Cold allergy: symptoms and treatment, causes, signs, remedy for it

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Cold urticaria is a poorly understood pathological condition that physicians observe in patients with abnormal cold intolerance. This condition manifests itself when a person stays in an environment with low temperature, falling under a shower, contact with cold water, snow, ice, the use of chilled food, drinks.

This article will focus on the symptoms and treatment of cold allergy-urticaria in children and adults, tell about the causes of the disease and its prognosis.

Features of the disease

The time of appearance of painful symptoms varies from 2 to 10 minutes to 1 to 3 hours after touching cold objects or prolonged exposure to cold air, sometimes delaying for a day. Disease in medicine is considered one of the types of physical urticaria, which is expressed by pathological skin changes - itchy rashes, swelling, flushing( redness) and more severe symptoms requiring special therapy.

For the first time the description of this unhealthy condition appeared more than 150 years ago, but even today specialists continue to investigate this phenomenon.

• Analysis of studies and medical statistics conducted by scientists in Finland showed that out of 100 patients suffering from this type of urticaria, almost 70% are women. The average age of primary development of the disease is 23 to 25 years, but an abnormal reaction to cold can appear at any age.
• Children - usually at the age of at least 2 - 3 years, and very rarely - up to a year and a half.
• In 30% of people suffering from this condition, a cold reaction occurs with already existing allergic diseases, often combined with other forms of the disease - thermal allergy and urticaria dermographism. Practice confirms that all symptoms in uncomplicated course in 87% of patients die down to 5-7 of the disease.

Cold urticaria( photo)

Classification of cold urticaria

In medicine, there are two basic types of cold urticaria:

• acquired , subdivided into primary( reflex, contact) and secondary form;
• is hereditary or familial, inherited in an autosomal dominant type, in which a mutagen is inherited by a child of any gender from any parent) that appears in early childhood.

In addition, various subspecies of the acquired type of pathology have been studied and isolated, for example:

• urticaria with immediate and delayed response to cold;
• local( local), manifested in a restricted area;
• is manifested systemically, when the entire body reacts to hypothermia( generalized form).

In most case histories, physicians are faced with acquired primary or idiopathic( unclear origin) hives in the cold. Suffer from it, mainly girls and women under 35, but the symptomatology is also observed in young children, preschoolers, adolescents. Usually - with the already existing reaction and other types of allergic stimuli: food, pollen, household chemicals and cosmetics.

The video below shows how cold allergy appears and appears:

Causes of

Etiopathogenesis( causes and mechanisms of appearance, development of the disease, its manifestations) of cold allergy has not been fully investigated. There are medical assumptions( confirmed) about the likelihood of an allergy connection to cold:

• with viral mononucleosis, mumps, measles;
• with cryoglobulinemia( the presence of special proteins deposited on the vascular walls in the blood), observed in patients suffering from lymphoid leukemia, hepatitis C;
• mycoplasma pneumonia;
• with development of malignant tumors;
• with autoimmune pathologies, systemic vasculitis, lupus erythematosus;
• diseases of the thyroid gland, skin - neurodermatitis, eczema, psoriasis;
• aggression of parasites( helminthiases, scabies), dysbiosis;
• with the use of certain medications, such as Griseofulvin, tetanus antitetra, oral contraceptives.

External causative factors provoking manifestations of cold allergies:

• exposure to the skin of any refrigerated objects, water, snow and cold air( drafts, frost);
• frostbite or general hypothermia of the whole organism when in a low temperature environment;
• ingestion of cold drinks( milk cocktails, fruit juices with ice - smussey, beer, soda), eating frozen food( ice cream, chilled desserts).

The main importance in the development of the cold form of pathology is given to histamine( the hormone regulator of allergic reactions), to the mast cells( producing it) and, probably, to acetylcholine( as in the heat form of the disease). An increase in the amount of histamine in the blood and skin fragments taken from biopsy in patients with cold urticaria has been found in many laboratory tests. And its concentration in the blood of patients is significantly different.

