cold urticaria
Introduction
Introduction to cold urticaria Cold urticaria, also known as wind sputum, wind squad, is mostly acute onset. It is characterized by the sudden itching of the skin after encountering cold air, cold water or cold objects, and there will be whistles of varying sizes, which are not isolated. After scratching, the skin has obvious scratches, which are tidal red, and may recur after relapse. On the cold and windy days, it is most likely to happen. Cold urticaria is more common in young adults who are chilly and windy, and the incidence of women is significantly higher than that of men. It is characterized by the fact that it is cold when it is sent, and it is fast and fast, and it can happen quickly in a few minutes or even seconds. In a warm environment, the wind group quickly subsided. It disappears throughout the cold season and is difficult to heal for many years. The patient feels that the itching is unbearable, which often affects work and rest. basic knowledge The proportion of illness: 0.03% Susceptible people: no special people Mode of infection: non-infectious Complications: laryngeal edema
Cause
Cause of cold urticaria
Family inheritance: Maybe the patient's parents have such a disease and pass it on to the next generation.
Acquired the day after tomorrow: continuous day and night, low immunity caused by moderate fatigue, or decreased immunity caused by some diseases.
It is believed that the cold can cause a certain normal metabolite in the body to become an antigen, thereby causing the production of antibodies, and may also change the stereostructure of the skin protein due to cold factors and become an antigenic substance in which the antibody cannot recognize its own tissue protein.
The formation of the wheal is the result of the accumulation of IgM macromolecular globulin after the skin is cold.
The main mediators are histamine and kinin. The pathogenesis is an IgE-mediated immediate allergic reaction.
Prevention
Cold urticaria prevention
Identify the cause of the disease as much as possible and remove it. If you are careful to inhale pollen, animal dander, feathers, dust, castor powder, avoid contact with sensitizers, disable or fasten certain drugs or foods that are allergic to the body.
Complication
Cold urticaria complications Complications laryngeal edema
Symptom
Cold urticaria symptoms Common symptoms Winter skin itching wind group systemic allergy and fever... Fever with chills
Its clinical manifestations are mainly caused by itching and wheal in different parts exposed to cold conditions. Skin lesions can be limited to exposed areas in cold conditions or to areas exposed to cold objects. They can also be spread, involving the oral mucosa, and even manifest as headache, chills, diarrhea, and tachycardia.
1, familial cold urticaria: autosomal dominant inheritance. Rarely, the onset of illness soon after birth, sustainable life, pathogenesis and media are unclear, more common in women, symptoms can be reduced with age. Generally exposed to cold air or cold water 0.5 to 4 hours after the onset, the red rash that is not more than 2cm in diameter, non-genuine wheal, no itching has a burning sensation, often accompanied by chills, fever, headache and joint pain and white blood cells Higher systemic symptoms.
2, acquired cold urticaria: may be autoimmune allergic reactions, allergic to cold, mostly idiopathic, about 1/3 have a history of genetic allergy. Frequently from the onset of children, after the temperature drops suddenly, after exposure to cold wind, cold water or cold matter, wheal or plaque edema occurs at the exposed or contact site, which can disappear for 0.5h~4h, and may have hand numbness, lip numbness, Chest tightness, heart palpitations, abdominal pain, diarrhea, syncope, and even shock. If it occurs during swimming, it can cause cold shock or even drowning.
Examine
Cold urticaria examination
1, check
The ice test is positive, and the ice is placed on the skin for performance. After 2 minutes, a typical wheal can be induced at the site. You can also use the ice water dipping method test, you can immerse your arm in cold water of 5 ~ 10 ° C for 5min, if the wind and erythema are positive.
2, identification
In rare cases, cold urticaria can occur in globulinemia (myeloma, macroglobulinemia, leukemia, liver disease, systemic lupus erythematosus), paroxysmal cold hemoglobinuria (syphilis), cold Fibrinogenemia, cold solubilization, especially in patients with mononucleosis.
Diagnosis
Diagnosis and identification of cold urticaria
1. Collection of medical history: After contact with cold water or other cold-cold substances, pruritic edema and wheal may occur in the cold zone, and may disappear after about half an hour to one hour. It occurs mostly in exposed areas such as face and hands, and other parts can be affected in severe cases. Mouth, tongue, throat and other mucous membranes can also cause edema or even abdominal pain in case of cold food or cold drinks.
2, neutrophils increased, passive transfer test was negative.
