Cold urticaria - What we know and what we do not know. Martes 19 de enero

Cold urticaria - What we know and what we do not know


Authors

Natalya Maltseva  Elena Borzova  Daria Fomina  Mojca Bizjak  Dorothea Terhorst‐Molawi  Mitja Košnik Kanokvalai Kulthanan  Raisa Meshkova  Simon Francis Thomsen  Marcus Maurer


 Abstract

Cold urticaria (ColdU) is a common form of chronic inducible urticaria characterized by the development of wheals, angioedema or both in response to cold exposure. Recent research and guideline updates have advanced our understanding and management of ColdU. Today, its pathophysiology is thought to involve the cold‐induced formation of autoallergens and IgE to these autoallergens, which provoke a release of proinflammatory mediators from skin mast cells. The classification of ColdU includes typical and atypical subtypes. We know that cold‐induced wheals usually develop on rewarming and resolve within an hour and that anaphylaxis can occur. The diagnosis relies on the patient's history and cold stimulation testing. Additional diagnostic work‐up, including a search for underlying infections, should only be done if indicated by the patient's history. The management of ColdU includes cold avoidance, the regular use of nonsedating antihistamines and the off‐label use of omalizumab. However, many questions regarding ColdU remain unanswered. Here, we review what is known about ColdU, and we present important unanswered questions on the epidemiology, underlying pathomechanisms, clinical heterogeneity and treatment outcomes. Our aim is to guide future efforts that will close these knowledge gaps and advance the management of ColdU.

DOI https://onlinelibrary.wiley.com/doi/10.1111/all.14674

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