Next, you will learn the signs of a cold allergy.

Symptoms of

In the typical development of cold allergies, changes occur on the skin within 2 to 5 minutes after the action of cold, accompanied by:

• itching, stinging, burning and soreness that precede skin reaction;
• by fast formation on a site of a skin:
  • pink or whitish bubbles, dense, itching;
  • erythema( abnormal redness);
  • of local edema in the area of ​​contact with cold;
• a peeling layer, sometimes covering the reddened swollen skin( like dermatitis);
• the appearance of bruises in places of rashes after a while( day - two).

In children, blisters and erythema often spread to the popliteal cavity, the inner surface of the thighs and lower legs.

In addition to skin symptoms when going to cold air, many patients have:

• mucus from the nose;
• sneezing, congestion with swelling of the nasal mucosa;
• cough dry, nasal;
• tear, eyelid swelling, itching, irritation in the eyes, sensitivity to light.

These symptoms quickly disappear when you return to a warm room.

Features of the manifestation

• Two, three or all signs can appear immediately. Sometimes they arise only when the whole body is cooled( generalized form).
• The atypical manifestation of reflex urticaria is expressed in the appearance around the cooled area of ​​the skin of a small-pointed itchy pink rash or blisters, while the skin directly affected by the cold is not affected.

• The signs fade within half an hour - an hour. However, with further "contacts with the cold" allergic manifestations are usually intensified.
• It happens that the disease is accompanied by urticaria eruptions that occur a few minutes after contact with the cold, but do not disappear on the skin for 7-10 days or longer.

The state of such prolonged retention of skin changes, as well as an abnormally slow manifestation of symptoms, warns of the development of other serious disorders in the body that require immediate diagnosis.

On how cold allergy looks in the severe current, we will tell below.

Severe

The severity of allergic and systemic manifestations in cold urticaria is related to the area of ​​cooling and the degree of exposure. A prolonged supercooling of the whole body can lead to severe disorders due to the sudden intake of a large amount of histamine released into the blood from a variety of mast cells.

With this development of cold urticaria, generalization of the process( spreading to the whole organism), there are more serious changes:

• blisters with their reddening grow, accompanied by a sharp itch and, merging with each other, form an extensive dense puffiness;
• in 5 out of 100 patients who have fallen ill after cold food or drink swell the tissues of the tongue, pharynx, which, in an unfavorable state, leads to asphyxia( more often - in children due to narrowness of the respiratory tract);
• appears marked weakness, nausea, pressing pain in the head;
• rises temperature to 38 - 39C;
• suddenly begin to hurt joints;
• nasal congestion, lacrimation, runny nose are observed.

With extreme sensitivity to cold, cooling a large surface of the skin can cause an anaphylactic reaction in which:

1. The patient suffers from vomiting, chills at high temperature.
2. Heart palpitations, the rhythm of breathing and contractions of the heart is disturbed.
3. There is bronchospasm, cough and shortness of breath.
4. There is a spasmodic pain in the abdomen, vomiting, diarrhea develops.
5. The patient complains of severe weakness, headache, nausea.
6. Decreases blood pressure, leading to dizziness and unconsciousness.

Genetically determined pathology of the

family. In most cases, the family cold syndrome is detected in infants by the main signs, developing for 1 to 3 hours after the action of cold:

1. Temperature rise. Itchy edematous rashes, red spots, blisters.
2. Articular pain.

These symptoms increase in the range of 6 to 8 hours, disappearing in about 20 to 24 hours. In addition, children during a cold allergic attack are often observed:

• itching, lacrimation and reddening of the mucous eyes;
• marked sweating, drowsiness, lethargy, complaints of children for headache;
• acute thirst, nausea.

And the attack provokes even a slight cooling of the body( for example, airing the room), and relapses often occur in the cold season. Specificity of family urticaria associated with the gene mutation is the delayed appearance of symptoms( in the interval from half an hour to 2 - 3 hours).

