = 30 years old at disease onset. The mean duration of surveillance was 9.0 +/- 6.9 years. During this time interval, 18 patients (29.0%) showed the same or even worse symptomatology, 26 patients reported some improvement (41.9%), while in 18 patients, symptoms resolved completely (29.0%); the mean time to resolution was 5.6 +/- 3.5 years. Disease severity was the only variable statistically significantly related to disease progression (P = 0.004).
  
  
  CONCLUSIONS
  Cold urticaria is a chronic persistent disorder with occasional severe clinical manifestations.
authors.affiliation: Sygros Hospital, School of Medicine, 1st Clinic of Dermatology and Venerealogy, University of Athens, Athens, Greece. alkats.duoa@yahoo.gr
authors.forename: A
authors.initials: A
authors.lastname: Katsarou-Katsari
authors.forename: M
authors.initials: M
authors.lastname: Makris
authors.forename: E
authors.initials: E
authors.lastname: Lagogianni
authors.forename: S
authors.initials: S
authors.lastname: Gregoriou
authors.forename: T
authors.initials: T
authors.lastname: Theoharides
authors.forename: D
authors.initials: D
authors.lastname: Kalogeromitros
mesh_terms: D000328:Adult; D000368:Aged; D003080:Cold Temperature; D005260:Female; D006115:Greece / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012017:Referral and Consultation; D014581:Urticaria / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology