THE INCREASING interest in the auto-immune state has refocused the medical view on the patient who is sensitive to cold. This is the individual who reacts to his own tissue upon cooling. A drop in skin temperature, whether it be produced by a breeze, contact with a cool object, or entering an air-conditioned room, may be followed by erythema, pruritus, and even urticaria. Such cold urticaria, because of its obviousness, is a diagnostic hallmark of the cold hypersensitive state, but it is still only one of a galaxy (Table 1)1-4 of signs and symptoms which may occur. Such patients experience frightening dysphagia after ingesting ice water or chilled foods. Moreover, cold showers, a chilling rain, and the winter wind are particular hazards that they soon learn to avoid also. But as Horton, Brown, and Roth 1 pointed up 25 years ago, swimming in cold water poses the ultimate
Juhlin L, Shelley WB. Role of Mast Cell and Basophil in Cold Urticaria with Associated Systemic Reactions. JAMA. 1961;177(6):371–377. doi:10.1001/jama.1961.73040320001004
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