And the main diagnostic test with the application of ice cube provoking allergy to the skin is negative. More common common manifestations, including arthralgia( joint pain), a rash in the form of red spots with blisters, burning, temperature, chills. Because with this type of disease, the urticaria rash( similar to the nettle burn) sometimes appears 10 to 30 hours after the cold, doctors often make a false diagnosis of chronic idiopathic urticaria( i.e., with an unclear reason).

Atypical hereditary cold allergy

It appears from an early childhood with itching, erythema( redness) and swelling, a rash. Often with this condition, seizures, severe angioedema( pronounced, tight swelling of the tissues, often - swelling of the larynx), loss of consciousness. The atypical form differs in the absence of common typical symptoms of cold allergy: temperature, chills, joint pains, nausea, vomiting.

• The attack in 100% of cases will cause cold air, being in an environment with high humidity and wind, swimming in cool water( 93%), chilled drinks and products.
• Acute allergic reaction with severe current can provoke children's games on the street at low temperatures( football, hockey, sledges, bicycles, skis).In this case, physical activity in a warm room does not lead to an exacerbation of the disease, and the standard diagnostic test for the cold gives a negative result.

Diagnosis

The method for diagnosing cold allergy is simple enough. This is a provocative test, which consists in applying a cold object to the skin to see the reaction. The ice cube is put in a thin plastic bag to prevent contact of water and skin, as with a positive test result, you can confuse the cold form of urticaria with aquatic( allergic reaction to normal water).

The ice is placed on the forearm on the backside for 4 minutes and the skin reaction is evaluated after 10 to 15 minutes. Provocation is seen as positive if an obvious reddening appears on the area of ​​application of the ice cube, a blister accompanied by itching, swelling, tingling, or soreness.

• If the body is too susceptible to cold, the skin swells and turns red after half a minute.
• However, with atypical development of genetically determined urticaria or with delayed( delayed) reaction, when all the signs on the skin appear late - from half an hour to several hours after the sample, this method is not accurate. Therefore, to confirm the diagnosis, conduct a study of the patient's blood.
• If the cutaneous test on the ice does not give a positive reaction, but a person suffers from cold allergy, then the serum of the patient shows the presence of cold agglutinins( antibodies to cold), cryoglobulins, cryofibrinogen.

To distinguish the family cold autoimmune urticaria from the ideopathic, an analysis is carried out for ESR( erythrocyte sedimentation rate) and C-reactive protein. An increase in the level of these indicators is characteristic of the first form of the disease.

Today, other kinds of cold samples such as finding a patient for 10 to 20 minutes without clothes in a room with a temperature of 4C or immersion for 10 minutes of a forearm into cold water are not used because of the high risk of developing an acute attack of cold urticaria.

On how to treat and cure cold allergies( urticaria), we will tell below.

Treatment of

Therapeutic method

Theoretical and practical medicine proves that the majority of patients with high sensitivity to irritant allergens( in this disease - to cold) are promoted by chronically current pathologies - inflammatory, autoimmune, infectious, bile duct diseases, liver.

Therefore, in the treatment of cold urticaria, their active detection and treatment is provided. An obligatory basis for alleviating the symptoms of cold allergy is the maximum possible exclusion of exposure to cold, including any hypothermia of the body or individual organs( refusal to stay long outside during the frost and rainy season, long summer swimming, cold food and drink).

For ointments, creams and other remedies for cold allergies, read below.

Medication

Local treatment

Skin manifestations after the action of irritating cold tissues, such as pruritus, rash, erythema, swelling, pain - are well removed with special ointments, emulsions, creams.

• Use Radevit, Fenistil-gel, Protopik, Skin Cap, Psilo-balm, Elidel, Eplan, Psilo-balm, La Cree, Gistan( without the letter "H"), Advantan( if these agents do not themselves provoke an allergy).
• In severe painful itching, edema, Glucosteroid ointments are provided for: Bufexamak, Gistan N, Elokom, Cinaph-ointment, Acriderm GK, Hydrocortisone, Celestoderm.

