title: Acquired cold urticaria: Clinical features, particular phenotypes, and disease course in a tertiary care center cohort.
abstract: BACKGROUND
  Data about special phenotypes, natural course, and prognostic variables of patients with acquired cold urticaria (ACU) are scarce.
  
  
  OBJECTIVE
  We sought to describe the clinical features and disease course of patients with ACU, with special attention paid to particular phenotypes, and to examine possible parameters that could predict the evolution of the disease.
  
  
  METHODS
  This study was a retrospective chart review of 74 patients with ACU who visited a tertiary referral center of urticaria between 2005 and 2015.
  
  
  RESULTS
  Fourteen patients (18.9%) presented with life-threatening reactions after cold exposure, and 21 (28.4%) showed negative results after cold stimulation tests (classified as atypical ACU). Nineteen patients (25.7%) achieved complete symptoms resolution at the end of the surveillance period and had no subsequent recurrences. Higher rates of atypical ACU along with a lower likelihood of achieving complete symptom resolution was observed in patients who had an onset of symptoms during childhood (P < .05). In patients with atypical ACU, shorter disease duration and lower doses of antihistamines required for achieving disease control were detected (P < .05). Age at disease onset, symptom severity, and cold urticaria threshold values were found to be related to disease evolution (P < .05).
  
  
  CONCLUSIONS
  This study was limited by its retrospective nature.
  
  
  CONCLUSIONS
  The knowledge of the clinical predictors of the disease evolution along with the clinical features of ACU phenotypes would allow for the establishment of an early and proper therapeutic strategy.
authors.affiliation: Department of Dermatology, Hospital del Mar- Institut Mar d'Investigacions Mèdiques, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain. Electronic address: gustavo.deza@gmail.com.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Deza
authors.affiliation: Department of Dermatology, Hospital del Mar- Institut Mar d'Investigacions Mèdiques, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Department of Dermatology, Hospital S. António dos Capuchos, Centro Hospitalar Lisboa Central, Lisbon, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Brasileiro
authors.affiliation: Department of Dermatology, Hospital del Mar- Institut Mar d'Investigacions Mèdiques, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Bertolín-Colilla
authors.affiliation: Department of Dermatology, Hospital del Mar- Institut Mar d'Investigacions Mèdiques, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
authors.forename: Laia
authors.initials: L
authors.lastname: Curto-Barredo
authors.affiliation: Department of Dermatology, Hospital del Mar- Institut Mar d'Investigacions Mèdiques, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
authors.forename: Ramon M
authors.initials: RM
authors.lastname: Pujol
authors.affiliation: Department of Dermatology, Hospital del Mar- Institut Mar d'Investigacions Mèdiques, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Giménez-Arnau
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000799:Angioedema / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003080:Cold Temperature / Q000009:adverse effects*; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology; D007223:Infant; D008297:Male; D010641:Phenotype; D011379:Prognosis; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014581:Urticaria / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
chemical_list: D006633:Histamine Antagonists
keywords: acquired cold urticaria; disease course; phenotypes; physical urticaria