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Cold urticaria prevalence, treatments, and risk of anaphylaxis

Published: October 18, 2021

Cold urticaria is a subtype of chronic urticaria and is a rare skin disease involving hives, itching, or swelling triggered by cold water, food, or objects. In a subset of patients, cold urticaria can trigger anaphylaxis, which is a life-threatening reaction. Few data are available on cold urticaria, especially regarding its prevalence, treatment, and risk of anaphylaxis.

In their study published by The Journal of Allergy and Clinical Immunology: In Practice, Prosty et al. conducted a comprehensive search of the recent literature on cold urticaria. Cohort studies of cold urticaria patients were selected from the search for inclusion in the study. Data on the prevalence of cold urticaria among cases of chronic urticaria, treatment strategies, and prevalence of associated anaphylaxis were extracted and statistically compiled.

The authors identified 22 relevant articles for inclusion in the study, of which 14 were statistically analyzed. Cold urticaria comprised 7.62% of cases of chronic urticaria. Using published prevalence estimates of chronic urticaria, it is estimated that cold urticaria is present in approximately 6 out of 10000 people worldwide at any given time. The most common treatments for cold urticaria were second generation H1-antihistamines in 95.67% of patients, followed by omalizumab in 5.95% of patients. Anaphylaxis induced by cold triggers occurred in 21.49% of patients with cold urticaria. Given that anaphylaxis is not rare in patients with cold urticaria, prescribing epinephrine autoinjectors should be considered.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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