Complex therapy

In order to relieve patients of cold allergic urticaria, a therapeutic tactic is used, which involves the complex use of several types of medicaments that solve different tasks. Assign the following medicines.

Antagonists of histamine H1 receptor

Fexofenadine 60 - 240 mg 2 times / day, Erius( desloratadine) 5 mg / day for patients from 12 years( if treatment effect is insignificant - take 20 mg).Children's daily doses of desloratadine in milligrams: 1.25 from 1 to 5 years and 2.5 from 6 to 11. Loratadin - adults only 10 mg.

• With acute attacks of intramuscularly administered Suprastin, Tavegil, Dimedrol, Pipolphen.
• For chronically occurring recurrences of , cold-related hives are used:
  • Ketotifen: Adults 0.001 g 2 times / day, children over 3 years are given 4 ml syrup, until 6 months - 2.5 ml twice daily( course 2 -5 months);
  • Ebastin: patients from 12 years of age receive 10 to 20 mg once, 6 to 11 to 5 mg;
  • Cyproheptadine: Adults take 4-8 mg( 3 to 4 times a day, respectively), children are given a 3-4 times divided daily dose, calculated taking into account the norm of 0.25-0.5 mg per 1 kg of body weight.

In addition to these antagonists, H1-receptors are prescribed: Cetrin, Cetirizine, Levocetirizine, Alersin, Kestin, Elerthu.

H2-receptor antagonists

Add if the patient does not respond to treatment with H1-receptor blockers.

• Cimetidine: adults 0.3 grams 3 to 4 times a day. Children from a year - in a daily dose, calculated on the basis of the norm of 25-30 mg / kg body weight, up to 12 months - the norm of 20 mg per 1 kg of the baby's weight), Ranitidine adult 150-300 mg per day, Famotidine 20 mg 2 r/day.
• A good therapeutic result gives a short course of antihistamines of the first generation with sedative( calming) action - Pipolphen, Tavegil, Suprastin, simultaneously with anti-allergic II-IV generations.

Glucocorticosteroids

Used in a short course in patients who do not respond to antiallergic treatment. And for a long time - in severe cases, as well as with a high probability of an anaphylactic reaction.

• Prednisolone 0.04-0.06 g / day or 0.02-0.04 g / day;
• Dexamethasone 0.004 - 0.020 g per day.

Elena Malysheva in this video will tell you whether cold urticaria is treated with folk remedies:

Additional medicines

• In addition, patients who do not respond positively to antihistamines are shown:
  • blocker of leukotriene receptors Montelukast - at 0.010 g / day;
  • calcium channel blocker Nifedipine - 0.020-0.060 g per day.
• If suspicion of cholinergic cold urticaria( poorly understood), in which acetylcholine is involved in addition to histamine in the inflammatory allergic process, appoint:
  • Combined agents with m-choline blockers: Bellaspon, Bellantaminal, Belloid( 1 dragee 3 r / day);
  • Cyproheptadine. Adults - 0,004 grams 3 - 4 r / day, children 2-6 years prescribed a daily dose of 0,006 g, which is divided into three doses, 6 - 14 years to 0,006 - 0,012 grams per day.
• With frequent relapses, exhausting the nervous system, accompanied by insomnia due to soreness and severe itching, antidepressants - Paxil, Paroxetine, Fluoxetine, Doxepin, tranquilizers-benzodiazepines are prescribed.
• For cold allergies associated with systemic diseases, a certain proportion of patients with "inaction" of traditional medicines use medications that are used in rheumatology, including Dapsone, Sulfasalazine, Colchicine, Hydroxychloroquine.

With common inflammatory-allergic manifestations, symptoms are eliminated by prescribing appropriate medications:

• chills, temperature-analgesics( Ibuprofen, Spazgan, Ketonal, Spazmalgon);
• nausea, vomiting - Cerucal( in tablets, injections);
• abdominal cramps - Decitel, Duspalitin, No-Shpa, Papaverin( injection), diarrhea - Loperamide, Smecta;
• bronchospasm - bronchodilators for respiration, Euphyllin with Dexamethasone( intravenously);
• if urticaria accompanies allergic rhinitis and conjunctivitis, when leaving for frost, drops are used: Acetastine, Parlazin, Allergodil, Fenistil.

Severe course of

Patients not sensitive to conventional therapy are shown:

1. Androgens.
2. Immunosuppressants: Ciclosporin, Omalizumab.
3. Antiviral interferon beta, giving in 85% of cases the complete disappearance of symptoms and cryoglobulins in the blood.
4. In the treatment of family cold auto-inflammatory syndrome, both non-hormonal anti-inflammatory drugs and high doses of corticosteroids( Dexamethasone, Prednisolone) are often prescribed during attacks. However, the interleukin-1 inhibitor Anakinra, which is administered every day in a dose calculated according to the formula 0.001 g per kg of patient weight, has a particularly high therapeutic effect.
5. Situations, upon cooling, a life-threatening state, similar to anaphylactic shock, requires immediate adrenaline administration to the patient.

On how to get rid of cold allergy hives with other methods, read below.

Other methods of

In severe and frequent relapses of cold allergies:

1. Procedures for extracorporeal cleansing of blood from cryoglobulins.
2. Autolymphocytotherapy.

It is considered as the safest technique, which consists in the subcutaneous injection of lymphocytes isolated from the blood of the patient himself. A total of 8 injections every other day, with the course continuing 3 - 4 weeks. With the help of autolymphocytotherapy, cold patients( of any age) are relieved of cold, which is contraindicated in other ways. And in 90% of cases this therapy heals patients with cold urticaria completely.

Prevention of the disease

General recommendations

Manifestations of this form of urticaria can be prevented if the patient avoids:

1. Subcooling in any form( cold humid air in combination with wind is especially dangerous).
2. Contact with ice, cold water and refrigerated products.
3. Before going out into the "wet" and frosty seasons:
   • puts on the face and lips a thin layer of greasy( in no case - moisturizing) cream, better - children's forms;
   • uses fatty lanolin lipstick;
   • wears thermal underwear with a high content of natural threads, uses warm balaclava, scarves-pipes, closes the face, hands - gloves and mittens made of natural materials to protect them from cold.

Hardening

For hardening with cold allergies, specialists can not come to a consensus, but all physicians agree that hypothermia is unacceptable. Extreme caution is necessary when trying to temper children, which even a little cooling can cause an acute attack with unpredictable consequences. Children under 3 years of all hardening procedures associated with cold - absolutely contraindicated.

In adults, with careful monitoring of symptoms, it is better to begin hardening from the face, hands and feet, at first simply by wiping them with water, the temperature of which is very slowly lowered. If the reaction does not cause concern, they go on to harden the face, arms and legs with water - with a smooth( within months) decrease in its temperature, being in constant readiness to immediately stop the procedure and having all the medical means to prevent an attack.

Complications of

All kinds of urticaria are dangerous for provocation of complications:

1. Penetration of harmful microbes deep into the skin in places of scratching with itching with its further infection.
2. Severe edema of organs, including the larynx, which threatens to block the airways and suffocate the patient( extreme danger to children).
3. Bronchial spasm by type of asthmatic reaction
4. Anaphylactic shock, within 2 to 5 minutes capable of causing death from cardiac arrest.

Therefore, if cold urticaria, in addition to itching and rash on the skin, causes coughing, wheezing and wheezing when breathing, dizziness, "gnats" in the eyes, vomiting, dizziness and loss of consciousness, and any other worrying symptoms -is subject to doubt.

Forecast of cold allergy

With proper treatment of urticaria, concomitant diseases and prevention, relapses are repeated less often, and for 3-7 years the disease can disappear without a trace.

But cold urticaria can become deadly with general cooling( with massive release of histamine).So, even after a harmless bath in cool water, a patient with a severe allergy to cold can die as a result of systemic damage( blood pressure drop, loss of consciousness, coma, suffocation).

More information about cold urticaria can be found in this video: